Diana

Virus imunodifisiensi manusia[1] (bahasa Inggris: human immunodeficiency virus; HIV ) adalah suatu
virus yang dapat menyebabkan penyakit AIDS.[2] Virus ini menyerang manusia dan menyerang
sistem kekebalan (imunitas) tubuh, sehingga tubuh menjadi lemah dalam melawan infeksi.
Bahasa Indonesia: HIV yang baru memperbanyak diri tampak bermunculan sebagai bulatan-bulatan
kecil (diwarnai hijau) pada permukaan limfosit setelah menyerang sel tersebut; dilihat dengan
mikroskop elektron.
English: Scanning electron micrograph of HIV. This image has been colored to highlight important
features; see PHIL 1197 for original black and white view of this image. Multiple round bumps on cell
surface represent sites of assembly and budding of virions.

MENGANCAM GENERASI MUDA INDONESIA
semakin banyak generasi muda yang terinfeksi HIV, semakin banyak anak juga terlahir dengan HIV.
Sebagian besar anak di bawah usia sepuluh tahun yang terinfeksi HIV tertular oleh ibunya. Penularan
dapat terjadi dalam kandungan, waktu melahirkan atau melalui menyusui.

PENGARUH DAN DAMPAKNYA HIV/AIDS
Sabtu, 07 Maret 2009

Mungkin Aku telat menmbuat artikel tentang AIDS DAN HIV.
Pertama Kita kenal tentang AIDS dulu.AIDS atau Acquired Imunodeficiency Syndrom,Sedangkan HIV
adalah Human Immunodeficiency Virus.Istilah ini baru dikenal 20 - 25 tahun yang lalu.
D Indonesia sendiri kasus pertama Aids terjadi pada tahun 1987 dan terjadi Di Bali.
Di Dunia sekarang ini kasus AIDS sangat memprihatinkan.Sudah banyak orang yang tewas dan
terjangkit penyakit ini.Di Afrika sendiri yang merupakan penderita terbanyak setiap tahunnya ada
jutaan orang mati.Kasus AIDS memang unik,banyak orang tidak mau membuka dirinya jika Ia terkena
AIDS.Orang dengan penyakit HIV/AIDS disebut dengan ODHA(Orang Dengan HIV AIDS).Perlu
diketahui saja penyakit ini memiliki gejala unik,yang baru muncul setelah 5 - 10 tahun setelah
terinfeksi virus HIV.AIDS disebabkan oleh virus HIV yang menyerang sistem kekebalan tubuh
kita.BAgi penderita AIDS mereka harus menjaga kesehatan dan kekebalan tubuh mereka karena
mereka sangat rawan terserang penyakit.Bagi pengidap AIDS mereka akan mendapati dirinya
terserang penyakit bawaan AIDS seperti Kanker,Tumor,Mutah Akut,dll.Semua Itu semua disebut
dengan Kompilasi HIV.Pada penderita ,mereka seperti mengetahui maut akan datang dengan
pasti.Tapi,sekarang ini mereka Dapat menyambung hidup dengan mengkonsumsi semacam Obat
terus menerus yang di beri nama ARV.

Sedangkan,bagi para ODHA yang mereka butuhkan adalah sokongan Spritual dan dukungan mental
dari orang disekitarnya.ODHA bukan merupakan momok bagi masyarakat,karena AIDS bukanlah
penyakit yang menular hanya karena sentuhan tangan atau sejenisnya.
AIDS/HIV adalah penyakit yang menular karena adanya hubungan badan dengan pengidap
AIDS,selaain itu juga dapat menular melalui Suntik yang tertular virus HIV selain itu melalui tranfusi
darah dengan penderita atau NARKOBA.AIDS Merupakan Penyakit yang harus kita tekan
keberadaanya dengan cara mensosilisasikan nya kepada masyarakat dan tidak berpikiran buruk pada
ODHA.Indonesia yang kini juga sangat memprihatinkan harus juga mulai bersiap,MARI KITA HINDARI
FREE SEKS DAN NARKOBA DEMI MASA DEPAN BANGSA.
AIDS there is A light in the Darks Of Fear Human In the World.

Siklus Hidup
Struktur HIV.

Seperti virus lain pada umumnya, HIV hanya dapat bereplikasi dengan memanfaatkan sel inang.
Siklus hidup HIV diawali dengan penempelan partikel virus (virion) dengan reseptor pada permukaan
sel inang, di antaranya adalah CD4, CXCR5, dan CXCR5. Sel-sel yang menjadi target HIV adalah sel
dendritik, sel T, dan makrofaga.[12] Sel-sel tersebut terdapat pada permukaan lapisan kulit dalam
(mukosa) penis, vagina, dan oral yang biasanya menjadi tempat awal infeksi HIV.[12] Selain itu, HIV
juga dapat langsung masuk ke aliran darah dan masuk serta bereplikasi di noda limpa.[12]

Setelah menempel, selubung virus akan melebur (fusi) dengan membran sel sehingga isi partikel
virus akan terlepas di dalam sel.[14] Selanjutnya, enzim transkriptase balik yang dimiliki HIV akan
mengubah genom virus yang berupa RNA menjadi DNA.[14] Kemudian, DNA virus akan dibawa ke
inti sel manusia sehingga dapat menyisip atau terintegrasi dengan DNA manusia.[14] DNA virus yang
menyisip di DNA manusia disebut sebagai provirus dan dapat bertahan cukup lama di dalam sel.[14]
Saat sel teraktivasi, enzim-enzim tertentu yang dimiliki sel inang akan memproses provirus sama
dengan DNA manusia, yaitu diubah menjadi mRNA.[14] Kemudian, mRNA akan dibawa keluar dari
inti sel dan menjadi cetakan untuk membuat protein dan enzim HIV.[14] Sebagian RNA dari provirus
yang merupakan genom RNA virus.[14] Bagian genom RNA tersebut akan dirakit dengan protein dan
enzim hingga menjadi virus utuh.[14] Pada tahap perakitan ini, enzim protease virus berperan
penting untuk memotong protein panjang menjadi bagian pendek yang menyusun inti virus.[14]
Apabila HIV utuh telah matang, maka virus tersebut dapat keluar dari sel inang dan menginfeksi sel
berikutnya.[15] Proses pengeluaran virus tersebut melalui pertunasan (budding), di mana virus akan
mendapatkan selubung dari membran permukaan sel inang.[15]
Deteksi HIV

Seorang wanita sedang menggunakan alat tes HIV.

Umumnya, ada tiga tipe deteksi HIV, yaitu tes PCR, tes antibodi HIV, dan tes antigen HIV.[16] Tes
reaksi berantai polimerase (PCR) merupakan teknik deteksi berbasis asam nukleat (DNA dan RNA)
yang dapat mendeteksi keberadaan materi genetik HIV di dalam tubuh manusia.[17] Tes ini sering
pula dikenal sebagai tes beban virus atau tes amplifikasi asam nukleat (HIV NAAT).[16] PCR DNA
biasa merupakan metode kualitatif yang hanya bisa mendeteksi ada atau tidaknya DNA virus.[18]
Sedangkan, untuk deteksi RNA virus dapat dilakukan dengan metode real-time PCR yang merupakan
metode kuantitatif.[18] Deteksi asam nukleat ini dapat mendeteksi keberadaan HIV pada 11-16 hari
sejak awal infeksi terjadi.[8] Tes ini biasanya digunakan untuk mendeteksi HIV pada bayi yang baru
lahir, namun jarang digunakan pada individu dewasa karena biaya tes PCR yang mahal dan tingkat
kesulitan mengelola dan menafsirkan hasil tes ini lebih tinggi bila dibandingkan tes lainnya.[16]

