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May 11, 1994, Vol 271, No. 18 >
ARTICLE | May 11, 1994

HIV Testing, Counseling, and Prophylaxis After Sexual Assault FREE

Lawrence O. Gostin, JD; Zita Lazzarini, JD, MPH; Diane Alexander; Allan M. Brandt, PhD; Kenneth H. Mayer, MD; Daniel C. Silverman, MD
[+] Author Affiliations

Reprint requests to Georgetown University Law Center, 600 New Jersey Ave NW, Washington, DC 20001 (Mr Gostin).

Health Law and Ethics section editors: Lawrence O. Gostin, JD, Georgetown/ Johns Hopkins Program on Law and Public Health, Washington, DC, and Baltimore, Md; Helene M. Cole, MD, Contributing Editor, JAMA.


JAMA. 1994;271(18):1436-1444. doi:10.1001/jama.1994.03510420068036
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References

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

REFERENCES

1 +
In this article, we use the more inclusive term sexual assault to describe assault of women, men, adolescents, and children involving vaginal, anal, or oral penetration.
2 +
Brandt AM. No Magic Bullet: A Social History of Venereal Disease in the United States Since 1880 . New York, NY: Oxford University Press; 1987;.
3 +
Fee E, Fox DM, eds. AIDS: The Burden of History . Berkeley: University of California Press; 1988;.
4 +
Brownmiller S. Against Our Will: Men, Women, and Rape . New York, NY: Paramount Publishing; 1975;.
5 +
Brandt AM.  Historical perspective.  In: Burns S, Dalton H, Miller JL, eds. AIDS Law Today: A Guide for the Public . New Haven, Conn: Yale University Press; 1993;: 46-53.
6 +
Jenny C, Hooton TM, Bowers A, et al.  Sexually transmitted diseases in victims of rape. N Engl J Med . 1990;;322:713-716.
7 +
Brandt AM, Cleary PD, Gostin LO.  Routine hospital testing for HIV: health policy implications.  In: Gostin L, ed. AIDS and the Health Care System . New Haven, Conn: Yale University Press; 1990;:125-142.
8 +
Gostin L.  Hospitals, health care professionals, and AIDS: the 'right to know' the health status of professionals and patients. Univ Maryland Law Rev . 1989;;48:12-54.
9 +
Gostin L.  The HI V-infected health care professional: public policy, discrimination, and patient safety. Arch Intern Med . 1991;;151:663-665.
10 +
Centers for Disease Control.  Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR Morb Mortal Wkly Rep . 1991;;40( (RR-8) ):1-9.
11 +
Centers for Disease Control.  Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other blood-borne pathogens in health-care settings. MMWR Morb Mortal Wkly Rep . 1988;;37: 377-382, 387-388.
12 +
Centers for Disease Control.  Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B virus to health-care and public-safety workers. MMWR Morb Mortal Wkly Rep . 1989;:38( (S-6) ):1-37.
13 +
Estrich S. Real Rape: How the Legal System Victimizes Women Who Say No . Cambridge, Mass: Harvard University Press; 1987;.
14 +
Contrary to common assumptions, 78%, more than three quarters of rapes, were committed by someone known to the survivor. This includes what is commonly referred to as "date rape."
15 +
National Victim Center, Crime Victims Research and Treatment Center.  National Women's Study, reported  in: Rape in America: A Report to the Nation . Arlington, Va: National Victim Center, Crime Victims Research and Treatment Center, Dept of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; April 23, 1992;.
16 +
National Committee for Prevention of Child Abuse. Current Trends in Child Abuse Reporting and Fatalities: The Results of the 1992 Annual Fifty State Survey . Chicago, Ill: National Committee for Prevention of Child Abuse; 1993;.
17 +
Zierler S, Feingold L, Laufer D, Velentgas P, Kantrowitz-Gordon I, Mayer K.  Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. Am J Public Health . 1991;;81:572-575.
18 +
Bureau of Justice Assistance. Testing Certain Offenders for Human Immunodeficiency Virus: Guidance for States on Section 1804 Requirements . Washington, DC: Office of Justice Programs, US Dept of Justice; April 1992;:1-7, i-iii.
19 +
Lipscomb GH, Muram D, Speck PM, Mercer BM.  Male victims of sexual assault. JAMA . 1992;;267:3064-3066.
20 +
Nacci P, Kane T. Sex and Sexual Aggression in Federal Prisons . Washington, DC: Federal Bureau of Prisons; 1982;.
21 +
Osterholm MT, MacDonald KL, Danila RN, Henry K.  Sexually transmitted diseases in victims of sexual assault. N Engl J Med . 1987;;316:1024.
22 +
Pappaioanou M, Dondero TJ, Peterson LR, et al.  The family of HIV seroprevalence surveys: objectives, methods, and uses of surveillance for HIV in the United States. Public Health Rep . 1990;;105:113-118.
23 +
Lewandowski C, Ognjan A, Rivers E, Pohlod D, Belian B, Saravolatz LD. HIV-1 and HTLV-1 seroprevalence in critically ill resuscitated emergency department patients. In: Program and abstracts of the Fifth International Conference on AIDS; June 4-9, 1989; Montreal, Quebec. Abstract ThAP9.
24 +
Kelen GD, DiGiovanna T, Bisson L, Kalainov D, Sivertson K, Quinn TC.  Human immunodeficiency virus infection in emergency department patients: epidemiology, clinical presentations, and risk to health care workers: the Johns Hopkins experience. JAMA . 1989;;262:516-522.
