Women, Sexual Assault and HIV: Are you at Risk?

Has anyone forced you to have sex?
What do you think of when someone mentions sexual assault?
What are HIV and AIDS?
Can I protect myself from HIV if I am being sexually assaulted?
Are there methods of HIV prevention that I can control?
Can PEP (Post Exposure Prophylaxis) reduce the risk of HIV infection?
How can I know if I’m infected with HIV?
I found out I’m HIV-positive. Now what can I do?

Has anyone forced you to have sex?

There are many ways someone can force you to have sex such as:
    • Holding you down, tying you up, hitting you or threatening to hurt you.
    • Having sex with you when you are not able to consent because you are asleep, unconscious, drunk or stoned.
    • Threatening to cut off your financial support, to take your children or to have you kicked out of the country.
    • Calling you names, criticizing you or making you feel stupid.
    • Threatening to reveal private information such as your sexual orientation, or HIV status.

When someone forces you to have sex, this is sexual assault or rape. If you have been sexually assaulted there is help and support. Counsellors at a Rape Crisis Centre or a Women’s Shelter can provide emotional support and help you find the health care and legal services you need. Your Regional Sexual Assault Association (see the bottom of this page) can direct you to an organization in your area.

What do you think of when someone mentions sexual assault?

In Canada, many of us think about a man, usually a stranger, attacking a woman in a dark alley. This can happen but most women are raped in their own homes by their partner or someone they know.

Sometimes it’s difficult for us to recognize sexual assault because we care about the person who has assaulted us. No one has the right to force you to have sex even if:
    • You are married to them;
    • They support you financially;
    • They have paid for your sexual services; or
    • They just bought you dinner and a movie.

Sexual assault is an act of violence and it is a crime.

What are HIV and AIDS?

HIV = Human Immunodeficiency Virus
AIDS = Acquired Immune Deficiency Syndrome

HIV is the virus that causes AIDS. People can live with HIV for many years without any symptoms or illnesses. HIV slowly attacks the immune system -- the part of our body that fights disease.

When the immune system becomes very weak, people with HIV get sick and in time they develop AIDS.

There is no cure for HIV or AIDS, but there is help and support for people living with HIV/AIDS. There are also medications available that help to control the effects of HIV. You can contact your AIDS/Sexual Health Information Line (see the bottom of this page) to find out what services are available in your community.

Sexual Assault and Risk for HIV: If a man forces you to have intercourse (vaginal, anal or oral) you are only at risk for HIV if:

1. Your attacker is infected with HIV
AND
2. The attacker’s body fluids (blood or semen) enter your vagina, anus or cuts in or on your mouth or other parts of your body.

Statistically, the risk of becoming infected with HIV from one incident of sexual assault is low, but it is possible. Your risk is greater if:
    • You have been repeatedly sexually assaulted;
    • You have been sexually assaulted by more than one man;
    • You had cuts, tears, burns or inflammation in your vagina, anus, mouth oe lips;
    • You were menstruating at the time of your attack;
    • You or your attacker had a sexually transmitted infection at the time of the assault.

Can I protect myself from HIV if I am being sexually assaulted?

During most sexual assaults women do not have the power to protect themselves from HIV infection.

BUT, if you are in a situation of ongoing sexual assault from a partner or acquaintance, there may be things you can do to decrease your risk of becoming infected with HIV.

These are some tools and strategies which women have tried:
    • Suggesting the use of condoms as a form of birth control instead of protection against HIV;
    • Suggesting the use of 'insertive' (female) condoms that you can put in your vagina (rather than having to have your male partner put on a condom). Although they cost more than male condoms, sometimes men are more willing to use them. You can insert female condoms into your vagina up to eight hours before having intercourse. In Canada you can buy Reality™ brand female condoms at most pharmacies.
    • Masturbating your partner using your hands or other parts of your body;
    • Performing oral sex on your partner, which is lower risk for HIV than vaginal or anal sex;

These are things you can do without your partners’ knowledge:
    • Get checked and treated regularly for sexually transmitted infections (STIs). If you have an STI your risk of becoming infected with HIV is greater.
    • Don’t douche or give yourself an enema. Douching and enemas weaken the lining of your vagina and anus, and this increases the risk of HIV infection.

Are there methods of HIV prevention that I can control?

Women need reliable HIV prevention methods that they have the power to control and use without their partner’s knowledge. Today, no such methods exist.

