HIV Infection Antiretroviral resistance Scientific bases and Recommendations for management PDF

Jump to navigation Jump to search This article is about a form of human sexual assault. For rape among non-human HIV Infection Antiretroviral resistance Scientific bases and Recommendations for management PDF, see Sexual coercion.


Ten percent of patients recently infected by HIV have contracted a strain of the virus that is resistant to currently used antiretroviral treatments. Moreover, the prevalence of resistance increases significantly at the various stages of management of the disease. Consequently, this is the main obstacle to treatment success. In this context, the guide HIV infection / Antiretroviral resistance -Scientific basis and Recommendations for management, is a highly useful, practical and specialised tool intended to improve management of infected subjects. The book is composed of two parts : the first (chapters 1 to 5) is an updated clarification of the epidemiology of viral resistance, the scientific bases of the mechanism of resistance and management strategy, and review of resistance tests and their interpretation. The second part (colour pages) offers recommendations on the realistic use of tests and management covering all prescribing circumstances. It is specifically intended for the following : doctors involved in the treatment of HIV infection; expert partners in medical decision-making; virologists, biologists and pharmacologists; health care management : departments heads and managers of hospitals or institutions, pharmacists.

Rape is a type of sexual assault usually involving sexual intercourse or other forms of sexual penetration carried out against a person without that person’s consent. The rate of reporting, prosecuting and convicting for rape varies between jurisdictions. Internationally, the incidence of rapes recorded by the police during 2008 ranged, per 100,000 people, from 0. 3 in Lithuania as the median. These practices are crimes against humanity and war crimes. People who have been raped can be traumatized and develop posttraumatic stress disorder. Rape is defined in most jurisdictions as sexual intercourse, or other forms of sexual penetration, committed by a perpetrator against a victim without their consent.

Health organizations and agencies have also expanded rape beyond traditional definitions. Some countries or jurisdictions differentiate between rape and sexual assault by defining rape as involving penile penetration of the vagina, or solely penetration involving the penis, while other types of non-consensual sexual activity are called sexual assault. Victims of rape or sexual assault come from a wide range of genders, ages, sexual orientations, ethnicitities, geographical locations, cultures and degrees of impairment or disability. Incidences of rape are classified into a number of categories, and they may describe the relationship of the perpetrator to the victim and the context of the sexual assault. Lack of consent is key to the definition of rape. Consent is affirmative « informed approval, indicating a freely given agreement » to sexual activity.

Duress is the situation when the person is threatened by force or violence, and may result in the absence of an objection to sexual activity. This can lead to the presumption of consent. Duress may be actual or threatened force or violence against the victim or someone close to the victim. Marital rape, or spousal rape, is non-consensual sex in which the perpetrator is the victim’s spouse.

It is a form of partner rape, domestic violence, and sexual abuse. Once widely accepted or ignored by law, spousal rape is now denounced by international conventions and is increasingly criminalized. Consent may be complicated by law, language, context, culture and sexual orientation. Studies have shown that men consistently perceive women’s actions as more sexual than they intend. In addition, verbalized ‘no’ to sex may be interpreted as ‘keep trying’, or even ‘yes’ by offenders. Sexual aggression is often considered a masculine identity characteristic of manhood in some male groups and is significantly correlated to the desire to be held higher in esteem among male peers.

Sexually aggressive behavior among young men has been correlated with gang or group membership as well as having other delinquent peers. One metric used by the WHO to determine the severity of global rates of coercive, forced sexual activity was the question « Have you ever been forced to have sexual intercourse against your will? Asking this question produced higher positive response rates than being asked, whether they had ever been abused or raped. Frequently, victims may not recognize what happened to them was rape. Some may remain in denial for years afterwards.

Confusion over whether or not their experience constitutes rape is typical, especially for victims of psychologically coerced rape. Victims may react in ways they did not anticipate. Dissociation can occur during the assault. Memories may be fragmented especially immediately afterwards. They may consolidate with time and sleep. A man or boy who is raped may be stimulated and even ejaculate during the experience of the rape.

Trauma symptoms may not show until years after the sexual assault occurred. In the weeks following the rape, the survivor may develop symptoms of post traumatic stress syndrome and may develop wide array of psychosomatic complaints. PTSD symptoms include re-experiencing of the rape, avoiding things associated with the rape, numbness, and increased anxiety and startle response. Most people recover from rape in three to four months, but many have persistent PTSD that may manifest in anxiety, depression, substance abuse, irritability, anger, flashbacks, or nightmares. Men experience similar psychological effects of being raped, but they are less likely to seek counseling.

Another effect of rape and sexual assault is the stress created in those who study rape or counsel the survivors. The presence or absence of physical injury may be used to determine whether a rape has occurred. Those who have experienced sexual assault yet have no physical trauma may be less inclined to report to the authorities or to seek health care. While penetrative rape generally does not involve the use of a condom, in some cases a condom is used. This significantly reduces the likelihood of pregnancy and disease transmission, both to the victim and to the rapist.

Those who have been raped have relatively more reproductive tract infections than those not been raped. The HIV virus can be transmitted through rape. Acquiring AIDS through rape puts people risk of suffering psychological problems. Acquiring HIV through rape may lead to the in behaviors that create risk of injecting drugs. Society’s treatment of victims has the potential to exacerbate their trauma.

People who have been raped or sexually assaulted are sometimes blamed and considered responsible for the crime. Commentators state: « individuals may endorse rape myths and at the same time recognize the negative effects of rape. A number of gender role stereotypes can play a role in rationalization of rape. For females, victim-blaming correlates with fear. Female jurors might look at the woman on the witness stand and believe she had done something to entice the defendant. In Chinese culture, victim blaming often is associated with the crime of rape, as women are expected to resist rape using physical force.