25 +
Kelen GD, Fritz S, Qaqish B, et al.  Unrecognized human immunodeficiency virus infection in emergency department patients. N Engl J Med . 1988;;318:1645-1650.
26 +
Hammett TM, Moini A. Update on AIDS in Prisons and Jails . Washington, DC: US Dept of Justice, Office of Justice Programs, National Institute of Justice; 1990;: 1-11. AIDS bulletin publication NCJ 124549.
27 +
Holmes KK, Johnson DW, Trostle HJ.  An estimate of the risk of men acquiring gonorrhea by sexual contact with infected females. Am J Epidemiol . 1970;;91:170-174.
28 +
Hooper RR, Reynolds GH, Jones OG, et al.  Cohort study of venereal disease, I: the risk of gonorrhea transmission from infected women to men. Am J Epidemiol . 1978;;108:136-144.
29 +
Centers for Disease Control. STD Fact Sheet . Atlanta, Ga: Centers for Disease Control and Prevention; 1979;. Publication CDC-79-8195.
30 +
Judson FN.  Epidemiology of sexually transmitted hepatitis B infections in heterosexuals: a review. Sex Transm Dis . 1981;;8( (suppl) ):336-343.
31 +
Peterman TA, Stoneburner RL, Allen JR, et al.  Risk of human immunodeficiency virus transmission from heterosexual adults with transfusion-associated infections. JAMA . 1988;;259:55-58.
32 +
Padian N.  Heterosexual transmission: infectivity and risks.  In: Alexander NJ, Gabelnick HL, Spieler JM, eds. Heterosexual Transmission of AIDS . New York, NY: Wiley-Liss; 1990;: 25-34.
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Steigbigel NH, Maude DW, Feiner CJ, et al. Heterosexual transmission of HIV infection. In: Program and abstracts of the fourth International Conference on AIDS; June 12-16, 1988; Stockholm, Sweden. Abstract 4057.
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Padian N, Greenblatt R, Glass S, Dull T. Clinical and immunological correlates of the heterosexual transmission of HIV. In: Program and abstracts of the 28th Interscience Conference on Antimicrobial Agents and Chemotherapy; October 23-26, 1988; Washington, DC. Abstract 344.
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DeGruttola V, Seage GR, Mayer KH, Horsburgh CR.  Infectiousness of HIV between male homosexual partners. J Clin Epidemiol . 1989;;42:849-856.
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Holmberg SD, Horsburgh CR Jr, Ward JW, Jaffe HW.  Biologic factors in sexual transmission of human immunodeficiency virus. J Infect Dis . 1989;;160:116-125.
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Padian N, Marwuis L, Francis DP, et al.  Male-to-female transmission of human immunodeficiency virus. JAMA . 1987;;258:788-790.
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Franzen C, Albert J, Biberfeld G, et al. Natural history of heterosexual HIV infection in a Swedish cohort. In: Program and abstracts of the Fourth International Conference on AIDS. June 12-16, 1988; Stockholm, Sweden. Abstract 4021.
39 +
Goedert JJ, Eyster ME, Biggar, Blattner WA.  Heterosexual transmission of human immunodeficiency virus: association with severe depletion of T-helper lymphocytes in men with hemophilia. AIDS Res Hum Retroviruses . 1988;;3:355-361.
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Eyster EE, Goedert JJ.  Apparent heterosexual transmission of HIV infection from an asymptomatic haemophiliac to his wife three or more years after seroconversion. AIDS . 1987;;1:131-134.
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Seage GR, Horsburgh CR, Hardy AM, et al.  Increased suppressor T cells in probable transmitters of HIV infection. Am J Public Health . 1989;;79:1638-1642.
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Holmberg SD, Horsburgh CR Jr, Ward JW, Jaffe HW.  Biologic factors in sexual transmission of human immunodeficiency virus. J Infect Dis . 1989;;160:116-125.
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Anderson DJ, O'Brien TR, Politch JA, et al.  Effects of disease state and zidovudine therapy on the detection of HIV-1 in Semen. JAMA . 1992;;267:2769-2774.
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Weber JN, McCreaner A, Berrie E, et al.  Factors affecting sero-positivity to human T cell lymphotropic virus type III (HTLV-III) or lymphadenopathy associated virus (LAV) and progression of disease in sexual partners of patients with AIDS. Genitourin Med . 1986;;62:177-180.
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DeGruttola V, Seage GR, Mayer KH, Horsburgh CR.  Infectiousness of HIV between male homosexual partners. J Clin Epidemiol . 1989;;42:849-856.
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Lifson AR, O'Malley PM, Hessol NA, et al.  HIV seroconversion in two homosexual men after receptive oral intercourse with ejaculation: implications for counseling concerning safe sexual practices. Am J Public Health . 1990;;80:1509-1510.
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Burgess AW, Holmstrom LL.  Rape trauma syndrome. Am J Psychiatry . 1974;; 131:981-986.
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American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987;.
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Silverman DC.  Male co-survivors: the shared trauma of rape.  In: Mezey GC, King MB, eds. Male Sexual Assault . New York, NY: Oxford University Press; 1992;:87-103.
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Silverman DC.  Sharing the crisis of rape: counseling the mates and families of victims. Am J Orthopsychiatry . 1978;;48:166-173.
