In a country long sickened by the frighteningly high level of sexual violence, one of the greatest challenges facing South Africa is closing the gap between the rhetoric of gender equality and the reality on the ground.The prevalence of gender-based violence is reflected in stark statistics: between April 2004 and March 2005, 55,114 cases of rape were reported to the police. The number of actual cases was likely much higher, considering only an estimated one in nine women report cases of sexual assault, according to the Medical Research Council (MRC). The MRC also estimates that a woman is killed by her intimate partner every six hours.South Africa has been hailed for its progressive constitution, which enshrines gender equality, and the number of women in parliament has risen substantially since 1994, creating a formidable force for legislative change.Changing laws can be swift; changing the mindsets that often nullify these impressive gains is another issue altogether. A culture of violence, born of years of political struggle against apartheid, has been blamed for the grim statistics, but women's groups also point to the persistence of patriarchal attitudes that view women as inferior to men.Part of the problem appears to be that many South Africans still have difficulty in defining rape. A 2004 nationwide survey of boys and girls aged between 10 and 19 found that 58 percent did not view "forced sex with someone you know" as sexual violence; another 30 percent of all respondents agreed that "girls do not have a right to refuse sex with their boyfriend".Vusi (not his real name), who used to physically abuse his partners before he discovered he was HIV positive and began receiving counselling and education on gender issues, explained the phenomenon to PlusNews."If a woman says no, as a man, you think - especially if she's someone you've been in love with or somebody you've paid a lobola [dowry] for - you think she is sleeping with someone else and you'll force yourself on her. I didn't even think of it as rape. To me it was a right thing to do - because she's mine, I have to sleep with her. Now I know that "no" is no and I don't have to question it because if she doesn't feel like it, she doesn't feel like it."Experts have described South Africa's unacceptable levels of gender-based violence and its 5.5 million HIV infections as interlinked epidemics, with behaviour change the key to both.As in many other parts of the world, poverty and unequal power relations between men and women often shape the nature of sexual relationships. One in four women experience domestic violence in South Africa - how can they suggest using a condom, knowing the suspicion and anger this might provoke?Researchers in the northern province of Limpopo targeted poor women, providing them with microcredit and education on gender and HIV/AIDS. After two years of involvement in the intervention, their experience of physical and sexual violence was reduced by half, compared to a control group of women from villages that did not participate in the intervention. The women's levels of economic wellbeing also improved, they were more self-confident, had greater influence in household decisions, and were challenging traditional gender norms.Despite the alarming levels of rape, women are still not accessing drugs to prevent HIV infection after being raped. Phindile Madonsela, 35, and HIV positive, conducts awareness sessions in schools. She was raped when she was 17 years old by someone she knew, who threatened to kill her if she reported the rape. "I disclose my rape at schools when I do HIV and AIDS education. I tell them they must report rape; they mustn't be like me and just keep quiet. Now ... there's this thing of HIV and AIDS, so if they report it, at least they can get PEP [post-exposure prophylaxis]."PEP is a course of antiretroviral drugs that can reduce the risk of contracting the HI virus from an HIV-positive attacker by as much as 80 percent if it is started within 72 hours of exposure.The new sexual offences bill, expected to be passed in early 2007, mandates designated public health facilities to provide rape survivors with PEP, but does not mention other treatment or counselling services; it also makes access to PEP drugs dependent on the survivor laying criminal charges. Advocacy groups have described the proposed legislation as a step backwards.There are also concerns that some sexual assaults of women might be driven by prejudice against their sexual orientation. Funeka Soldaat, a lesbian activist from Khayelitsha, a township about 30km west of Cape Town, was gang-raped by four men, who told her they would make her "a real woman". She believes many similar cases are not being reported out of fear of secondary discrimination by officers of the law.