Untuk mendeteksi HIV pada orang dewasa, lebih sering digunakan tes antibodi HIV yang murah dan
akurat.[16] Seseorang yang terinfeksi HIV akan menghasilkan antibodi untuk melawan infeksi
tersebut.[16] Tes antibodi HIV akan mendeteksi antibodi yang terbentuk di darah, saliva (liur), dan
urin.[16] Sejak tahun 2002, telah dikembangkan suatu penguji cepat (rapid test) untuk mendeteksi
antibodi HIV dari tetesan darah ataupun sampel liur (saliva) manusia.[19] Sampel dari tubuh pasien
tersebut akan dicampur dengan larutan tertentu. Kemudian, kepingan alat uji (test strip) dimasukkan
dan apabila menunjukkan hasil positif maka akan muncul dua pita berwarna ungu kemerahan.[19]
Tingkat akurasi dari alat uji ini mencapai 99.6%, namun semua hasil positif harus dikonfirmasi
kembali dengan ELISA.[19] Selain ELISA, tes antibodi HIV lain yang dapat digunakan untuk
pemeriksaan lanjut adalah Western blot.[17]

Tes antigen dapat mendeteksi antigen (protein P24) pada HIV yang memicu respon antibodi.[16]
Pada tahap awal infeksi HIV, P24 diproduksi dalam jumlah tinggi dan dapat ditemukan dalam serum
darah.[16] Tes antibodi dan tes antigen digunakan secara berkesinambungan untuk memberikan
hasil deteksi yang lebih akurat dan lebih awal.[16] Tes ini jarang digunakan sendiri karena
sensitivitasnya yang rendah dan hanya bisa bekerja sebelum antibodi terhadap HIV terbentuk.[16]
Penularan dan Pencegahan

HIV dapat ditularkan melalui injeksi langsung ke aliran darah, serta kontak membran mukosa atau
jaringan yang terlukan dengan cairan tubuh tertentu yang berasal dari penderita HIV.[20] Cairan
tertentu itu meliputi darah, semen, sekresi vagina, dan ASI.[20] Beberapa jalur penularan HIV yang
telah diketahui adalah melalui hubungan seksual, dari ibu ke anak (perinatal), penggunaan obatobatan intravena, transfusi dan transplantasi, serta paparan pekerjaan.[21]
Hubungan seksual

Menurut data WHO, pada tahun 1983-1995, sebanyak 70-80% penularan HIV dilakukan melalui
hubungan heteroseksual, sedangkan 5-10% terjadi melalui hubungan homoseksual. Kontak seksual
melalui vagina dan anal memiliki resiko yang lebih besar untuk menularkan HIV dibandingkan
dengan kontak seks secara oral.[22] Beberapa faktor lain yang dapat meningkatkan resiko penularan
melalui hubungan seksual adalah kehadiran penyakit menular seksual, kuantitas beban virus,
penggunaan douche. Seseorang yang menderita penyakit menular seksual lain (contohnya: sifilis,
herpes genitali, kencing nanah, dsb.) akan lebih mudah menerima dan menularkan HIV kepada orang
lain yang berhubungan seksual dengannya.[23] [24] Beban virus merupakan jumlah virus aktif yang
ada di dalam tubuh. Penularah HIV tertinggi terjadi selama masa awal dan akhir infeksi HIV karena
beban virus paling tinggi pada waku tersebut.[24] Pada rentan waktu tersebut, beberapa orang
hanya menimbulkan sedikit gejala atau bahkan tidak sama sekali.[24] Penggunaan douche dapat
meningkatkan resiko penularan HIV karena menghancurkan bakteri baik di sekitar vagina dan anus
yang memiliki fungsi proteksi.[24] Selain itu, penggunaan douche setelah berhubungan seksual
dapat menekan bakteri penyebab penyakit masuk ke dalam tubuh dan mengakibatkan infeksi.[24]

Pencegahan HIV melalui hubungan seksual dapat dilakukan dengan tidak berganti-ganti pasangan
dan menggunakan kondom.[21] Cara pencegahan lainnya adalah dengan melakukan hubungan seks
tanpa menimbulkan paparan cairan tubuh.[23] Untuk menurunkan beban virus di dalam saluran
kelamin dan darah, dapat digunakan terapi anti-retroviral.[24]
Ibu ke anak (transmisi perinatal)

Penularan HIV dari ibu ke anak dapat terjadi melalui infeksi in utero, saat proses persalinan, dan
melalui pemberian ASI.[21] Beberapa faktor maternal dan eksternal lainnya dapat mempengaruhi
transmisi HIV ke bayi, di antaranya banyaknya virus dan sel imun pada trisemester pertama,
kelahiran prematur, dan lain-lain.[21] Penurunan sel imun (CD4+) pada ibu dan tingginya RNA virus
dapat meningkatkan resiko penularan HIV dari ibu ke anak. Selain itu, sebuah studi pada wanita
hamil di Malawi dan AS juga menyebutkan bahwa kekurangan vitamin A dapat meningkatkan risiko
infeksi HIV. Risiko penularan perinatal dapat dilakukan dengan persalinan secara caesar, tidak
memberikan ASI, dan pemberian AZT pada masa akhir kehamilan dan setelah kelahiran bayi.[21] Di
sebagian negara berkembang, pencegahan pemberian ASI dari penderita HIV/AIDS kepada bayi
menghadapi kesulitan karena harga susu formula sebagai pengganti relatif mahal.[25] Selain itu,
para ibu juga harus memiliki akses ke air bersih dan memahami cara mempersiapan susu formula
yang tepat.[25]
Lain-lain

Cara efektif lain untuk penyebaran virus ini adalah melalui penggunaan jarum atau alat suntik yang
terkontaminasi, terutama di negara-negara yang kesulitan dalam sterilisasi alat kesehatan.[21] Bagi
pengguna obat intravena (dimasukkan melalui pembuluh darah), HIV dapat dicegah dengan
menggunakan jarum dan alat suntik yang bersih.[21] Penularan HIV melalui transplantasi dan
transfusi hanya menjadi penyebab sebagian kecil kasus HIV di dunia (3-5%).[21] Hal ini pun dapat

dicegah dengan melakukan pemeriksaan produk darah dan transplan sebelum didonorkan dan
menghindari donor yang memiliki resiko tinggi terinfeksi HIV.[21]

Penularan dari pasien ke petugas kesehatan yang merawatnya juga sangat jarang terjadi (< 0.0001%
dari keseluruhan kasus di dunia).[21] Hal ini dicegah dengan memeberikan pengajaran atau edukasi
kepada petugas kesehatan, pemakaian pakaian pelindung, sarung tangan, dan pembuangan alat dan
bahan yang telah terkontaminasi sesuai dengan prosedur.[21] Pada tahun 2005, sempat diusulkan
untuk melakukan sunat dalam rangka pencegahan HIV. Namun menurut WHO, tindakan pencegahan
tersebut masih terlalu awal untuk direkomendasikan.[26]

Ada beberapa jalur penularan yang ditakutkan dapat menyebarkan HIV, yaitu melalui ludah, gigitan
nyamuk, dan kontak sehari-hari (berjabat tangan, terekspos batuk dan bersin dari penderita HIV,
menggunakan toilet dan alat makan bersama, berpelukan).[20] Namun, CDC (Pusat Pengendalian
dan Pencegahan Penyakit) menyatakan bahwa aktivitas tersebut tidak mengakibatkan penularan
HIV.[20] Beberapa aktivitas lain yang sangat jarang menyebabkan penularan HIV adalah melalui
gigitan manusia dan beberapa tipe ciuman tertentu.[20]

Sub-Sahara Afrika tetap merupakan daerah yang paling parah terkena HIV di antara kaum
perempuan hamil pada usia 15-24 tahun di sejumlah negara di sana. Ini diduga disebabkan oleh
banyaknya penyakit kelamin, praktik menoreh tubuh, transfusi darah, dan buruknya tingkat
kesehatan dan gizi di sana.[27]

Klasifikasi

Pohon kekerabatan (filogenetik) yang menunjukkan kedekatan SIV dan HIV.