Some women have tried using spermicide and lubricant as protection against HIV because they have no other way to protect themselves. Spermicides (like nonoxynol-9, which is found in products such as the Advantage 24™) have not been proven to reduce the risk of HIV infection. In fact, recent data suggest that the use of nonoynol-9 may actually increase the risk of HIV transmission. If used to prevent pregnancy, they should be used in small quantities (50 – 100 mg) and no more than once a day. Many women have allergies to spermicides and should not use them. If you get sore, irritated or inflamed from using spermicides, this will increase your risk of HIV infection.

Water-based lubricant (lube) helps prevent HIV infection when it is used with condoms by preventing trauma (rips, cuts, tears) in your vagina or anus and by decreasing the chance that a condom will break. Lube used on its own may slightly reduce the risk of HIV infection by reducing cuts and tears.

Can PEP (Post Exposure Prophylaxis) reduce the risk of HIV infection?

'Post' means after.
'Exposure' means to be in contact with HIV.
'Prophylaxis' means a treatment that prevents disease.

PEP is a powerful combination of drugs that fight HIV. PEP can be taken by people who think they may have been exposed to HIV. A month-long course of these drugs taken soon after possible exposure can help prevent HIV infection. PEP works best if it is taken 1-2 hours after possible exposure, but it can be taken up to 72 hours later.

In some areas of the country PEP is now available for women who have been sexually assaulted. To find out more about PEP and if it is available in your area, call your AIDS Information Line or Regional Sexual Assault Association (at the bottom of this page).

How can I know if I’m infected with HIV?

The only way to find out if you have HIV is through a blood test. It tales a while for HIV antibodies to show us in blood. It could take 2-3 months from the day you think you may have been infected to get an accurate test result.

There are three types of HIV testing in Canada: anonymous, non-nominal, and nominal.
    • Anonymous testing: a code is sent to the lab instead of your name. Only you know the code.
    • Non-nominal testing: a code is sent to the lab. Only you and your doctor know the code.
    • Nominal testing: Your name is sent to the lab.
Tests results from anonymous, non-nominal and nominal are confidential information.
    • Anonymous testing: Test results are not recorded in any medical chart.
    • Non-nominal testing: Test results are recorded on your medical chart (this may not be true for all provinces/territories: ask when going for testing).
    • Nominal testing: Test results are recorded on your medical chart (this may not be true for all provinces/territories: ask when going for testing).

It is important to get counselling before and after you get tested. A counsellor or health care worker can tell you more about testing and help you consider the impact that testing HIV-positive may have on your life. If you decide to get an HIV test, try to get the support you need. You may want to bring a friend or a counsellor when you go for your test and when you get your test result.

Your AIDS/Sexual Health Information Line can give you more information about HIV testing and where testing sites are located in your area. In some provinces 'rapid' HIV testing is availble - your results are ready in 20 minutes.

I found out I’m HIV-positive. Now what can I do?

Being diagnosed with a life-threatening illness can be very scary. You may want support and information to help you adjust. Talking with a counsellor can help.

Women with HIV infection can live healthy lives for many years. There are things you can do to take care of yourself physically and emotionally in order to stay well. Anti-HIV medications have improved the lives of many people living with HIV. You can get information about local services, HIV treatment options and self-care from your provincial AIDS/Sexual Health Information Line.

AIDS/Sexual Health Information Lines

For confidential information and referrals about HIV/AIDS call:

Alberta: 1-800-772-2437
British Columbia: 1-800-661-4337
Manitoba: 1-800-782-2437
New Brunswick: 1-800-561-4009
Newfoundland and Labrador: 1-800-563-1575
Northwest Territories: 1-800-661-0844
Nova Scotia: 1-800-566-2437
Nunavut: 1-800-265-3333 (5pm – 1am)
Ontario: 1-800-668-2437 (English); 1-800-267-7432 (French)
Prince Edward Island: 1-800-314-2437
Quebec: 514-521-7432 (collect calls accepted) - - or call your local Info-Sante CLSC
Saskatchewan: 1-800-667-6876
Yukon: 1-800-661-0507

Regional Sexual Assault Associations

For confidential information and referrals about sexual assault call:

Canadian Association of Sexual Assault Centre (CASAC): 604-872-8212
National Clearinghouse on Family Violence: 1-800-267-1291; (TTY) 1-800-561-5643
Alberta Association of Sexual Assault Centres (AASAC): 403-237-6905
Ontario Coalition of Rape Crisis Centres: 519-439-0844
PEI Rape and Sexual Assault Crisis Centre: 1-800-289-5656
Regroupement quebecois des centres d’aide et de lutte contre les aggressions a caractere sexuel : 514-529-5252
Sexual Assault Services of Saskatchewan (SASS): 306-934-1022