Adolescents worldwide often face tremendous sexual violence; a growing problem and a leading reproductive health concern. The prevalence of this violence ranges between 15 and 40% in sub-Saharan Africa, with studies showing rates of sexual coercion and abuse among female adolescents in Nigeria between 11 and 55% (1, 2). Little is known about the impact of rape on adolescents living with HIV (ALHIV), and how their HIV status affects how they cope with this traumatic experience. A recent survey in Nigeria showed 31.4 and 5.7% of sexually active adolescent females and males, respectively, reported forced sex (rape) at sexual initiation (3). The same study showed significantly more reported cases of rape among female ALHIV compared to their HIV-negative peers (p=0.008). Supporting literature from South Africa highlights rape as a risk factor for HIV in women (4). Achunike and Kitause provide vivid accounts of rape in Nigeria and its impact on victims, including physical injuries, fatigue and chronic headaches, and emotional problems, such as suicide attempts, stress disorders, depression, and sexual dysfunction (5, 6). Alcohol and drug abuse were also prominent for victims. In addition, adolescents and youths who have been sexually abused are more likely to have multiple concurrent sex partners, are less likely to report using contraception, and are more likely to report pregnancy (6).
Prior reports have shown that 4–6% of all adolescent girls in southwestern Nigeria experience rape (3, 7). The strict code of silence among victims implies the potential for under-reporting, especially when victim blaming is the norm. Less than one in five (18.1%) of 10,000 respondents who have been raped in Nigeria report the offence to the police (8). There are many reasons for this. Rape results in stigmatization of the victim, resulting in rejection by families and communities, and with police sometimes unwilling to make official reports. Due to this stigma, women and adolescents may be unwilling or unable to obtain a medical examination to substantiate their report of rape (8). High rates of rape and low reporting underscore the need for specific actions to address sexual violence and to stem the tide on potential risks of HIV transmission. A report by Sinclair et al. showed that building self-defense skills of girls in Kenya significantly reduced incidence of rape over a 10-month period (9). However, prior to planning and implementing a similar program in Nigeria, it is important that leadership recognizes there is a rape epidemic. HIV infection is just one of the multiple challenges rape victims face, but a strong reason for stakeholders engaged with HIV prevention programmes to incorporate rape prevention in current and proposed HIV prevention programmes for adolescents.
Olatunji conducted an extensive review of the Nigerian anti-rape law and identified shortcomings in the provisions which make rape prevention challenging (10). First, according to the law, rape can only be committed by a man to a woman, and it involves only penal and vaginal sex. The law does not acknowledge male rape victims nor does it recognize anal sex as part of rape. Second, a victim of rape needs to establish that penetration occurred, corroboration (or validation) of the crime needs to be established, and proof must be provided that consent was not given. The limitations with establishing consent make proving many of the few valid rape cases difficult (10). Overall, the low prospect of receiving legal judgment for rape stifles enthusiasm in seeking legal recourse.
The recent rape and abduction of 276 female adolescents in Nigeria have further stirred up discussions and media attention about rape of girls and women within the context of conflict in the country (Table 1). Unfortunately, there is still little public dialogue linking rape and HIV infection, even when rape is occurring among married couples. The general population, government, and lawmakers need to understand the epidemic proportions of the crime and its potential long-term impact on the health of victims. This will help facilitate more structured interventions for the prevention of HIV among female adolescents in Nigeria.
Table 1.