Kedua spesies HIV yang menginfeksi manusia (HIV-1 dan -2) pada mulanya berasal dari
Afrika barat dan tengah, berpindah dari primata ke manusia dalam sebuah proses yang
dikenal sebagai zoonosis.[7] HIV-1 merupakan hasil evolusi dari simian immunodeficiency
virus (SIVcpz) yang ditemukan dalam subspesies simpanse, Pan troglodyte troglodyte.
Sedangkan, HIV-2 merupakan spesies virus hasil evolusi strain SIV yang berbeda (SIVsmm),
ditemukan pada Sooty mangabey, monyet dunia lamaGuinea-Bissau.[7] Sebagian besar infeksi
HIV di dunia disebabkan oleh HIV-1 karena spesies virus ini lebih virulen dan lebih mudah
menular dibandingkan HIV-2.[7] Sedangkan, HIV-2 kebanyakan masih terkurung di Afrika
barat.[7]
Berdasarkan susuanan genetiknya, HIV-1 dibagi menjadi tiga kelompok utama, yaitu M, N,
dan O.[8] Kelompok HIV-1 M terdiri dari 16 subtipe yang berbeda.[8] Sementara pada
kelompok N dan O belum diketahui secara jelas jumlah subtipe virus yang tergabung di
dalamnya.[8] Namun, kedua kelompok tersebut memiliki kekerabatan dengan SIV dari
simpanse.[8] HIV-2 memiliki 8 jenis subtipe yang diduga berasal dari Sooty mangabey yang
berbeda-beda.[8]
Apabila beberapa virus HIV dengan subtipe yang berbeda menginfeksi satu individu yang
sama, maka akan terjadi bentuk rekombinan sirkulasi (circulating recombinant forms CRF)[9] (bahasa Inggris: circulating recombinant form, CRF). Bagian dari genom beberapa
subtipe HIV yang berbeda akan bergabung dan membentuk satu genom utuh yang baru.[10]
Bentuk rekombinan yang pertama kali ditemukan adalah rekombinan AG dari Afrika tengah
dan barat, kemudian rekombinan AGI dari Yunani dan Siprus, kemudian rekombinan AB dari
Rusia dan AE dari Asia tenggara.[10] Dari seluruh infeksi HIV yang terjadi di dunia, sebanyak
47% kasus disebabkan oleh subtipe C, 27% berupa CRF02_AG, 12,3% berupa subtipe B,
5.3% adalah subtipe D dan 3.2% merupakan CRF AE, sedangkan sisanya berasal dari subtipe
dan CRF lain.[10]
Latar Belakang Masalah
Virus adalah organisme yang kecil, bahkan lebih kecil dari pada bakteri yang bisa
menyebabkan TBC atau kolera. Virus tersebut begitu umum sehingga manusia dapat
terserang olehnya beruulang kali sepanjang hidupnya. Virus dapat menyebabkan masu angin,
demikian juga polio, campak, gondok, dan flu. Virus-virus ini dapat tersebarkan oleh batuk,
bersin/ sentuhan.
HIV ( Human Immunodeficiency Virus) berbeda meskipun juga termasuk salah satu
virus. HIV tidak dapat menyebar dengan cara yang sama seperti virus-virus pada umumnya.
HIV hanya dapat disebarkan oleh hubungan seks, darah, jarum kotor, dan alat-alat lain, serta
dari seorang ibu kepada anaknya yang belum lahir atau ibu yang menyusui bayinya.
HIV berbeda karena belum ada vaksin untuknya. Tetapi dengnan mengubah perilaku
dapat juga menghentikan penyebaran penyakit ini. Misalnya, mencuci tangan setelah dari
kamar mandi akan merendahkan peluang penyebaran penyakit kepada orang lain.
Ada dua jenis virus pelemah system kekebalan manusia, yaitu HIV-1 dan HIV-2.
HIV-1 ditemukan di semua belahan dunia, sedangkan HIV-2 ditemukan paling banyak di

Afrika Barat. Karena penyebaran kedua virus ini dapat dicegah dengan cara yang sama. Oleh
karena itu, dalam makalah ini, penyusun akan membahas HIV-1 dan HIV-2 secara bersamasama sebagai HIV saja.

B. Rumusan Masalah
1. Apakah HIV/ AIDS itu?
2. Bagaimanakah HIV melemahkan sistem kekebalan tubuh?
3. Bagaimana HIV dapat ditularkan?
4. Bagaimanakah HIV dapat mengakibatkan AIDS?
5. Bagaimana melindungi diri dari penularan AIDS?

C. Tujuan Penulisan Makalah
1. Menjelaskan pengertian HIV/ AIDS
2. Menjelaskan bahwa virus HIV bisa menimbulkan kerusakan pada system kekebalan manusia
3. Menjelaskan cara penularan HIV
4. Menjelaskan bahwa HIV dapat mengakibatkan penyakit AIDS
5. Menjelaskan upaya-upaya melindungi diri dari infeksi HIV dan penyakit AIDS

BAB II
PEMBAHASAN

1. Pengertian HIV/ AIDS

HIV (Human Immunodeficiency Virus) adalah Virus yang
menyerang sistim kekebalan tubuh manusia yang menyebabkan timbulnya AIDS.
Virus HIV ditemukan dalam cairan tubuh terutama pada darah, cairan sperma, cairan vagina
dan air susu ibu.

HIV merupakan retrovirus yang menjangkiti sel-sel sistem kekebalan tubuh manusia,
terutama CD4 positive T-sel dan macrophages (komponen-komponen utama sistem
kekebalan sel) dan menghancurkan atau mengganggu fungsinya. Infeksi virus ini
mengakibatkan terjadinya penurunan sistem kekebalan yang terus-menerus, yang akan
mengakibatkan defisiensi kekebalan tubuh.
CD 4 adalah sebuah marker atau penanda yang berada di permukaan sel-sel darah
putih manusia, terutama sel-sel limfosit. CD4 pada orang dengan sistem kekebalan yang
menurun menjadi sangat penting, karena berkurangnya nilai CD4 dalam tubuh manusia
menunjukkan berkurangnya sel-sel darah putih atau limfosit yang seharusnya berperan dalam
memerangi infeksi yang masuk ke tubuh manusia. Pada orang dengan sistem kekebalan yang
baik, nilai CD4 berkisar antara 1400-1500. Sedangkan pada orang dengan sistem kekebalan
yang terganggu (misal pada orang yang terinfeksi HIV) nilai CD 4 semakin lama akan
semakin menurun (bahkan pada beberapa kasus bisa sampai nol).
Sel yang mempunyai marker CD4 di permukaannya berfungsi untuk melawan
berbagai macam infeksi. Di sekitar kita banyak sekali infeksi yang beredar, entah itu berada
dalam udara, makanan ataupun minuman. Namun kita tidak setiap saat menjadi sakit, karena
CD4 masih bisa berfungsi dengan baik untuk melawan infeksi ini. Jika CD4 berkurang,

mikroorganisme yang patogen di sekitar kita tadi akan dengan mudah masuk ke tubuh kita
dan menimbulkan penyakit pada tubuh manusia.
Sistem kekebalan dianggap defisien ketika sistem tersebut tidak dapat lagi
menjalankan fungsinya dalam memerangi infeksi dan penyakit- penyakit. Orang yang
kekebalan tubuhnya defisien (Immunodeficient) menjadi lebih rentan terhadap berbagai
ragam infeksi, yang sebagian besar jarang menjangkiti orang yang tidak mengalami defisiensi
kekebalan. Penyakit-penyakit yang berkaitan dengan defisiensi kekebalan yang parah dikenal
sebagai ―infeksi oportunistik‖ karena infeksi-infeksi tersebut memanfaatkan sistem kekebalan
tubuh yang melemah.
AIDS merupakan penyakit yang paling ditakuti pada saat ini. HIV merupakan virus
yang menyebabkan penyakit ini, merusak sistem pertahanan tubuh (sistem imun), sehingga
orang-orang yang menderita penyakit ini kemampuan untuk mempertahankan dirinya dari
serangan penyakit menjadi berkurang. Seseorang yang positif mengidap HIV, belum tentu
mengidap AIDS. Banyak kasus di mana seseorang positif mengidap HIV, tetapi tidak
menjadi sakit dalam jangka waktu yang lama. Namun, HIV yang ada pada tubuh seseorang
akan terus merusak sistem imun. Akibatnya, virus, jamur dan bakteri yang biasanya tidak
berbahaya menjadi sangat berbahaya karena rusaknya sistem imun tubuh.
AIDS (Acquired Immune Deficiency Syndrome) adalah kumpulan gejala penurunan
kekebalan tubuh, sehingga tubuh rentan terhadap penyakit lain yang mematikan. AIDS disebabkan
oleh Virus (Jasad Sub Renik) yang disebut dengan HIV. sedangkan HIV (Human Immunodeficiency
Virus) itusendiri adalah Virus yang menyerang sistem kekebalan tubuh manusia yang menyebabkan
timbulnya AIDS.