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Holmstrom LL, Burgess AW.  Rape: the husband's and boyfriend's initial reactions. Fam Coordinator . 1979;;28:321-330.
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White PN, Rollins JC.  Rape: a family crisis. Fam Relations . 1981;;30:103-109.
57 +
Only estimates of the number of victim service providers are available since these programs are not required to be licensed or registered in any uniform national way. The National Victim Center, Arlington, Va, uses 8400 as the estimate of the number of victim service programs based on their own organizational database (6500), the printed program directory of the National Organization for Victim Assistance (approximately 8000), and estimates of the number of additional community-based organizations providing victim services that have not identified themselves to either national organization.
58 +
Counseling of children and adolescents after sexual assault is an important and complex area in which providers must balance the importance of providing information with the constraints posed by the special psychological and developmental needs and the special legal position of minors. A full discussion is outside the scope of this article.
59 +
American Academy of Pediatrics Committee on Adolescence.  Rape and the adolescent. Pediatrics . 1988;;81:595-597.
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Gellert GA, Durfee MJ.  HIV infection and child abuse. N Engl J Med . 1989;;361: 685.
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Gaines H, von Sydow M, Sonnerborg A, et al.  Antibody response in primary human immunodeficiency virus infection. Lancet . 1987;;1:1249-1253.
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Horsburgh Jr CR, Ou C-Y, Jason J, et al.  Duration of human immuno-deficiency virus infection before detectable antibody. Lancet . 1989;;2:637-639.
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New York Criminal Procedure Laws, Article 60.42. New York Consolidated Laws Service, Lawyers Cooperative Publishing; 1994:1-5.
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Cal Penal Code §§261, 262 (Deering 1993)
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La Rev Stat §§14:41, 14:43 (West 1992)
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Tex Crim Proc Code Ann §22.011 (1994).
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Greene v Aberle, 150 Misc2d 306, 568 NYS2d 300 (1991).
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Pennsylvania v Ritchie, 480 US 39 (1987).
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Sherman R.  When can therapists testify? National Law J . (September 13) , 1993;; 16:2, 33.
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Commonwealth v Bishop, 416 Mass 169 (1993).
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Commonwealth v Stockhammer, 409 Mass 867 (1991).
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Commonwealth v Figueroa, 413 Mass 193 (1992).
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Sherman R.  Rape victims' records vulnerable. National Law J . (January 4) , 1993;; 15:1, 28.
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Gerberding JL, Henderson DK.  Management of occupational exposures to blood-borne pathogens: hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Clin Infect Dis . 1992;;14:1179-1185.
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Shih CC, Kaneshima H, Rabin L, et al.  Postexposure prophylaxis with zidovudine suppresses human immunodeficiency virus type 1 infection in SCID-hu mice in a time-dependent manner. J Infect Dis . 1991;;163:625-627.
77 +
McCune JM, Namikawa R, Shih CC, et al.  Suppression of HIV infection in AZT-treated SCID-hu mice. Science . 1991;;247:564-566.
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Lafon SW, Mooney BD, McCullen JP, et al. A double-blind, placebo-controlled study of the safety and efficacy of Retrovir (zidovudine) as a chemoprophylactic agent in health care workers exposed to HIV. In: Program and abstracts of the 30th Interscience Conference on Antimicrobial Agents and Chemotherapy; October 21-24, 1990; Washington, DC. Abstract 489.
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Henderson DJ.  Postexposure chemoprophylaxis for occupational exposure to human immunodeficiency virus type 1: current status and prospects for the future. Am J Med . 1991;;91( (suppl 3B) ):312S-319S.
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National Institute of Health, National Institute of Allergy and Infectious Diseases, AIDS Clinical Trial Group (ACTG 076). Clinical Alert: Important Information on the Benefit of Zidovudine (AZT) for the Prevention of the Transmission of HIV From Mother to Infant . Bethesda, Md: Office of Communications, National Institutes of Health; February 21, 1994;.
81 +
Fazely F, Haseltine WA, Rodger RF, Ruprecht RM.  Postexposure chemo-phrophylaxis with ZDV or ZDV combined with interferon-alpha: failure after inoculating rhesus monkeys with a high dose of SIV. J Acquir Immune Defic Syndr . 1991;;4:1093-1097.
82 +
It is also unknown whether topically applied viricidal medications would prevent transmission or whether vaginal douching might be beneficial.
83 +
Ala Code §22-11A-17 (1993) (STDs, all correctional facility inmates)
84 +
Ariz Rev Stat Ann §31-281 (1993) (DNA)
85 +
Cal Penal Code §290.2 (Deering 1993) (DNA)
86 +
Colo Rev Stat 17-2-2-1 (1993) (DNA)
87 +
Fla Stat Ch 943.325 (1993) (DNA)
88 +
Ga Code Ann §24-4-60 (Michie 1993) (DNA)
89 +
La Rev Stat Ann §15:535 (West 1992) (DNA and STDs)
90 +
Mont Code Ann §46-18-256(1993) (HIV and other STDs)
91 +
Nev Rev Stat Ann §441A.320 (Michie 1993)
92 +
NM Stat Ann §24-1-9.1 (Michie 1993)
93 +
NC Gen Stat §15A-615 (1993) (STDs)
94 +
ND Cent Code §23-07.7-01 (1993) (STDs)
95 +
Tex Crim Proc Code Ann §21.31 (1994)
96 +
Wis Laws 32 (1993), amending, Wis Stat §968.38 (1991-1992).
