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The system is fragmented, lacking cohesive links between one service provider and another in the overall service chain – from the police services, to the forensic unit to the courtroom. Many cases fall between the cracks and are lost or weakened as a result. Government departments responsible for state service providers are unable to collaborate effectively to tackle the problem at higher levels of influence. Survivors are unaware of the fact that they can complain about the system, and don’t know how to go about doing so if their rights are not being upheld. The way the system is set up gives the accused more rights and greater levels of representation in court than the victim of the crime. It is no wonder that conviction rates are low, the rate for Gauteng being 4%[8] and the Western Cape 7%. Rape is prevalent in the Western Cape and in South Africa, but, as already discussed, it is also under-reported. This is partly because communities have no faith in a system that lacks the capacity to address their needs and that allows rapists to go unpunished. The resulting culture of impunity can only drive the number of rape incidents upwards, thereby seriously denying women their right to live free from violence. Levels of violence Rape in South Africa has emerged as a crime of extreme violence. Commentators liken the types of rape they see in South Africa to those perpetrated during armed conflict, in terms of the degradation, ritual humiliation and the extent of injuries, such as mutilation, that are involved.[9] Further indicating the extremity of the violence that accompanies rape, researchers have found that twelve times more women are raped and then murdered in South Africa every year than in the United States. A recent national mortuary-based study concluded that in South Africa a woman is killed every six hours by an intimate partner, another record-setting statistic.[10] Studies at various sites have found multiple perpetrator involvement in 25% to 55% of rapes.[11] In 2011, 55% of the rape survivors counselled by Rape Crisis had been raped by more than one offender. Of these rapes, 25% had been perpetrated by known gangs. In multiple perpetrator rapes, the number of offenders ranged from 2 to 30 in respect of any one victim. Rape and HIV The horror of rape in South Africa is compounded by the fact that around 10% of South Africans are estimated to be HIV positive. The highest rates of infection are found among women below the age of 30,[12] who make up a large percentage of rape survivors,[13] with almost one in three estimated to be infected. Scholars have started to draw a link between these high levels of HIV infection and the prevalence of coerced sex within that group.[14] A study done in 2009 found that 19,6% of men who had committed rape were HIV-positive,[15] confirming that rape is a significant factor in the spread of HIV. Additionally, injuries to the vagina or anus often result from the violence used during rape, which further increases the victim’s likelihood of contracting HIV.[16] Another important factor to remember in terms of HIV and rape in South Africa is the high rate of multiple-offender rapes. In these rapes, there is a higher probability of at least one of the offenders being HIV positive. In addition, the victim is exposed to the virus to a greater degree if more than one offender is HIV positive, and the victim suffers greater damage to the vagina or anus because of repeated penetration.[17] Under the Criminal Law (Sexual Offences and Related Matters) Amendment Act (Act 32 of 2007), all HIV-negative rape survivors have the right to free PEP (post-exposure prophylaxis) to reduce the risk of HIV infection from the rape. In practice, however, there are various barriers that make it difficult or impossible for rape survivors to access PEP or to take the medication as prescribed. Some of these barriers include: inadequate knowledge and awareness of PEP among both health workers and patients[18] secondary trauma caused by prejudice among health care workers[19] the emotional and psychological effects of the trauma of rape[20] the stigma surrounding HIV and the resulting ostracism, abuse or violence that a rape survivor could potentially suffer after revealing a positive HIV status the emotional challenges of coming to terms with possible HIV infection on top of the trauma of rape pervasive gender inequality and the resultant powerlessness of women, to varying degrees, in South African communities. A lot of work therefore still needs to be done – in terms of service delivery in the health care system, changing attitudes in communities as well as empowering women – in order to find useful ways of supporting PEP compliance in rape survivors so that

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