Istilah AIDS dipergunakan untuk tahap- tahap infeksi HIV yang paling lanjut.
Sebagian besar orang yang terkena HIV, bila tidak mendapat pengobatan, akan menunjukkan
tanda-tanda AIDS dalam waktu 8-10 tahun. AIDS diidentifikasi berdasarkan beberapa infeksi
tertentu, yang dikelompokkan oleh Organisasi Kesehatan Dunia (World Health Organization)
sebagai berikut:
Tahap I penyakit HIV tidak menunjukkan gejala apapun dan tidak dikategorikan sebagai
AIDS.
Tahap II (meliputi manifestasi mucocutaneous minor dan infeksi-infeksi saluran pernafasan
bagian atas yang tidak sembuh- sembuh)
Tahap III (meliputi diare kronis yang tidak jelas penyebabnya yang berlangsung lebih dari
satu bulan, infeksi bakteri yang parah, dan TBC paru-paru), atau

Tahap IV (meliputi Toksoplasmosis pada otak, Kandidiasis pada saluran tenggorokan
(oesophagus), saluran pernafasan (trachea), batang saluran paru-paru (bronchi) atau paru-paru
dan Sarkoma Kaposi). Penyakit HIV digunakan sebagai indikator AIDS.

2. HIV Melemahkan Sistem Kekebalan Manusia
Sasaran penyerangan HIV adalah Sistem Kekebalan Tubuh, terutama adalah sel-sel
Limfosit T4. Selama terinfeksi, limfosit menjadi wahana pengembangbiakan virus. Bila selsel Limfosit T4 -nya mati, virus akan dengan bebas menyerang sel-sel Limfosit T4 lainnya
yang masih sehat. Akibatnya, daya tahan tubuh menurun.
Akhirnya sistem kekebalan tak mampu melindungi tubuh, sehingga kuman penyakit
infeksi lain (kadang disebut Infeksi Oportunistik / Infeksi Mumpung) akan masuk dan
menyerang tubuh orang tersebut. Bahkan kuman-kuman lain yang jinak tiba-tiba menjadi
ganas. Kumannya bisa Virus lain, Bakteri, Mikroba, Jamur, maupun Mikroorganisme
patogen lainnya. Penderita bisa meninggal karena TBC, Diare, Kanker kulit, Infeksi Jamur,
dll.
Bila seseorang telah seropositif terhadap HIV, maka dalam tubuhnya telah
mengandung HIV. Dalam jumlah besar HIV terdapat dalam darah, cairan vagina, air mani
serta produk darah lainnya. Apabila sedikit darah atau cairan tubuh lain dari pengidap HIV
berpindah secara langsung ke tubuh orang lain yang sehat, maka ada kemungkinan orang
lain tersebut tertular AIDS. Cara penularan yang paling umum ialah: senggama, transfusi
darah, jarum suntik dan kehamilan. Penularan lewat produk darah lain, seperti ludah, kotoran,
keringat, dll. secara teoritis mungkin bisa terjadi, namun resikonya sangat kecil.

3. Penularan HIV
Bila seseorang telah seropositif terhadap HIV, maka dalam tubuhnya telah
mengandung HIV. Dalam jumlah besar HIV terdapat dalam darah, cairan vagina, air mani
serta produk darah lainnya. Apabila sedikit darah atau cairan tubuh lain dari pengidap HIV
berpindah secara langsung ke tubuh orang lain yang sehat, maka ada kemungkinan orang lain
tersebut tertular AIDS. Cara penularan yang paling umum ialah: senggama, transfusi darah,
jarum suntik dan kehamilan. Penularan lewat produk darah lain, seperti ludah, kotoran,
keringat, dll. secara teoritis mungkin bisa terjadi, namun resikonya sangat kecil.

a. Penularan lewat senggama :

Pemindahan yang paling umum dan paling sering terjadi
senggama, dimana HIV dipindahkan melalui

cairan

sperma

atau

ialah melalui
cairan vagina.

Adanya luka pada pihak penerima akan memperbesar kemungkinan penularan. Itulah
sebabnya pelaku senggama yang tidak wajar (lewat dubur terutama), yang cenderung lebih
mudah menimbulkan luka, memiliki kemungkinan lebih besar untuk tertular HIV.
b. Penularan lewat transfusi darah :
Jika darah yang ditranfusikan telah terinfeksi oleh HIV , maka virus HIV akan
ditularkan kepada orang yang menerima darah, sehingga orang itupun akan terinfeksi
virus HIV. Risiko penularan melalui transfusi darah ini hampir 100 %.
c.

Penularan lewat jarum suntik :
Model penularan lain secara teoritis dapat terjadi antara lain melalui :

1) Penggunaan akupunktur (tusuk jarum), tatoo, tindikan.
2) Penggunaan alat suntik atau injeksi yang tidak steril, sering dipakai oleh para pengguna
narkoba suntikan, juga suntikan oleh petugas kesehatan liar.
d. Penularan lewat kehamilan :
Jika ibu hamil yang dalam tubuhnya terinfeksi HIV , maka HIV dapat menular
ke janin yang dikandungnya melalui darah dengan melewati plasenta. Risiko penularan Ibu
hamil ke janin yang dikandungnya berkisar 20% - 40%. Risiko ini mungkin lebih besar
kalau ibu telah menderita kesakitan AIDS (full blown).
HIV tidak akan menular melalui bersalaman, berpelukan, berciuman, batuk, bersin,
memakai peralatan rumah tangga seperti alat makan, telepon, kamar mandi, kamar tidur,
gigtan nyamuk, bekerja, bersekolah, berkendaraan bersama, dan memakai fasilitas umum
misalnya kolam renang, toilet umum, sauna.
HIV tidak dapat menular melalui udara. Virus ini juga cepat mati jika berada di luar
tubuh. Virus ini dapat dibunuh jika cairan tubuh yang mengandungnya dibersihkan dengan
cairan pemutih (bleach) seperti Bayclin atau Chlorox, atau dengan sabun dan air. HIV tidak
dapat diserap oleh kulit yang tidak luka.

4. HIV mengakibatkan AIDS
Infeksi HIV menyebabkan penurunan dan melemahnya sistem kekebalan tubuh. Hal
ini menyebabkan tubuh rentan terhadap infeksi penyakit dan dapat menyebabkan
berkembangnya AIDS. Virus HIV membutuhkan waktu untuk menyebabkan sindrom AIDS
yang mematikan dan sangat berbahaya. Penyakit AIDS disebabkan oleh melemah atau

menghilangnya sistem kekebalan tubuh yang tadinya dimiliki karena sel CD4 pada sel darah
putih banyak dirusak oleh Virus HIV.
Ketika manusia terkena Virus HIV belum tentu terkena AIDS. Untuk menjadi AIDS
dibutuhkan waktu yang lama, yaitu beberapa tahun untuk dapat menjadi AIDS yang
mematikan. Dengan gaya hidup sehat, jarak waktu antara infeksi HIV dan menjadi sakit
karena AIDS dapat berkisar antara 10-15 tahun, kadang-kadang bahkan lebih lama. Terapi
antiretroviral dapat memperlambat perkembangan AIDS dengan menurunkan jumlah virus
(viral load) dalam tubuh yang terinfeksi.
Ada beberapa tahapan ketika seseorang dikatakan terinfeksi HIV hingga terkena
AIDS. Tahapan-tahapan itu antara lain:
1.

Tahap 1: Periode Jendela

a) HIV masuk ke dalam tubuh, sampai terbentuknya antibody terhadap HIV dalam darah
b) Tidak ada tanda2 khusus, penderita HIV tampak sehat dan merasa sehat
c) Test HIV belum bisa mendeteksi keberadaan virus ini
d) Tahap ini disebut periode jendela, umumnya berkisar 2 minggu - 6 bulan
2.