97 +
Federal Bureau of Investigation. Crime in the United States, 1991 . Washington, DC: Federal Bureau of Investigation; August 30, 1992;.
98 +
Bureau of Justice Statistics.  Felony sentences in state courts 1990. Bureau Justice Stat Bull . (March) 1993;.
99 +
42 USCA §3756(f) (West Supp 1993), Crime Control Act of 1990, Title XVIII: Correctional Options Incentives Amendments, §1804.
100 +
Bills entitled the Sexual Assault Prevention Act of 1993 and the Crime Control Act of 1993 were introduced in the Senate on January 21,1993. (Compulsory testing at the time of pretrial release unless the judicial officer determines that the conduct of the person created no risk of HIV transmission.)
101 +
Results based on a state-by-state survey of HIV-testing provisions applicable to cases of sexual assault, compiled by AIDS Policy Center Intergovernmental Health Project, George Washington University, and D. T. Nelson, legislative analyst, National Victim Center; 1993.
102 +
Centers for Disease Control and Prevention.  Recommendations for HIV testing services for inpatients and outpatients in acute-care hospital settings and technical guidance on HIV counseling. MMWR Morb Mortal Wkly Rep . 1993;;42( (RR-2) ):1-17.
103 +
World Health Organization, Global Programme on AIDS. Statement From the Consultation on Testing and Counseling for HIV Infection . Geneva, Switzerland: World Health Organization; November 16-18, 1992;. WHO/GPA/INF/93.2.
104 +
Bayer R, Levine C, Wolf SM.  HIV antibody screening: an ethical framework for evaluating proposed programs. JAMA . 1986;;256:1768-1774.
105 +
Centers for Disease Control.  Public Health Service guidelines for counseling and antibody testing to prevent HIV infection and AIDS. MMWR Morb Mortal Wkly Rep . 1987;;36:509-515.
106 +
Cal Penal Code, §1524.1, (a)-(k) (Deering 1993).
107 +
Morgan M.  The problems of testing for HIV in the criminal courts. Judges J . 1990;;29:22-69.
108 +
Graham NH, Zeger SL, Park LP, et al.  The effects on survival of early treatment of human immunodeficiency virus infection. N Engl J Med . 1992;;326:1037-1042.
109 +
Fischl MA, Richman DD, Causey DM, et al.  Prolonged zidovudine therapy in patients with AIDS and advanced AIDS-related complex. JAMA . 1989;;262:2405-2410.
110 +
Centers for Disease Control.  Guidelines for prophylaxis against Pneumocystis pneumonia for persons infected with HIV. MMWR Morb Mortal Wkly Rep . 1989;;38 ( (S-5) ):1-9.
111 +
Aboulker J-P, Swart AM.  Preliminary analysis of the Concorde trial. Lancet . 1993;;341:889-890.
112 +
Estreich S, Forster GE.  Sexually transmitted diseases and rape. N Engl J Med . 1990;;323:1141-1142.
113 +
Gostin LO.  The AIDS Litigation Project: a national review of court and human rights commission decisions, I: the social impact of AIDS. JAMA . 1990;;263:1961-1970.
114 +
A plaintiff might also seek civil damages based on a defendant's failure to disclose HIV status, even where the plaintiff does not, or cannot, show lack of consent.
115 +
Schmerber v California, 384 US 757 (1966).
116 +
Mincey v Arizona, 437 US 385 (1978).
117 +
People v Thomas, 529 NYS2d 429 (1988).
118 +
Jackson MH.  The criminalization of HIV.  In: Hunter ND, Rubenstein WB, eds. AIDS Agenda: Emerging Issues in Civil Rights . New York, NY: The New Press; 1992;:239-270.
119 +
National Treasury Employees Union v Von Raab, 489 US 656 (1989).
120 +
Skinner v Railway Labor Executives' Association, 489 US 602 (1989).
121 +
Griffin v Wisconsin, 483 US 868, 873 (1987)
122 +
New Jersey v TLO, 469 US 325, 351 (1985).
123 +
People v Adams, 597 NE2d 574 (Ill 1992).
124 +
People v Cook, 532 NYS2d 940 (AD3 1988), appeal denied, 536 NYS2d 746 (November 4, 1988).
125 +
Johnetta J. v Municipal Court, 218 CalApp3d 1255 (1990).
126 +
Government of the Virgin Islands v Roberts, 756 FSupp 898 (DVI 1991).
127 +
Glover v Eastern Neb Corn Office of Retardation, 867 F2d 461 (8th Cir 1989).
128 +
Barlow v Ground, 943 F2d 1132 (9th Cir 1991).
129 +
Eisenstat S.  An analysis of the rationality of mandatory testing for the HIV antibody: balancing the governmental public health interests with the individual's privacy interest. Univ Pittsburgh Law Rev . 1991;;52:327-382.
130 +
Simotas L.  In search of a balance: AIDS, rape, and the special needs doctrine. New York Univ Law Rev . 1991;;66:1881-1927.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
In this article, we use the more inclusive term sexual assault to describe assault of women, men, adolescents, and children involving vaginal, anal, or oral penetration.
2 +
Brandt AM. No Magic Bullet: A Social History of Venereal Disease in the United States Since 1880 . New York, NY: Oxford University Press; 1987;.
