Experiences of female survivors of sexual violence in eastern Democratic Republic of the Congo: a mixed-methods study

Using a mixed-methods approach, we surveyed a non-random sample of 255 women attending a referral hospital and two local non-governmental organizations to characterize their experiences of sexual and gender-based violence (SGBV). We then conducted focus groups of 48 women survivors of SGBV to elaborate on survey findings. Quantitative and qualitative data underwent thematic and statistical analysis respectively.Of the women surveyed, 193 (75.7%) experienced rape. Twenty-nine percent of raped women were rejected by their families and 6% by their communities. Thirteen percent of women had a child from rape. Widowhood, husband abandonment, gang rape, and having a child from rape were significant risk factors for social rejection. Mixed methods findings show rape survivors were seen as "contaminated" with HIV, contributing to their isolation and over 95% could not access prophylactic care in time. Receiving support from their husbands after rape was protective against survivors' feelings of shame and social isolation.Rape results not only in physical and psychological trauma, but can destroy family and community structures. Women face significant obstacles in seeking services after rape. Interventions offering long-term solutions for hyper-vulnerable women are vital, but lacking; reintegration programs on SGBV for women, men, and communities are also needed.More than a decade of fighting in eastern Democratic Republic of the Congo (DRC) has decimated the government and healthcare infrastructure in this region, creating some of the worst health and development indicators in the world. In an assessment of the health systems of 191 member countries, the World Health Organization (WHO) ranks DRC 188th [1], and Oxfam and WHO estimate between 37% [2] and 75% [3] of the population have no access to healthcare.In 1996, Laurent Kabila launched a revolution that unseated the 30-year rule of President Mobutu Sese Seko. At the same time, an influx of armed actors and refugees from