Seroprevalence and Risk Factors for Hepatitis B, HIV, and Syphilis Among Survivors of Sexual Violence in the Eastern Cape Province, South Africa

TL;DR

This study found that survivors of sexual violence in South Africa have high rates of HIV and syphilis, highlighting the need for better healthcare support.

Contribution

The study provides new data on infection rates and risk factors for HBV, HIV, and syphilis among sexual violence survivors in the Eastern Cape.

Findings

The overall seroprevalence rates for HBV, syphilis, and HIV were 0.7%, 4.9%, and 17.3%, respectively.

Age and race were significant predictors for HIV infection, while age and urban residence predicted syphilis.

Six individuals were co-infected with at least two of the studied infections.

Abstract

Understanding the prevalence of hepatitis B (HBV), human immunodeficiency virus (HIV), and syphilis among survivors of sexual violence in South Africa is crucial for guiding targeted healthcare interventions, despite the limited available data. This study aimed to investigate the prevalence of these infections and their associated risk factors in survivors from the Eastern Cape Province, South Africa. This retrospective cross-sectional study reviewed 1957 medical records of survivors of sexual violence who received care at two large healthcare facilities in the Eastern Cape Province of South Africa between January 2019 and December 2020. All survivors were screened for HBV, HIV, and syphilis infections. Logistic regression analysis was used to identify factors associated with HIV and syphilis infections. The overall seroprevalence rates for HBV, syphilis, and HIV were 0.7%, 4.9%, and 17.3%, respectively. Six individuals were co-infected with at least two of these infections. Predictors for HIV infection included age (age < 16: adjusted odds ratio [aOR] 0.05; 95% confidence interval [CI], 0.03–0.08 and ages 16–25: aOR 0.45; 95% CI, 0.34–0.59) and black race (aOR 4.78; 95% CI, 1.09–20.88). Predictors for syphilis infection were age (age < 16: aOR 0.05; 95% CI, 0.02–0.15 and ages 16–25: aOR 0.41; 95% CI, 0.25–0.66) and residing in an urban area (aOR 0.23; 95% CI, 0.10–0.50). Survivors of sexual violence are at increased risk of HBV, HIV, and syphilis. Urgent measures are needed to provide comprehensive screening, treatment, prevention, and education to address this critical public health issue.