3 +
Fee E, Fox DM, eds. AIDS: The Burden of History . Berkeley: University of California Press; 1988;.
4 +
Brownmiller S. Against Our Will: Men, Women, and Rape . New York, NY: Paramount Publishing; 1975;.
5 +
Brandt AM.  Historical perspective.  In: Burns S, Dalton H, Miller JL, eds. AIDS Law Today: A Guide for the Public . New Haven, Conn: Yale University Press; 1993;: 46-53.
6 +
Jenny C, Hooton TM, Bowers A, et al.  Sexually transmitted diseases in victims of rape. N Engl J Med . 1990;;322:713-716.
7 +
Brandt AM, Cleary PD, Gostin LO.  Routine hospital testing for HIV: health policy implications.  In: Gostin L, ed. AIDS and the Health Care System . New Haven, Conn: Yale University Press; 1990;:125-142.
8 +
Gostin L.  Hospitals, health care professionals, and AIDS: the 'right to know' the health status of professionals and patients. Univ Maryland Law Rev . 1989;;48:12-54.
9 +
Gostin L.  The HI V-infected health care professional: public policy, discrimination, and patient safety. Arch Intern Med . 1991;;151:663-665.
10 +
Centers for Disease Control.  Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR Morb Mortal Wkly Rep . 1991;;40( (RR-8) ):1-9.
11 +
Centers for Disease Control.  Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other blood-borne pathogens in health-care settings. MMWR Morb Mortal Wkly Rep . 1988;;37: 377-382, 387-388.
12 +
Centers for Disease Control.  Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B virus to health-care and public-safety workers. MMWR Morb Mortal Wkly Rep . 1989;:38( (S-6) ):1-37.
13 +
Estrich S. Real Rape: How the Legal System Victimizes Women Who Say No . Cambridge, Mass: Harvard University Press; 1987;.
14 +
Contrary to common assumptions, 78%, more than three quarters of rapes, were committed by someone known to the survivor. This includes what is commonly referred to as "date rape."
15 +
National Victim Center, Crime Victims Research and Treatment Center.  National Women's Study, reported  in: Rape in America: A Report to the Nation . Arlington, Va: National Victim Center, Crime Victims Research and Treatment Center, Dept of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; April 23, 1992;.
16 +
National Committee for Prevention of Child Abuse. Current Trends in Child Abuse Reporting and Fatalities: The Results of the 1992 Annual Fifty State Survey . Chicago, Ill: National Committee for Prevention of Child Abuse; 1993;.
17 +
Zierler S, Feingold L, Laufer D, Velentgas P, Kantrowitz-Gordon I, Mayer K.  Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. Am J Public Health . 1991;;81:572-575.
18 +
Bureau of Justice Assistance. Testing Certain Offenders for Human Immunodeficiency Virus: Guidance for States on Section 1804 Requirements . Washington, DC: Office of Justice Programs, US Dept of Justice; April 1992;:1-7, i-iii.
19 +
Lipscomb GH, Muram D, Speck PM, Mercer BM.  Male victims of sexual assault. JAMA . 1992;;267:3064-3066.
20 +
Nacci P, Kane T. Sex and Sexual Aggression in Federal Prisons . Washington, DC: Federal Bureau of Prisons; 1982;.
21 +
Osterholm MT, MacDonald KL, Danila RN, Henry K.  Sexually transmitted diseases in victims of sexual assault. N Engl J Med . 1987;;316:1024.
22 +
Pappaioanou M, Dondero TJ, Peterson LR, et al.  The family of HIV seroprevalence surveys: objectives, methods, and uses of surveillance for HIV in the United States. Public Health Rep . 1990;;105:113-118.
23 +
Lewandowski C, Ognjan A, Rivers E, Pohlod D, Belian B, Saravolatz LD. HIV-1 and HTLV-1 seroprevalence in critically ill resuscitated emergency department patients. In: Program and abstracts of the Fifth International Conference on AIDS; June 4-9, 1989; Montreal, Quebec. Abstract ThAP9.
24 +
Kelen GD, DiGiovanna T, Bisson L, Kalainov D, Sivertson K, Quinn TC.  Human immunodeficiency virus infection in emergency department patients: epidemiology, clinical presentations, and risk to health care workers: the Johns Hopkins experience. JAMA . 1989;;262:516-522.
25 +
Kelen GD, Fritz S, Qaqish B, et al.  Unrecognized human immunodeficiency virus infection in emergency department patients. N Engl J Med . 1988;;318:1645-1650.
26 +
Hammett TM, Moini A. Update on AIDS in Prisons and Jails . Washington, DC: US Dept of Justice, Office of Justice Programs, National Institute of Justice; 1990;: 1-11. AIDS bulletin publication NCJ 124549.
27 +
Holmes KK, Johnson DW, Trostle HJ.  An estimate of the risk of men acquiring gonorrhea by sexual contact with infected females. Am J Epidemiol . 1970;;91:170-174.
28 +
Hooper RR, Reynolds GH, Jones OG, et al.  Cohort study of venereal disease, I: the risk of gonorrhea transmission from infected women to men. Am J Epidemiol . 1978;;108:136-144.
29 +
Centers for Disease Control. STD Fact Sheet . Atlanta, Ga: Centers for Disease Control and Prevention; 1979;. Publication CDC-79-8195.
