A kit, a clinic, a chance: For survivors of sexual violence in DRC, safety depends on dwindling supplies

Essential, confidential support

“Two men stopped me suddenly,” Neema says quietly. “I was scared and ran.” Her hands move restlessly over her skirt, and she does not look up as her words speed up. It is as though she wants to move through this part of the story as quickly as possible. “They caught me and then they raped me. They took me into the bush and pulled me away from the road.”

What she did next saved her life.

She learned from awareness-raising groups that survivors could find help at the local health center free of charge, and free of judgment.

“I heard they keep it confidential and support girls like me,” she says. “So, I immediately went there to seek help.”

At the clinic, staff welcomed her, listened, and provided a post-exposure prophylaxis (PEP) kit — medicine that can mean the difference between healing and lifelong trauma. The kit includes:

• A pregnancy test
• HIV prevention drugs (which are effective only within 72 hours of exposure)
• Antibiotics
• Emergency contraception

It is essential for survivors to begin their PEP treatment as soon as possible after they are assaulted. For maximum efficacy, HIV PEP should be initiated as soon as possible after exposure – ideally within two hours or less and certainly not later than 72 hours following possible HIV exposure. Data suggests that the earlier the treatment is commenced, the greater the likelihood of success.

Neema also received a dignity kit with soap, cloth, and other essentials.

“I felt relief, because I was in so much pain. Suddenly, I felt safe. I knew that I would not face the repercussions of social exclusion and stigma, as they treated what happened to me confidentially. A psychologist also talked to me and helped me understand what happened and how to cope with it.”

Growing dangers, dwindling resources

Across DRC, sexual violence has reached epidemic levels. In the first four months of 2025, more than 67,000 cases were reported, a 38% increase over the same period in 2024. The real number is likely far higher than reported, because survivors face pervasive negative stigma. Women may worry that reporting sexual violence could lead to reprisals by perpetrators, or that it could make them targets of further violence. Others fear being ostracized by their own families, friends, partners, and communities. All of this means that many women and girls never report their abuse.

In conflict zones, sexual violence is not a random side effect of war — it is a deliberate weapon. Armed groups use sexual violence to terrify communities, drive families from their land, and tear apart the fabric of society.

Amadou Bocoum, CARE DRC country director, noted that “the systematic use of rape as a weapon of war is not only a violation of human rights but a deliberate strategy to destabilize communities. The stories we hear daily are harrowing. Women and girls are subjected to unimaginable atrocities, their lives forever altered by violence and deprivation.”

For survivors like Neema, a PEP kit can mean the difference between recovery and dire consequences. Without access to healthcare, the risks are enormous: illness, social exclusion, lifelong stigma, and worse.

But conflict and violence have made accessing healthcare, which was already limited in rural and hard-to-reach areas, even more difficult. Active combat often makes roads impassable, adding to the danger already traumatized survivors must face as they try to reach clinics within the critical 72-hour window following an assault.

No survivor should be turned away. Yet ongoing funding cuts by the U.S. government have halted the distribution of PEP kits to 3.5 million people this year. By March, most stocks had already run dry. Only one in four health facilities in eastern DRC still has supplies, and nearly 40% of facilities have reported losing staff. Women often walk for hours or days to reach a clinic, only to be told there is nothing left for them.

This nightmare, coupled with the dire scarcity of the kits themselves, creates deadly barriers to prevention, exposing the survivors to sexually transmitted infections, HIV, and unwanted pregnancies resulting from rape and assault.

The path to safety

In just one week at the start of 2025, 500 cases of rape were reported in DRC, 150 of them children. According to UNOCHA, only 58% of documented survivors received appropriate medical care within the critical 72-hour time frame.

At Neema’s clinic, survivors arrive daily. On the day she returned for a follow-up, staff said that seven other women needed treatment that day. “Two have already arrived; five are on their way here,” a nurse told her. The clinic had just ten kits available for the entire month.

“The lack of access to PEP kits, which are vital for preventing HIV infection following rape and sexual assault, means survivors are left without vital support to prevent additional harm,” said Bocoum. “The shortage comes amid major funding cuts, limiting access to PEP kits for those who need them most.”

“The support I received here changed my life,” Neema says quietly as she looks around the clinic. “Without the project, my life would have been very different.”

Neema knows she cannot change what happened to her. But she also knows what saved her: a clinic with open doors, a healthcare worker with a PEP kit, and a system that did not fail.

What she wants now is simple: for every girl to have that same chance.

With the right support, that chance can become a promise, not an exception.

_{*Names have been changed to protect individuals.}