This guidebook intends to provide a basic framework, examples, resources, and contact information for health providers and managers who coordinate service provision for child victims of sexual violence and who ultimately work to ensure that children and adolescents receive the services they need. The resource is premised on the observation that such violence is a global human rights violation with severe immediate and long-term health and social consequences. It serves as a companion guide to the 2012 Clinical Management of Children and Adolescents Who Have Experienced Sexual Violence: Technical Considerations for PEPFAR Programs, which provides step-by-step guidance on the appropriate clinical/forensic care for children and adolescents who have experienced sexual violence and exploitation. The companion guide helps health providers and managers to better understand and facilitate linkages with critical social and community services for comprehensive care of children and adolescents who have experienced sexual violence and exploitation beyond the clinical exam, take additional steps to help children and adolescents receive information and support their needs, and contribute to changes in sociocultural norms that perpetuate a culture of violence and silence that can also increase HIV risk and vulnerability.
For example, the role of communication is an integrated, multisectoral response is highlighted in a box within the document that characterises children and adolescents with disabilities as among the most vulnerable, because they “are systematically denied basic information about sexual health and relationships, including sexual violence. They may be in isolated settings away from neighbors, extended family, or local community members who could play a role in identifying abuse. Staff at disability-specific organizations may lack training in recognizing ACEs [adverse childhood experiences], including sexual violence, and thus miss signs of abuse of their clients. Those services that do exist are likely not able to provide disability-specific services, due to physical barriers to access or lack of providers who are trained to work with children/adolescents with disabilities. Access to justice is routinely denied….(they are not considered credible witnesses, and/or their cases are not taken seriously, and/or the court system lacks appropriate services).”