Tahap 2: HIV Positif (tanpa gejala) rata-rata selama 5-10 tahun:

a) HIV berkembang biak dalam tubuh
b) Tidak ada tanda-tanda khusus, penderita HIV tampak sehat dan merasa sehat
c)

Test HIV sudah dapat mendeteksi status HIV seseorang, karena telah terbentuk antibody
terhadap HIV

d) Umumnya tetap tampak sehat selama 5-10 tahun, tergantung daya tahan tubuhnya (rata-rata 8
tahun (di negara berkembang lebih pendek)
3.

Tahap 3: HIV Positif (muncul gejala)

a) Sistem kekebalan tubuh semakin turun
b) Mulai muncul gejala infeksi oportunistik, misalnya: pembengkakan kelenjar limfa di seluruh
tubuh, diare terus menerus, flu, dll
c) Umumnya berlangsung selama lebih dari 1 bulan, tergantung daya tahan
4.

Tahap 4: AIDS

a) Kondisi sistem kekebalan tubuh sangat lemah
b) Berbagai penyakit lain (infeksi oportunistik) semakin parah

tubuhnya

5. Cara Melindungi Diri dari Penularan AIDS
Sampai saat ini belum ada jenis obat khusus untuk menyembuhkan orang yamg
terkena infeksi HIV/ AIDS. Hanya saja perkembangan virus ini dapat diperlambat.
Kombinasi yang tepat antara berbagai obat-obatan antiretroviral dapat memperlambat
kerusakan yang diakibatkan oleh HIV pada sistem kekebalan tubuh dan menunda awal
terjadinya AIDS. Pengobatan dan perawatan yang ada terdiri dari sejumlah unsur yang
berbeda, yang meliputi konseling dan tes mandiri (VCT), dukungan bagi pencegahan
penularan HIV, konseling tindak lanjut, saran-saran mengenai makanan dan gizi, pengobatan
IMS, pengelolaan efek nutrisi, pencegahan dan perawatan infeksi oportunistik (IOS), dan
pemberian obat-obatan antiretroviral.
Dalam suatu sel yang terinfeksi, HIV mereplikasi diri, yang kemudian dapat
menginfeksi sel-sel lain dalam tubuh yang masih sehat. Semakin banyak sel yang diinfeksi
HIV,

semakin

besar

dampak

yang

ditimbulkannya

terhadap

kekebalan

tubuh

(immunodeficiency). Obat antiretroviral digunakan dalam pengobatan infeksi HIV. Obatobatan ini bekerja melawan infeksi itu sendiri dengan cara memperlambat reproduksi HIV
dalam tubuh. Obat-obatan antiretroviral memperlambat replikasi sel-sel, yaitu memperlambat
penyebaran virus dalam tubuh dengan cara mengganggu proses replikasi. Cara yang
dilakukan antara lain sebagai berikut :
a. Menghambat Nucleoside Reverse Transcriptase (NRTI)
HIV memerlukan enzim yang disebut reverse transcriptase untuk mereplikasi diri.
Jenis obat-obatan ini memperlambat kerja reverse transcriptase dengan cara mencegah proses
pengembangbiakkan materi genetik virus tersebut.

b. Menghambat Non-Nucleoside Reverse Transcriptase (NNRTI)
Jenis obat-obatan ini juga mengacaukan replikasi HIV dengan mengikat enzim
reverse transcriptase itu sendiri. Hal ini mencegah agar enzim ini tidak bekerja dan
menghentikan produksi partikel virus baru dalam sel-sel yang terinfeksi.
c.

Menghambat Protease (PI)
Protease merupakan enzim pencernaan yang diperlukan dalam replikasi HIV untuk
membentuk partikel-partikel virus baru. Protease memecah belah protein dan enzim dalam
sel-sel yang terinfeksi, yang kemudian dapat menginfeksi sel yang lain. Penghambat protease
mencegah pemecah-belahan protein dan karenanya memperlambat produksi partikel virus
baru.

Setiap orang, khususnya remaja harus “melindungi diri “ dari AIDS. Karena kalau
seorang remaja tertular HIV, maka keseluruhan cita-cita dan masa depan remaja tersebut
hancur lebur. Secara mudah, perlindungan dari AIDS dilakukan dengan cara ‘ABC’, ialah:
a.

[A] : Abstinence) alias PUASA
Bagi remaja yang belum menikah. Jauhkan diri dari zina. Onani atau masturbasi, merangsang
diri sendiri sehingga puas (orgasmus) sebenarnya kurang baik. Namun resikonya paling kecil.
Jadi dalam keadaan yang benar-benar tidak kuasa menahan diri dan tidak mampu berpuasa,
onani dapat dijadikan jalan keluar. Asal jangan menjadi kebiasaan. Jangan terlalu sering.

b. [B] : Be Faithful alias Setia Pasangan Hidup
Bagi mereka yang sudah menikah. Hanya bersenggama dengan pasangan setianya. Sebagian
besar satu suami dengan satu istri. Dalam keadaan khusus satu suami dengan 2-4 istri, namun
yang penting kesetiaan dari semua pihak, baik istri maupun suami. Di sinipun, bila suami istri
berpisah dalam waktu lama, onani merupakan jalan keluar sementara yang paling tidak
beresiko.

c.

[C] Condom alias Kondom
Bagi mereka yang berada dalam keadaan-keadaan khusus, antara lain ialah para suami atau
remaja yang tidak kuat puasa atau setia (atau onani), dan masih terdorong melakukan zina.
Pemakaian kondom akan melindungi mereka dari penularan PHS dan AIDS, dan melindungi
istri atau pacar mereka dari penularan penyakit. Bagi para pelacur, patut ditumbuhkan
motivasi memakaikan kondom pada pasangan kencan mereka. Dalam keadaan darurat,
misalnya pasangan suami-istri di mana salah satu menderita PHS, juga AIDS, pemakaian
kondom amat dianjurkan untuk mencegah pen

ularan AIDS lebih lanjut kepada

pasangannya. Yang penting dalam pemakaian kondom ialah (sambil dipraktekkan)
melindungi keseluruhan penis dan dipakai sepanjang proses senggama untuk menghindari
sentuhan antara penis dan vagina.

Selain itu, perlindungan yang sangat penting ialah:
a) Hindari transfusi, dengan selalu berhati-hati. Bila terpaksa ditransfusi, yakinkan bahwa
darah yang ditransfusi adalah darah yang

telah

diperiksa

oleh Unit Kesehatan

Transfusi Darah (UKTD) PMI sebagai darah bebas HIV (juga bebas hepatitis, malaria dan
sifilis).

b) Hindari suntik-menyuntik. Sebagian besar obat sama atau lebih efektif diminum daripada
disuntikkan. Bila terpaksa disuntik, yakinkah jarum dan tabung suntiknya baru dan belum
dipakai untuk orang lain.
c) Berhati-hatilah dalam menolong orang luka dan berdarah. Gunakan prosedur P3K yang baku
dan aman.
d) Bila ada sesuatu tanda atau gejala yang meragukan, secepatnya periksa ke dokter.

BAB III
PENUTUP
1. Kesimpulan
a.

HIV merupakan sebuah virus berbahaya yang dapat merusak sistem kekebalan tubuh
manusia. Selain itu, virus inilah yang menyebabkan AIDS.

b.

AIDS (Aqcuired Immune Deficiency Syndrome) adalah kumpulan gejala penurunan
kekebalan tubuh sehingga tubuh rentan terhadap penyakit lain yang mematikan.

c.

Cara penularan HIV yang paling umum ialah melalui senggama, transfusi darah, jarum
suntik dan kehamilan. Penularan lewat produk darah lain, seperti ludah, kotoran, keringat, dll.
secara teoritis mungkin bisa terjadi, namun resikonya sangat kecil.

d. Secara mudah, perlindungan dari AIDS dilakukan dengan cara ‘ABC’, yaitu Abstinence, Be
faithful, Condom.

2. Saran
Sebagai insan yang yang berpendidikan sudah menjadi sebuah kewajiban untuk
berpartisipasi dalam memerangi HIV/ AIDS. Untuk memerangi hal itu dapat dimulai dari
kesadaran diri sendiri untuk selalu menjaga diri agar terhindar dari HIV/ AIDS.