30 +
Judson FN.  Epidemiology of sexually transmitted hepatitis B infections in heterosexuals: a review. Sex Transm Dis . 1981;;8( (suppl) ):336-343.
31 +
Peterman TA, Stoneburner RL, Allen JR, et al.  Risk of human immunodeficiency virus transmission from heterosexual adults with transfusion-associated infections. JAMA . 1988;;259:55-58.
32 +
Padian N.  Heterosexual transmission: infectivity and risks.  In: Alexander NJ, Gabelnick HL, Spieler JM, eds. Heterosexual Transmission of AIDS . New York, NY: Wiley-Liss; 1990;: 25-34.
33 +
Steigbigel NH, Maude DW, Feiner CJ, et al. Heterosexual transmission of HIV infection. In: Program and abstracts of the fourth International Conference on AIDS; June 12-16, 1988; Stockholm, Sweden. Abstract 4057.
34 +
Padian N, Greenblatt R, Glass S, Dull T. Clinical and immunological correlates of the heterosexual transmission of HIV. In: Program and abstracts of the 28th Interscience Conference on Antimicrobial Agents and Chemotherapy; October 23-26, 1988; Washington, DC. Abstract 344.
35 +
DeGruttola V, Seage GR, Mayer KH, Horsburgh CR.  Infectiousness of HIV between male homosexual partners. J Clin Epidemiol . 1989;;42:849-856.
36 +
Holmberg SD, Horsburgh CR Jr, Ward JW, Jaffe HW.  Biologic factors in sexual transmission of human immunodeficiency virus. J Infect Dis . 1989;;160:116-125.
37 +
Padian N, Marwuis L, Francis DP, et al.  Male-to-female transmission of human immunodeficiency virus. JAMA . 1987;;258:788-790.
38 +
Franzen C, Albert J, Biberfeld G, et al. Natural history of heterosexual HIV infection in a Swedish cohort. In: Program and abstracts of the Fourth International Conference on AIDS. June 12-16, 1988; Stockholm, Sweden. Abstract 4021.
39 +
Goedert JJ, Eyster ME, Biggar, Blattner WA.  Heterosexual transmission of human immunodeficiency virus: association with severe depletion of T-helper lymphocytes in men with hemophilia. AIDS Res Hum Retroviruses . 1988;;3:355-361.
40 +
Eyster EE, Goedert JJ.  Apparent heterosexual transmission of HIV infection from an asymptomatic haemophiliac to his wife three or more years after seroconversion. AIDS . 1987;;1:131-134.
41 +
Seage GR, Horsburgh CR, Hardy AM, et al.  Increased suppressor T cells in probable transmitters of HIV infection. Am J Public Health . 1989;;79:1638-1642.
42 +
Holmberg SD, Horsburgh CR Jr, Ward JW, Jaffe HW.  Biologic factors in sexual transmission of human immunodeficiency virus. J Infect Dis . 1989;;160:116-125.
43 +
Anderson DJ, O'Brien TR, Politch JA, et al.  Effects of disease state and zidovudine therapy on the detection of HIV-1 in Semen. JAMA . 1992;;267:2769-2774.
44 +
Kreiss JK, Koech D, Pulmmer FA, et al.  AIDS virus infection in Nairobi prostitutes: spread of the epidemic of East Africa. N Engl J Med . 1986;;314:414-418.
45 +
Cameron DW, D'Costa LJ, Ndinya-Achola JO, Piot P, Plummer FA. Incidence and risk factors for female to male transmission of HIV. In: Program and abstracts of the Fourth International Conference on AIDS. June 12-16, 1988; Stockholm, Sweden. Abstract 4061.
46 +
Weber JN, McCreaner A, Berrie E, et al.  Factors affecting sero-positivity to human T cell lymphotropic virus type III (HTLV-III) or lymphadenopathy associated virus (LAV) and progression of disease in sexual partners of patients with AIDS. Genitourin Med . 1986;;62:177-180.
47 +
DeGruttola V, Seage GR, Mayer KH, Horsburgh CR.  Infectiousness of HIV between male homosexual partners. J Clin Epidemiol . 1989;;42:849-856.
48 +
Lifson AR, O'Malley PM, Hessol NA, et al.  HIV seroconversion in two homosexual men after receptive oral intercourse with ejaculation: implications for counseling concerning safe sexual practices. Am J Public Health . 1990;;80:1509-1510.
49 +
Kilpatrick DG, Veronen LJ, Saunders BE, Amick-McMullen A, Paduhovich J. The Psychological Impact of Crime: A Study of Randomly Surveyed Crime Victims . Washington, DC: National Institute of Justice; March 1987;. Final report, grant 84-IJ-CX-0039.
50 +
Rothbaum BO, Foa EB, Murdock T, Riggs DS, Walsh W.  A prospective examination of post-traumatic stress disorder in rape victims. J Trauma Stress . 1992;;5: 455-475.
51 +
Burgess AW, Holmstrom LL.  Rape trauma syndrome. Am J Psychiatry . 1974;; 131:981-986.
52 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987;.
53 +
Silverman DC.  Male co-survivors: the shared trauma of rape.  In: Mezey GC, King MB, eds. Male Sexual Assault . New York, NY: Oxford University Press; 1992;:87-103.
54 +
Silverman DC.  Sharing the crisis of rape: counseling the mates and families of victims. Am J Orthopsychiatry . 1978;;48:166-173.
