1. Janel Smith, MPH, RN Clinical Care for Sexual Assault Survivors Specialist International Rescue Committee

2.  Worldwide, an estimated 1 in 3 women will be physically or sexually abused, and 1 in 5 will experience rape or attempted rape in their lifetime.*  The risk of HIV among women who have experienced violence may be up to 3 times higher than among those who have not.*  Limited access to compassionate, competent, and confidential clinical care, essential to begin a survivor’s physical and emotional healing and prevent HIV.  Training health care providers to strengthen the clinical response to GBV and HIV has been prioritized by humanitarian actors globally.* *WHO, 2009 **UNHCR, 2011; USAID, 2010

5.  Goal: Evaluate impact of training on clinician compassion, competence, and confidential care  Design: Comparison at pre and 3 months post-training  Sample: 106 clinicians in 39 health facilities in refugee camp and post-conflict settings in DRC, Ethiopia, Kenya, and Jordan  Method: Mixed-methods: KAP surveys, in-depth interviews, health facility checklists, participatory mapping, medical record audits

6. Before we thought they would not understand…now we give them the information…the patient has the right to accept or refuse interventions. Doctor, Kenya Now I know it’s not my responsibility to find sexual assault…my work is not to judge but to give treatment according to the patient’s right. Nurse, Kenya

7. They don’t come with medical problems, they come for referral… a chance of resettlement. Nurse, Ethiopia We have the consultation to determine if it is true or false…to diagnose and guide treatment… I would ask her what she was doing, what is her occupation, if she sells sex or is married. Nurse, DRC

9. We’ve found that the nurses providing the care didn’t know PEP. She [the survivor] showed us what was provided and said she was told to take them but not told what it was. GBV Manager, Ethiopia

10. Maternity is too congested and lacks privacy …it attracts a lot of onlookers…so they perceive it as not a very safe place. There is now improvement in the facility, there is more privacy and confidentiality because now we are giving the services at one center. Nurse, Kenya

11.  Limited capacity of the health care response to GBV and HIV in humanitarian settings were identified including negative attitudes among health care providers, lack of follow-up, and limited resources  Multimedia CCSAS training demonstrated effective at improving health care provider respect for patient rights, HIV PEP treatment initiation, and coordination of services to protect patient confidentiality  Additional interventions should be implemented with training to ensure a quality comprehensive health care response to GBV and HIV including long term BCC interventions, multi- sectoral coordination, and supply chain management

12. Training materials in English and French: clinicalcare.rhrc.org Contact: Janel.smith@rescue.org