Sebatas.com – Ciri-ciri Positif Terinfeksi HIV – HIV Aids merupakan penyakit yang
sangat mengerikan dan menakutkan bagi setiap orang. Seseorang yang terinfeksi virus HIV
kadang tidak akan menyadarinya sebelum virus tersebut menyebar dalam tubuhnya.
Waktunya tidak tentu, bisa 2, 3 atau 10 tahun ke depan. Tanda-tanda tersebut dapat terlihat
bila masa inkubasi virus telah berakhir. Oleh karena itu harus melakukan tes laboratorium
untuk mengetahui apakah terinfeksi HIV atau tidak.
Namun selain itu, ada beberapa tanda dasar yang mungkin terlihat bila seseorang terinfeksi
virus HIV, seperti berikut:
1. Deman tiba-tiba. Ketika virus mulai menginfeksi, biasanya akan muncul demam tiba-tiba
yang disertai dengan batuk dan flu. Hal tersebut hanya terjadi dalam beberapa hari, lalu
seusainya bisa saja tidak ada tanda-tanda lain selama bertahun-tahun.
2. Sering merasa lelah. Meski istirahat sudah cukup, makan makanan bergizi dan tidak
banyak melakukan aktivitas namun tetap sering merasa kelelahan, ini bisa jadi tanda awal
bahwa seseorang terinfeksi HIV.
3. Pembengkakan kelenjar getah bening. Terjadinya pembengkakan kelenjar getah bening
dan sakit pada otot, karena virus HIV kebanyakan menyerang pada cairan limpha.
4. Kulit menjadi sensitif. Kulit menjadi sensitif dan mudah merah serta berdarah meski hanya
terkena sentuhan kecil atau goresan.
5. Sering merasa pusing. Sering kali merasakan pusing yang terus-menerus dan tidak putus
disertai demam serta kelelahan.
6. Perubahan pada kuku. Kuku akan tampak rapuh, bergelombang dan berubah menjadi
warna atau bahkan tipis dan transparan.
Jika mengalami beberapa tanda diatas, ada sebaiknya untuk segera mengetes ke laboratorium
untuk menjaga-jaga dan sebisa mungkin untuk mencegah virus tersebut menyebar dalam
tubuh
seseorang.

1.Understanding HIV / AIDS
HIV (Human I mmunodeficiency Virus) is a virus that attacks the human immune system that causes
AIDS.
HIV is found in body fluids, especially blood, semen, vaginal fluids and breast milk.
HIV is a retrovirus that infects cells of the human immune system, particularly CD4 positive T-cells
and macrophages (key components of the immune system cells) and destroys or impairs their
function. This viral infection resulted in a decline in the immune system that constantly, which would
result in immune deficiency.
AIDS (Acquired Immune Deficiency Syndrome) is a collection of symptoms decreased immunity,
making the body vulnerable to other deadly diseases. AIDS is caused by a virus (Sub-organism's
body) is called with HIV. whereas HIV (Human Immunodeficiency Virus) is the virus itself that attacks
the human immune system that causes AIDS.

explanation HIV
Someone who is HIV positive, do not necessarily have AIDS. Many cases where a person is HIV
positive, but did not become ill in the long term. However, existing HIV in a person's body will
continue to damage the immune system. As a result, viruses, fungi and bacteria are usually harmless
to extremely dangerous because of the destruction of the body's immune system.
The immune system is considered deficient when the system can no longer perform its function in
the fight against infections and diseases. People who are immune deficient (Immunodeficient)
become more susceptible to a wide range of infections, most of which rarely infects people who are
not immune deficient. Diseases associated with severe immune deficiency known as "opportunistic
infections" because these infections take advantage of a weakened immune system.

AIDS used to the stages of the most advanced HIV infection.
Phase I HIV disease have no symptoms and are not categorized as AIDS.
· Phase II (includes minor mucocutaneous manifestations and infections of the upper respiratory
tract that does not heal)
· Phase III (including chronic diarrhea is not clear why that lasted more than a month, severe
bacterial infections and pulmonary tuberculosis), or
· Stage IV (includes Toxoplasmosis of the brain, candidiasis in the channel throat (esophagus),
respiratory tract (trachea), pulmonary trunk channel (bronchi) or lungs and Kaposi's sarcoma). Used
as an indicator of HIV disease AIDS.

transmission of HIV
When someone has been seropositive for HIV, then the body already contains HIV. Large amounts of
HIV in the blood, vaginal fluid, semen, and other blood products. If a little blood or other body fluids
of people with HIV was transferred directly to another person's body is healthy, then it is possible
that other people infected with AIDS. The most common modes of transmission are: sexual
intercourse, blood transfusion, needle and pregnancy. Transmission through blood products, such as
saliva, feces, sweat, etc.. theoretically might occur, but the risk is very small.

AIDS can be transmitted through:
a. Transmission through intercourse
b. Transmission through blood transfusion
c. Transmission through syringe
d. Transmission through pregnancy

How to Protect Yourself from AIDS Transmission
-avoid transfusion and was always careful
-Avoid injecting syringe
-Be careful in helping people injured and bleeding.
-If there is something dubious signs or symptoms, see a doctor immediately.

conclusion
a. HIV is a harmless virus that can damage the human immune system. In addition, the virus that
causes AIDS.
b. AIDS (Aqcuired Immune Deficiency Syndrome) is a collection of symptoms that decrease the
body's immune system vulnerable to other deadly diseases.
c. Modes of transmission of HIV is the most common is through intercourse, blood transfusions,
needles and pregnancy. Transmission through blood products, such as saliva, feces, sweat, etc..
theoretically might occur, but the risk is very small.
d. Easily, protection from AIDS is done by 'ABC', that is Abstinence, Be faithful, Condom.

suggestion
As an educated man who has become an obligation to participate in the fight against HIV / AIDS. To
combat it can be started from self-awareness to always keep themselves to avoid HIV / AIDS.

This article is about a form of sexual assault. For other uses, see Rape (disambiguation). For
rape among non-human animals, see Sexual coercion.

Sexual assault
Classification and external resources

The rape of noblewoman Lucretia was a starting
point of events that led to the overthrow of the
Roman Kingdom and establishment of the Roman
Republic. As a direct result of rape, Lucretia
committed suicide. Many artists and writers were
inspired by the story, including Shakespeare,
Botticelli, Rembrandt, Dürer, Artemisia Gentileschi,
Geoffrey Chaucer, Thomas Heywood and others.
E960.1
ICD-9
001955
MedlinePlus
article/806120
eMedicine
D011902
MeSH
Rape is a type of sexual assault usually involving sexual intercourse, which is initiated by
one or more persons against another person without that person's consent. The act may be
carried out by physical force, coercion, abuse of authority or against a person who is
incapable of valid consent, such as one who is unconscious, incapacitated, or below the legal
age of consent.[1][2][3][4]
Internationally, the incidence of rapes recorded by the police during 2008 varied between 0.1
in Egypt per 100,000 people and 91.6 per 100,000 people in Lesotho with 4.9 per 100,000
people in Lithuania as the median.[5] According to the American Medical Association (1995),
sexual violence, and rape in particular, is considered the most underreported violent
crime.[6][7] The rate of reporting, prosecution and convictions for rape varies considerably in
different jurisdictions. The U.S. Bureau of Justice Statistics (1999) estimated that 91% of
U.S. rape victims are female and 9% are male, with 99% of the offenders being male.[8] Rape
by strangers is usually less common than rape by persons the victim knows,[9][10][11][12][13] and

several studies argue that male-male and female-female prison rape are quite common and
may be the least reported forms of rape.[14][15][16]
When part of a widespread and systematic practice, rape and sexual slavery are recognized as
crimes against humanity and war crimes. Rape is also recognized as an element of the crime
of genocide when committed with the intent to destroy, in whole or in part, a targeted ethnic
group.
People who have been raped can be severely traumatized and may suffer from
posttraumatic stress disorder;[17] in addition to psychological harm resulting from the
act, rape may cause physical injury, or have additional effects on the victim, such as
acquiring of a sexually transmitted infection or becoming pregnant. Furthermore,
following a rape, a victim may face violence or threats of thereof from the rapist, and, in
some cultures, from the victim's own family and relatives.[18][19][20]

Definitions
Main article: Types of rape
See also: Rape by gender
There are several types of rape, generally categorized by reference to the situation in which it
occurs, the sex or characteristics of the victim, and/or the sex or characteristics of the
perpetrator. Different types of rape include date rape, gang rape, marital rape, incestual rape,
child sexual abuse, prison rape, acquaintance rape, war rape and statutory rape.[21]