Short list of reported rape in Nigerian media
| Source | Month–year | Article topic |
|---|---|---|
| Independent Television & Radio | July 2013 | Increase in rape cases in Nigeria |
| Gist Ville | October 2013 | 18-year old girl commits suicide after gang rape in Bayelsa |
| Punch | February 2014 | Tackling the rape epidemic in Nigeria |
| HmmNaija.com | February 2014 | 12-year-old rape victim: I'm glad he had an accident after raping me |
| Vanguard | March 2014 | Obesere rape saga-case transferred to SCID |
| Nigerian Tribune | April 2014 | Over 80 rape cases recorded in Edo State in 7 months |
| Premium times | April 2014 | Checking high incidence of rape in Nigeria |
| Channels TV | April 2014 | Ondo Police Record 45 Rape Cases in 2013 |
| Scan News | April 2014 | ICC moves against rape in Nigeria |
| The Paradigm | May 2014 | Two Chibok girls raped and left to die In Sambisa Forest By Boko Haram |
| DailyPost | May 2014 | Gunmen invade Benue University, rape 20 female students |
| News 24 Nigeria | June 2014 | UN: Nigerian schoolgirls face rape danger |
| Naija Standard Newspaper | July 2014 | Policeman 32, rapes JSS 1 virgin girl |
Morenike O. Folayan
Institute of Public Health
Obafemi Awolowo University, Ile-Ife, Nigeria
Department of Child Dental Health
Obafemi Awolowo University, Ile-Ife, Nigeria
Morolake Odetoyinbo
Positive Action for Treatment Access, Lagos, Nigeria
Abigail Harrison
Department of Behavioral and Social Sciences
Brown University School of Public Health Providence, RI, USA
Brandon Brown
Department of Population Health & Disease Prevention
University of California, Irvine, CA, USA
Email: brandon.brown@uci.edu
Authors’ and contributions
Abigail Harrison was engaged with the literature search, review, and final edits of the manuscript. Morolake Odetoyinbo was engaged with the review and final edits of the manuscript. Morenike Folayan initiated the idea of the manuscript, engaged with the literature search, review, and final edits of the manuscript. Brandon Brown was engaged with the literature search, review, and final edits of the manuscript.
Conflict of interest and funding
We declare that we have no conflicts of interest.
References
- 1.Fatusi AO, Blum RB. Adolescent health in an international context: the challenge of sexual and reproductive Health in Sub-Saharan Africa. Adolesc Med State Art Rev. 2009;20:874–86. [PubMed] [Google Scholar]
- 2.Ajuwon AJ, Olaleye A, Faromoju B, Ladipo O. Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria. BMC Public Health. 2006;6:310. doi: 10.1186/1471-2458-6-310. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Positive Action for Treatment Access. Lagos Nigeria: Positive Action for Treatment Access; 2013. Sexual and reproductive health needs of adolescents living with HIV in Nigeria: report of a national survey in Nigeria. [Google Scholar]
- 4.Jewkes RK, Dunkle K, Nduna M, Shai N. Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study. Lancet. 2010;376:41–8. doi: 10.1016/S0140-6736(10)60548-X. [DOI] [PubMed] [Google Scholar]
- 5.Achunike HC, Kitause RH. Rape epidemic in Nigeria: cases, causes, consequences and responses to the pandemic. IMPACT Int J Res Appl Natl Soc Sci. 2014;2:31–44. [Google Scholar]
- 6.National Center for Post-Traumatic Stress Disorder. Sexual assault against females. Information on trauma and PTSD: veterans, general public & family. 2007 Available from: http://www.ptsd.va.gov/public/pages/sexual-assault-females.asp [cited 29 July 2014].
- 7.Fawole OI, Ajuwon AJ, Osungbade KO, Faweya OC. Prevalence of violence against young female hawkers in three cities in south-western Nigeria. Health Educ. 2002;102:230–8. [Google Scholar]
- 8.CLEEN Foundation. National crime victimization survey 2005 – overview of 2005 report, Power Point presentation of 12 June 2006. Available from: http://www.cleen.org [cited 29 July 2014].
- 9.Stanford University Medical Center. Reduced incidence of rape for Kenyan girls who received self-defense training. Medical News Today. MediLexicon. 2013. Available from: http://www.medicalnewstoday.com/releases/261927.php [cited 23 June 2013].
- 10.Olatunji OA. Penetration, corroboration and non-consent: examining the Nigerian law of Rape and addressing its shortcomings. Univ Ilorin Law J. 2012;8:79–105. [Google Scholar]