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HIV Testing, Counseling, and Prophylaxis After Sexual Assault

Lawrence O. Gostin, JD; Zita Lazzarini, JD, MPH; Diane Alexander; Allan M. Brandt, PhD; Kenneth H. Mayer, MD; Daniel C. Silverman, MD
JAMA. 1994;271(18):1436-1444. doi:10.1001/jama.1994.03510420068036.
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THE IMPACT of possible infection with the human immunodeficiency virus (HIV) in survivors of sexual assault1 has received little attention in the first decade of the acquired immunodeficiency syndrome (AIDS) epidemic. This may be due in part to society's conflicting attitudes and beliefs concerning sexually transmitted diseases (STDs), AIDS, and rape. The meaning of STDs historically has been shaped by powerful social and cultural constructions. These diseases often have been viewed as the result of socially unacceptable sexuality, a morally based failure of impulse control by individuals, and fair punishment for transgressing societal norms.2,3 Similar moralistic reasoning often underlies the conventional wisdom concerning rape and AIDS. Rape, a violent crime where sex is used as a weapon, has been seen as the result of inappropriate seductive behavior or a sudden change of heart on the part of the victim who initially had consented to a sexual encounter.4

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