The Pattern of sexual assault in people presenting to a gynaecological unit of a tertiary hospital in South-West Nigeria

Context: Sexual assault is a crime of violence that incorporates unwanted sexual behaviour, such as sexual coercion, uninvited kissing, fondling, touching and ultimately, rape. Individuals prone to sexual abuse are usually the young, poor, and vulnerable members of society, who are often subject to other forms of social vices, such as domestic violence. Aims: To ascertain the pattern of sexual assault in people presenting to a large gynaecological unit of a tertiary referral centre, in Nigeria. Settings and Design: Methods and Material: The study is a descriptive cross-sectional study that was undertaken over a 2-year period from January 2011 to December 2012. Statistical analysis used: SPSS. Results: The prevalence of sexual assault in this study was 1.64%. The majority (90.3%) of victims were single. At least a third (n=35) had secondary education. 62.65% of the patients delayed presentation until after 24hours, (n=52). The commonest reason for delay in presentation was of fear or embarrassment in 51.80% (n=43). The commonest place of assault was at the assailant's home in 33.7% (n=28). Many cases of assault occurred at night. 63.65% of the victims wanted suspects to be prosecuted (n=53). 67.46% of the victims expressed the desire to take legal action (n=56). Only 51.80% of the respondents (n=43) were aware of a route of seeking re-dress. Conclusions: Victims of sexual assault delay their presentation to health facilities because of fear and embarrassment. A significant percentage of the victims do not know how to obtain medical help

Potential for false-positive HIV test results using rapid HIV testing algorithms

Background: In order to scale up access to HIV counselling and testing in Nigeria; an HIV diagnostic algorithm based on rapid testing was adopted. However; there was the need to further evaluate the testing strategy in order to better assess its performance; because of the potential for false positivity.Objectives: The objective of this study was to compare positive HIV test results obtained from the approved rapid testing algorithm with results from western blot tests performed on samples from the same patient.Methodology: A retrospective review was conducted of HIV screening and confirmatory results for patients seen between 2007 and 2008. Rapid test and western blot results were extracted and compared for concordance. Discordant results were further reviewed using a combination of HIV-1 RNA viral load and CD4+ cell count test results and clinical presentation from medical records. Results: Analysis of 2228 western blot results showed that 98.3% (n = 2191) were positive for HIV-1; 0.4% (n = 8) were positive for HIV-2 and 0.3% (n = 7) were dual infections (positive for both HIV-1 and HIV-2); 0.6% (n = 13) were indeterminate and 0.4% (n = 9) were negative. Further investigation of the 13 indeterminate results showed nine to be HIV-1 positive and four to be HIV-negative; for a total of 13 negative results. The positive predictive value of the HIV counselling and testing algorithm was 99.4%.Conclusion: Using the rapid testing algorithm alone; false positives were detected. Therefore; effective measures such as training and retraining of staff should be prioritised in order to minimise false-positive diagnoses and the associated potential for long-term psychological and financial impact on the patients