HIV, AIDS & Sexual Assault

HIV stands for Human Immunodeficiency Virus. AIDS stands for Acquired Immune Deficiency Syndrome. HIV is the virus that cause AIDS. HIV slowly attacks the body’s immune system, weakening the body’s disease fighting ability. When the immune system is attacked, people with HIV get sick and may develop AIDS.

People can live with HIV for many years without symptoms or illness. The virus can be transmitted through blood, semen, vaginal fluids, and breast milk. As of right now, there is no cure for HIV or AIDS but a positive test is not a death sentence. AIDS is a manageable disease thanks to medical developments and drug therapies that assist the body in building up the immune system and keeping infections at bay. There are several organizations that provide help and support for people living with HIV and AIDS.

Risk for HIV

The psychological stress of a possible HIV infection after a sexual assault is very significant and real to each survivor.  The risk of becoming infected with HIV from one incident of sexual assault is low. However, you may be at greater risk if: the assault included penetration (vaginal, anal, oral with ejaculation), the assault was repeated or there was more than one assailant, you had injuries prior to the assault or sustained physical injuries from the assault (tears, burns or inflammation of the vagina, anus, mouth or lips), you were menstruating at the time of the assault, or the assailant had HIV or an STD at the time of the assault.

Children might be at higher risk for transmission because child sexual abuse is frequently associated with multiple episodes of assault and might result in mucosal trauma. HIV infection has been reported in children whose only known risk factor was sexual abuse.

The risk of HIV transmission from a single sexual assault is estimated to be less than 1.0% (HIV and Sexual Violence Against Women. (1998). Health Canada.)

Damage to the anal or genital area has been proven to facilitate the transmission of HIV. 40% to 87% of women who are sexually assaulted show signs of genital injury. (HIV and Sexual Violence Against Women. (1998). Health Canada.)

If a victim/survivor and/or the perpetrator has a sexually transmitted infection (STI), the victim/survivor is three to five times more likely to acquire HIV if exposed to the virus. A history of repeated STIs may increase the risk of HIV infection. (HIV and Sexual Violence Against Women. (1998). Health Canada.)

Adolescents with a history of abuse are significantly less likely than their peers to have knowledge of the risks surrounding HIV. They report less condom self-efficacy, higher rates of sexually transmitted infections, and higher rates of drug use. (Brown, L.K. 2000. Impact of sexual abuse on the HIV-risk-related behavior of adolescents in intensive psychiatric treatment. The American Journal of Psychiatry. Vol. 157: 1413-1415.)

What is PEP?

PEP stands for Post-Exposure Prophylaxis. PEP (sometimes referred to as nPEP or Non-Occupational Post-Exposure Prophylaxis) is a month-long course of a powerful combination of drugs that fight HIV. It is most effective when taken within 2 to 36 hours of an assault. According to the Centers for Disease Control, Sexually Transmitted Disease Treatment Guidelines (2006), the possibility of HIV exposure from the assault should be assessed at the time of the post-assault examination. The possible benefit of PEP in preventing HIV infection also should be discussed with the assault survivor if risk exists for HIV exposure from the assault. Depending on the details of your assault and the HIV status of the offender (if known), a healthcare provider may or may not recommend nPEP. It is best to speak with a sexual assault crisis counselor, sexual assault nurse examiner, or private healthcare provider to assess what is best for you.

Testing Options

The Department of Public Health offers three options for HIV tests. Venipuncture (blood drawn) tests provide results within one week. Ora-Sure (oral swab and/or finger stick) tests also provide results in one week. Many locations now offer Rapid Testing (oral swab and/or finger stick), which provides results in twenty minutes. If you get an HIV test immediately following your assault (often called a baseline test), regardless of the result, it is important to get tested again after 3 months to get a more accurate result.

Confidential testing records the person’s name with the test result. Records are kept secret from everyone except medical personnel or, in some states, the state health department. At some centers, however, such as doctor offices or clinics, test results may become part of your medical record and may be seen by health care workers, insurers, or employers. If any health care provider proposes to test you for HIV, the reasons and the potential benefits should be discussed before deciding whether or not to take the test.

Anonymous testing uses a code rather than a name for the test results. Only you know the code and only you can reveal the results to anyone. Anonymous testing is highly recommended for survivors of sexual assault. It is recommended to avoid getting tested for HIV at the hospital immediately following an assault. The results of this test will not be free or confidential, and they will not reveal if HIV was contracted during the assault. Many hospitals, community clinics and Planned Parenthood offices offer anonymous HIV testing.

For information on HIV testing, you can talk to your health care provider or you can find the location of the HIV testing site nearest to you by calling: 1-800-CDC-INFO

National HIV Testing Resource: