Results: Similar to the parent study (n=248), the present sample of women (n=77) were 18-50, on average 27 years of age, single (88%), unemployed (75%) and low-income with few resources, but were more educated. T tests and chi-square tests were performed to compare physical health symptoms, symptoms of post-traumatic stress and depression, coping styles, rape myths and social undermining at baseline and 12-month follow-up. High levels of post-traumatic stress and moderate levels of depression, overall physical symptoms, and specific gynecological complaints were maintained over time. Women increased their use of several personal coping strategies, and a decrease in emotional support. They reported an increase in social undermining from family and friends and endorsed more rape myths over the study period.

Conclusion: Gynecologists and other health providers treating South African women need to assess histories of nonconsensual sexual experiences (rape) and mental health issues when patients present with physical symptoms that may have been trauma-induced and refer them for more care. Although their use of coping strategies increased, women’s mental and physical health symptoms persisted over time. Rape survivors may have required more targeted support to cope with mental and physical health symptoms. Gynecological care and behavioral interventions tailored to address the sociocultural context in which these experiences occur are needed to mitigate the negative-and persistent-health consequences of rape and to increase their gynecological health.

Keywords: Rape; South Africa; Women; Physical symptoms; Gynecological symptoms; Post- traumatic stress symptoms