55 +
Holmstrom LL, Burgess AW.  Rape: the husband's and boyfriend's initial reactions. Fam Coordinator . 1979;;28:321-330.
56 +
White PN, Rollins JC.  Rape: a family crisis. Fam Relations . 1981;;30:103-109.
57 +
Only estimates of the number of victim service providers are available since these programs are not required to be licensed or registered in any uniform national way. The National Victim Center, Arlington, Va, uses 8400 as the estimate of the number of victim service programs based on their own organizational database (6500), the printed program directory of the National Organization for Victim Assistance (approximately 8000), and estimates of the number of additional community-based organizations providing victim services that have not identified themselves to either national organization.
58 +
Counseling of children and adolescents after sexual assault is an important and complex area in which providers must balance the importance of providing information with the constraints posed by the special psychological and developmental needs and the special legal position of minors. A full discussion is outside the scope of this article.
59 +
American Academy of Pediatrics Committee on Adolescence.  Rape and the adolescent. Pediatrics . 1988;;81:595-597.
60 +
Gellert GA, Durfee MJ.  HIV infection and child abuse. N Engl J Med . 1989;;361: 685.
61 +
Gellert GA, Mascola L.  Rape and AIDS. Pediatrics . 1989;;83( (suppl) ):644.
62 +
Gaines H, von Sydow M, Sonnerborg A, et al.  Antibody response in primary human immunodeficiency virus infection. Lancet . 1987;;1:1249-1253.
63 +
Horsburgh Jr CR, Ou C-Y, Jason J, et al.  Duration of human immuno-deficiency virus infection before detectable antibody. Lancet . 1989;;2:637-639.
64 +
New York Criminal Procedure Laws, Article 60.42. New York Consolidated Laws Service, Lawyers Cooperative Publishing; 1994:1-5.
65 +
Cal Penal Code §§261, 262 (Deering 1993)
66 +
La Rev Stat §§14:41, 14:43 (West 1992)
67 +
Tex Crim Proc Code Ann §22.011 (1994).
68 +
Greene v Aberle, 150 Misc2d 306, 568 NYS2d 300 (1991).
69 +
Pennsylvania v Ritchie, 480 US 39 (1987).
70 +
Sherman R.  When can therapists testify? National Law J . (September 13) , 1993;; 16:2, 33.
71 +
Commonwealth v Bishop, 416 Mass 169 (1993).
72 +
Commonwealth v Stockhammer, 409 Mass 867 (1991).
73 +
Commonwealth v Figueroa, 413 Mass 193 (1992).
74 +
Sherman R.  Rape victims' records vulnerable. National Law J . (January 4) , 1993;; 15:1, 28.
75 +
Gerberding JL, Henderson DK.  Management of occupational exposures to blood-borne pathogens: hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Clin Infect Dis . 1992;;14:1179-1185.
76 +
Shih CC, Kaneshima H, Rabin L, et al.  Postexposure prophylaxis with zidovudine suppresses human immunodeficiency virus type 1 infection in SCID-hu mice in a time-dependent manner. J Infect Dis . 1991;;163:625-627.
77 +
McCune JM, Namikawa R, Shih CC, et al.  Suppression of HIV infection in AZT-treated SCID-hu mice. Science . 1991;;247:564-566.
78 +
Lafon SW, Mooney BD, McCullen JP, et al. A double-blind, placebo-controlled study of the safety and efficacy of Retrovir (zidovudine) as a chemoprophylactic agent in health care workers exposed to HIV. In: Program and abstracts of the 30th Interscience Conference on Antimicrobial Agents and Chemotherapy; October 21-24, 1990; Washington, DC. Abstract 489.
79 +
Henderson DJ.  Postexposure chemoprophylaxis for occupational exposure to human immunodeficiency virus type 1: current status and prospects for the future. Am J Med . 1991;;91( (suppl 3B) ):312S-319S.
80 +
National Institute of Health, National Institute of Allergy and Infectious Diseases, AIDS Clinical Trial Group (ACTG 076). Clinical Alert: Important Information on the Benefit of Zidovudine (AZT) for the Prevention of the Transmission of HIV From Mother to Infant . Bethesda, Md: Office of Communications, National Institutes of Health; February 21, 1994;.
81 +
Fazely F, Haseltine WA, Rodger RF, Ruprecht RM.  Postexposure chemo-phrophylaxis with ZDV or ZDV combined with interferon-alpha: failure after inoculating rhesus monkeys with a high dose of SIV. J Acquir Immune Defic Syndr . 1991;;4:1093-1097.
82 +
It is also unknown whether topically applied viricidal medications would prevent transmission or whether vaginal douching might be beneficial.
83 +
Ala Code §22-11A-17 (1993) (STDs, all correctional facility inmates)
84 +
Ariz Rev Stat Ann §31-281 (1993) (DNA)
85 +
Cal Penal Code §290.2 (Deering 1993) (DNA)
86 +
Colo Rev Stat 17-2-2-1 (1993) (DNA)
87 +
Fla Stat Ch 943.325 (1993) (DNA)
88 +
Ga Code Ann §24-4-60 (Michie 1993) (DNA)
89 +
La Rev Stat Ann §15:535 (West 1992) (DNA and STDs)
90 +
Mont Code Ann §46-18-256(1993) (HIV and other STDs)
91 +
Nev Rev Stat Ann §441A.320 (Michie 1993)
92 +
NM Stat Ann §24-1-9.1 (Michie 1993)
93 +
NC Gen Stat §15A-615 (1993) (STDs)
94 +
ND Cent Code §23-07.7-01 (1993) (STDs)
95 +
Tex Crim Proc Code Ann §21.31 (1994)
96 +
Wis Laws 32 (1993), amending, Wis Stat §968.38 (1991-1992).
