Difference in the emergency care provided to women who have suffered sexual violence, according to skin color: a cross-sectional retrospective study

Abstract

Abstract Background: In Brazil, emergency healthcare for victims of sexual aggression should follow guidelines defining treatment, with notification by health centers being mandatory. Conversely, there is solid evidence that skin color or racial discrimination has led to significant social inequalities in health throughout the country. The objective of this study was to evaluate the quality of care provided to female victims of sexual aggression seen in public hospitals in the Federal District of Brasília, Brazil according to the victim’s self-reported skin color. Methods: This cross-sectional, retrospective study evaluated the care provided to female victims of sexual violence seen at a public hospital within the State Health Department network in the Federal District of Brasília. The data analyzed were retrieved from the Brazilian National Health Surveillance Agency database, which contains the compulsory notification records registered at all healthcare services in the country. The study included 2,256 females of 1-79 years of age who received care at one of these hospitals between January 1, 2012 and December 31, 2016 following sexual aggression. The four types of treatment recommended for women who suffer sexual violence were taken into consideration: prophylactic treatment against human immunodeficiency virus, sexually transmitted and hepatitis B infections, and emergency contraception. The independent variable was the victim’s ethnicity/skin color. Results: Overall, 50.4% of the women in the sample self-reported as being of mixed race or brown skinned, 37.4% as white and 12.2% as black. The percentage of white women who received any of the four components of emergency care following sexual violence was always higher than the percentage of brown- or black-skinned women receiving the same component. The differences between white and brown-skinned or black women were always much greater than the differences between brown-skinned and black women. Conclusions: The quality of emergency care provided following sexual aggression was poorer in the case of black or brown-skinned women compared to white women. The data from the present study may contribute towards improving the quality of the emergency care provided to all women and adolescents who suffer sexual violence irrespective of their skin color, thus eliminating the discrimination identified here.