Penetrative and non-penetrative
See also: Laws regarding rape
The definition of rape varies both in different parts of the world and at different times in
history.[22] It is defined in many jurisdictions as sexual intercourse, or other forms of sexual
penetration, of one person by another person without the consent of the victim.[22] The United
Nations Office on Drugs and Crime defines it as "sexual intercourse without valid
consent,"[5][23] and the World Health Organization defined it in 2002 as "physically forced or
otherwise coerced penetration – even if slight – of the vulva or anus, using a penis, other
body parts or an object".[24]
In 2012, the FBI changed their definition from "The carnal knowledge of a female forcibly
and against her will." to "The penetration, no matter how slight, of the vagina or anus with
any body part or object, or oral penetration by a sex organ of another person, without the
consent of the victim." for their annual Uniform Crime Reports. The definition, which had
remained unchanged since 1927, was considered outdated and narrow. The updated definition
includes any gender of victim and perpetrator, not just women being raped by men,
recognizes that rape with an object can be as traumatic as penile/vaginal rape, includes
instances in which the victim is unable to give consent because of temporary or permanent
mental or physical incapacity, and recognizes that a victim can be incapacitated and thus
unable to consent because of ingestion of drugs or alcohol. However, the definition does not
change federal or state criminal codes or impact charging and prosecution on the federal,
state or local level; it rather means that rape will be more accurately reported
nationwide.[25][26]

Some countries, such as Germany, are now using more inclusive definitions which do not
require penetration,[22] and the 1998 International Criminal Tribunal for Rwanda defines it as
"a physical invasion of a sexual nature committed on a person under circumstances which are
coercive".[22] In some jurisdictions, the term "rape" has been phased out of legal use in favor
of terms such as "sexual assault" or "criminal sexual conduct".[27] Other countries or
jurisdictions continue to define rape to cover only acts involving penile penetration of the
vagina, treating all other types of non-consensual sexual activity as sexual assault. Scotland,
for instance, requires that a rapist commit a sexual assault with a penis, so only males can
legally be rapists.

Consent
In any allegation of rape, the absence of consent to sexual intercourse on the part of the
victim is critical.[4] Consent need not be expressed, and may be implied from the context and
from the relationship of the parties, but the absence of objection does not of itself constitute
consent. Lack of consent may result from either forcible compulsion by the perpetrator or an
incapacity to consent on the part of the victim (such as persons who are asleep, intoxicated or
otherwise mentally helpless).[4][28] The law can also invalidate consent in the case of sexual
intercourse with a person below the age at which they can legally consent to such relations
with older persons. (See age of consent.) Such cases are sometimes called statutory rape or
"unlawful sexual intercourse", regardless of whether it was consensual or not, as people who
are under a certain age in relation to the perpetrator are deemed legally incapable of
consenting to sex.[4] Consent can always be withdrawn at any time, so that any further sexual
activity after the withdrawal of consent constitutes rape.
Duress, in which the victim may be subject to or threatened by overwhelming force or
violence, and which may result in absence of objection to intercourse, leads to the
presumption of lack of consent.[28] Duress may be actual or threatened force or violence
against the victim or somebody else close to the victim. Even blackmail may constitute
duress. Abuse of power may constitute duress. For instance, in Philippines, a man commits
rape if he engages in sexual intercourse with a woman "By means of fraudulent machination
or grave abuse of authority".[29] The International Criminal Tribunal for Rwanda in its
landmark 1998 judgment used a definition of rape which did not use the word 'consent': "a
physical invasion of a sexual nature committed on a person under circumstances which are
coercive."[30]

Marital rape
Main article: Marital rape
Marital rape, also known as spousal rape, is non-consensual sex in which the perpetrator is
the victim's spouse. As such, it is a form of partner rape, of domestic violence, and of sexual
abuse. Once widely condoned or ignored by law, spousal rape is now repudiated by
international conventions and increasingly criminalized. Still, in many countries, spousal rape
either remains legal, or is illegal but widely tolerated and accepted as a husband's prerogative.
In 2006, it was estimated that marital rape could be prosecuted in at least 104 countries (in
four of these countries, marital rape could be prosecuted only when the spouses were
judicially separated),[31] and since 2006 several other countries have outlawed marital rape. In
the US, spousal rape is illegal in all 50 states; the first state to outlaw it was South Dakota in

1975,[32] and the last North Carolina in 1993.[33] In many countries, it is not clear if marital
rape may or may not be prosecuted under ordinary rape laws. However, in the absence of a
spousal rape law it may be possible to bring prosecutions for what is effectively rape by
characterizing it as an assault.
Throughout much of the history, in most cultures, sex in marriage was considered a 'right',
that could be taken by force, if 'denied'. As the concept of human rights started to develop in
the 20th century, and with the arrival of second wave feminism, such views have become less
widely held. The legal and social concept of marital rape, has developed, in most
industrialized countries, in the mid to late 20th century; and in many parts of the world it is
still not recognized, socially and legally, as a form of abuse. Several countries in Eastern
Europe and Scandinavia made marital rape illegal before 1970, but other countries in Western
Europe and the English-speaking Western World outlawed it much later, mostly in the 1980s
and 1990s. In England and Wales, marital rape was made illegal in 1991. The views of Sir
Matthew Hale, a 17th-century jurist, published in The History of the Pleas of the Crown
(1736), stated that a husband cannot be guilty of the rape of his wife because the wife "hath
given up herself in this kind to her husband, which she cannot retract"; in England and Wales
this would remain law for more than 250 years, until it was abolished by the Appellate
Committee of the House of Lords, in the case of R v R in 1991.[34]
There have been various justifications historically for the "marital exemption", that is, a rule,
statutory and/or in common law/case law, which precluded the prosecution of husbands for
rape. In English common law, this was based on the idea of implied consent: when a woman
was married she was deemed to be consenting to lifelong sexual intercourse with her
husband, as such, if there was consent, there was no rape. Under Roman Dutch law, a wife
was subjected to the marital power of her husband. A husband had a right to sexual
intercourse with his wife, his status afforded to him by the marital power gave him the right
to use "moderate chastisement" to force his wife into performing marital duties - sex was a
marital duty, and, as such, he could force her into doing it, this was not rape.
Historically, most religions were interpreted as tolerating or ignoring forced sexual relations
in marriage; however Judaism has been considered an exception to this way of thinking; in
fact, in Israel, in 1980, when the Israeli Supreme Court affirmed that marital rape is a crime,
it was mostly religious arguments based on the Talmud that were given by the judges.[35][36]
In 1924, in G v G, a case involving the annulment of a marriage because the wife had refused
to have sexual intercourse with her husband, Lord Dunedin expressed his view that "gentle
violence" in order to enforce sex would have been desirable.[37] Such views were by no
means extreme at that time; in fact, the view that if a husband desires to have sex with his
wife, there must be full consent from her, and that if he ignores her refusal and forces himself
on her, he is committing a crime, is a modern view, which is, or at least has been until very
recently, largely restricted to the Western world; in many parts of the world marital rape is a
very new concept that is only now being introduced and discussed. In many parts of the
world, where women have very few rights, it is considered unthinkable for a woman to refuse
her husband's sexual demands: for instance one survey found that 74% of women in Mali said
that a husband is justified to beat his wife if she refuses to have sex with him.[38]
Because traditionally forced sex was considered a right of a husband, it was not considered a
form of abuse or a wrongdoing, and therefore it was not considered a ground for divorce for
the wife. An exemplification of these views can be seen in an 1985 Tokyo district court

decision which denied a woman‘s request for divorce on grounds of the husband having
compelled her through physical force to have sex with him; the judge ruled:
"The marriage presupposes sexual union between both sexes. It is in no way illegal
for a husband to demand sexual intercourse from a wife, nor does a wife have any
rights to deny such a request. Because of the plaintiff's [wife] complete refusal of a
sexual relationship for no reason, the defendant [husband] became sexually frustrated,
could not tolerate it, and forced sexual intercourse upon the plaintiff.(...) Although it
involved a certain degree of violent acts, it is within the range of the degree of force
used in fights among ordinary married couples, and thus, it does not warrant a special
consideration [by court]."[39]
In cultures influenced by Christianity, the religious concept of "marital debt" (explained in
the Bible at 1 Corinthians 7:3-5[40]), that is, a duty to have marital sex with one's spouse (in
sharp opposition with the prohibition of premarital/ extramarital sex) has played a role in
precluding husbands from being prosecuted with rape. The verse "The wife does not have
authority over her own body, but the husband does. And likewise the husband does not have
authority over his own body, but the wife does. Do not deprive one another (...)"[40] has been
central in the religious debate on marital rape.
The concept of marital rape is controversial in Islam, too, due to certain religions
teachings, such as: "Allah's Apostle said, 'If a husband calls his wife to his bed [i.e. to
have sexual relations] and she refuses and causes him to sleep in anger, the angels will
curse her till morning'."[41]