97 +
Federal Bureau of Investigation. Crime in the United States, 1991 . Washington, DC: Federal Bureau of Investigation; August 30, 1992;.
98 +
Bureau of Justice Statistics.  Felony sentences in state courts 1990. Bureau Justice Stat Bull . (March) 1993;.
99 +
42 USCA §3756(f) (West Supp 1993), Crime Control Act of 1990, Title XVIII: Correctional Options Incentives Amendments, §1804.
100 +
Bills entitled the Sexual Assault Prevention Act of 1993 and the Crime Control Act of 1993 were introduced in the Senate on January 21,1993. (Compulsory testing at the time of pretrial release unless the judicial officer determines that the conduct of the person created no risk of HIV transmission.)
101 +
Results based on a state-by-state survey of HIV-testing provisions applicable to cases of sexual assault, compiled by AIDS Policy Center Intergovernmental Health Project, George Washington University, and D. T. Nelson, legislative analyst, National Victim Center; 1993.
102 +
Centers for Disease Control and Prevention.  Recommendations for HIV testing services for inpatients and outpatients in acute-care hospital settings and technical guidance on HIV counseling. MMWR Morb Mortal Wkly Rep . 1993;;42( (RR-2) ):1-17.
103 +
World Health Organization, Global Programme on AIDS. Statement From the Consultation on Testing and Counseling for HIV Infection . Geneva, Switzerland: World Health Organization; November 16-18, 1992;. WHO/GPA/INF/93.2.
104 +
Bayer R, Levine C, Wolf SM.  HIV antibody screening: an ethical framework for evaluating proposed programs. JAMA . 1986;;256:1768-1774.
105 +
Centers for Disease Control.  Public Health Service guidelines for counseling and antibody testing to prevent HIV infection and AIDS. MMWR Morb Mortal Wkly Rep . 1987;;36:509-515.
106 +
Cal Penal Code, §1524.1, (a)-(k) (Deering 1993).
107 +
Morgan M.  The problems of testing for HIV in the criminal courts. Judges J . 1990;;29:22-69.
108 +
Graham NH, Zeger SL, Park LP, et al.  The effects on survival of early treatment of human immunodeficiency virus infection. N Engl J Med . 1992;;326:1037-1042.
109 +
Fischl MA, Richman DD, Causey DM, et al.  Prolonged zidovudine therapy in patients with AIDS and advanced AIDS-related complex. JAMA . 1989;;262:2405-2410.
110 +
Centers for Disease Control.  Guidelines for prophylaxis against Pneumocystis pneumonia for persons infected with HIV. MMWR Morb Mortal Wkly Rep . 1989;;38 ( (S-5) ):1-9.
111 +
Aboulker J-P, Swart AM.  Preliminary analysis of the Concorde trial. Lancet . 1993;;341:889-890.
112 +
Estreich S, Forster GE.  Sexually transmitted diseases and rape. N Engl J Med . 1990;;323:1141-1142.
113 +
Gostin LO.  The AIDS Litigation Project: a national review of court and human rights commission decisions, I: the social impact of AIDS. JAMA . 1990;;263:1961-1970.
114 +
A plaintiff might also seek civil damages based on a defendant's failure to disclose HIV status, even where the plaintiff does not, or cannot, show lack of consent.
115 +
Schmerber v California, 384 US 757 (1966).
116 +
Mincey v Arizona, 437 US 385 (1978).
117 +
People v Thomas, 529 NYS2d 429 (1988).
118 +
Jackson MH.  The criminalization of HIV.  In: Hunter ND, Rubenstein WB, eds. AIDS Agenda: Emerging Issues in Civil Rights . New York, NY: The New Press; 1992;:239-270.
119 +
National Treasury Employees Union v Von Raab, 489 US 656 (1989).
120 +
Skinner v Railway Labor Executives' Association, 489 US 602 (1989).
121 +
Griffin v Wisconsin, 483 US 868, 873 (1987)
122 +
New Jersey v TLO, 469 US 325, 351 (1985).
123 +
People v Adams, 597 NE2d 574 (Ill 1992).
124 +
People v Cook, 532 NYS2d 940 (AD3 1988), appeal denied, 536 NYS2d 746 (November 4, 1988).
125 +
Johnetta J. v Municipal Court, 218 CalApp3d 1255 (1990).
126 +
Government of the Virgin Islands v Roberts, 756 FSupp 898 (DVI 1991).
127 +
Glover v Eastern Neb Corn Office of Retardation, 867 F2d 461 (8th Cir 1989).
128 +
Barlow v Ground, 943 F2d 1132 (9th Cir 1991).
129 +
Eisenstat S.  An analysis of the rationality of mandatory testing for the HIV antibody: balancing the governmental public health interests with the individual's privacy interest. Univ Pittsburgh Law Rev . 1991;;52:327-382.
130 +
Simotas L.  In search of a balance: AIDS, rape, and the special needs doctrine. New York Univ Law Rev . 1991;;66:1881-1927.

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