Motivation of perpetrators
Further information: Causes of sexual violence
The World Health Organization (WHO) states that the principal factors that lead to the
perpetration of sexual violence, including rape, are:[42]
beliefs in family honor and sexual purity;
ideologies of male sexual entitlement;
weak legal sanctions for sexual violence.
However, there is no single scientific theory that conclusively explains the motivation for
rape; the motives of rapists can be multi-factorial and are subject to debate. Several factors
have been proposed: anger; a desire for power; sadism; sexual gratification in tandem with
evolutionary proclivities.[43][44]

Effects
See also: Effects and aftermath of rape and Pregnancy from rape
Victims of rape can be severely traumatized by the assault and may have difficulty
functioning as well as they had been used to prior to the assault, with disruption of
concentration, sleeping patterns and eating habits, for example. They may feel jumpy or be
on edge. After being raped, it is common for the victim to experience acute stress disorder,

including symptoms similar to those of posttraumatic stress disorder, such as intense,
sometimes unpredictable emotions, and they may find it hard to deal with their memories of
the event.[45][46] In the months immediately following the assault, these problems may be
severe and upsetting and may prevent the victim from revealing their ordeal to friends or
family, or seeking police or medical assistance. Additional symptoms of Acute Stress
Disorder include:[46]
Depersonalization or dissociation (feeling numb and detached, like being in a daze or
a dream, or feeling that the world is strange and unreal)
Difficulty remembering important parts of the assault
Reliving the assault through repeated thoughts, memories, or nightmares
Avoidance of things, places, thoughts, and/or feelings that remind the victim of the
assault
Anxiety or increased alertness (difficulty sleeping, concentrating, etc.)
Avoidance of social life or place of rape
For one-third to one-half of the victims, these symptoms continue beyond the first few
months and meet the conditions for the diagnosis of posttraumatic stress disorder.[45][47][48] In
general, rape and sexual assault are among the most common causes of PTSD in women.[47]
Pregnancy can also result from rape.[49][50]

HIV/AIDS
Rape may result in the transmission of HIV/AIDS, and this is especially a problem in parts of
the world where the disease is endemic, such as Sub-Saharan Africa. Some estimate that
around 60% of combatants in Congo are HIV-infected.[51]
Rape acts both as a direct factor, as the virus can be transmitted through the forced sexual
intercourse, and as an indirect factor, as victims of rape are at higher risk of suffering
psychological problems, which may lead to victims being more likely to engage in behaviors
that create risk of contracting HIV/AIDS, such as injecting drugs.[52]
In many parts of Africa, the myth that sex with a virgin can cure HIV/AIDS continues to
prevail, and, as such, many young girls are raped.

Victim blaming
Main article: Victim blaming
"Victim blaming" is holding the victim of a crime to be in whole or in part responsible for the
crime. In the context of rape, this concept refers to the Just World Theory and popular
attitudes that certain victim behaviours (such as flirting, or wearing sexually provocative
clothing) may encourage rape.[56] In extreme cases, victims are said to have "asked for it",
simply by not behaving demurely. In most Western countries, the defense of provocation is
not accepted as a mitigation for rape.[57] A global survey of attitudes toward sexual violence
by the Global Forum for Health Research shows that victim-blaming concepts are at least
partially accepted in many countries. In some countries[which?], victim-blaming is more
common, and women who have been raped are sometimes deemed to have behaved
improperly. Often, these are countries where there is a significant social divide between the

freedoms and status afforded to men and women.[58] Amy M. Buddie and Arthur G. Miller, in
a review of studies of rape myths, state:
Rape victims are blamed more when they resist the attack later in the rape encounter rather
than earlier (Kopper, 1996), which seems to suggest the stereotype that these women are
engaging in token resistance (Malamuth & Brown, 1994; Muehlenhard & Rogers, 1998) or
leading the man on because they have gone along with the sexual experience thus far. Finally,
rape victims are blamed more when they are raped by an acquaintance or a date rather than
by a stranger (e.g., Bell, Kuriloff, & Lottes, 1994; Bridges, 1991; Bridges & McGr ail, 1989;
Check & Malamuth, 1983; Kanekar, Shaherwalla, Franco, Kunju, & Pinto, 1991; L'Armand
& Pepitone, 1982; Tetreault & Barnett, 1987), which seems to evoke the stereotype that
victims really want to have sex because they know their attacker and perhaps even went out
on a date with him. The underlying message of this research seems to be that when certain
stereotypical elements of rape are in place, rape victims are prone to being blamed.
However, they also state that "individuals may endorse rape myths and at the same time
recognize the negative effects of rape."[59] A number of gender role stereotypes can play a
role in rationalization of rape. In the case of male-on-female rape, these include the idea that
power is reserved to men whereas women are meant for sex and objectified, that women want
forced sex and to be pushed around,[60] and that male sexual impulses and behaviors are
uncontrollable and must be satisfied.[61] In the case of female-on-male rape, the victim may
either be perceived as weak or, in cultures where men acquire status by sexual conquest, as
fortunate.
It has been proposed by Dr. Roxanne Agnew-Davies, a clinical psychologist and an expert on
the effects of sexual violence, that victim-blaming correlates with fear. "It is not surprising
when so many rape victims blame themselves. Female jurors can look at the woman in the
witness stand and decide she has done something 'wrong' such as flirting or having a drink
with the defendant. She can therefore reassure herself that rape won't happen to her as long as
she does nothing similar."[62]

Honor killings, violence by and forced marriages to the rapist
In many cultures, those who are raped are at very high risk of suffering additional violence or
threats of violence after the rape. These acts may be perpetrated by the rapist or by friends
and relatives of the rapist, as a way of preventing the victims from reporting the rape, of
punishing them for reporting it, or of forcing them to withdraw the complaint; or they may be
perpetrated by the relatives of the victim as a punishment for "bringing shame" to the family.
This is especially the case in cultures where female virginity is highly valued and considered
mandatory before marriage; in extreme cases, rape victims are killed in honor
killings.[18][19][20]
In some places, girls and women who are raped are often forced by their families to marry
their rapist. Because being the victim of rape and losing virginity carry extreme social stigma,
and the victims are deemed to have their "reputation" tarnished, a marriage with the rapist is
arranged. This is claimed to be in the advantage of both the victim - who does not remain
unmarried and doesn't lose social status - and of the rapist, who avoids punishment. In 2012,
after a Moroccan 16-year-old girl committed suicide after having been forced by her family
to marry her rapist, at the suggestion of the prosecutor, and having endured abuse by the
rapist after they married, there have been protests from activists against the law which allows

the rapist to marry the victim in order to escape criminal sanctions, and against this social
practice which is common in Morocco.[63]

Prosecution
Reporting
Sexual violence, and rape in particular, is considered the most under-reported violent crime
(American Medical Association, 1995).[7] Thus, the number of reported rapes is lower than
both incidence and prevalence rates (Walby and Allen, 2004).[64] The legal requirements for
reporting rape vary by jurisdiction — each U.S. state may have different requirements[65]
while other countries may have less stringent limits.[66]
In Italy, a 2006 National Statistic Institute survey on violence against women found that
91,6% of women who experienced rape did not report it to the police.[67]

Investigation
Main article: Rape investigation
Since the vast majority of rapes are committed by persons known to the victim, the initiation
and process of a rape investigation depends much on the victim's willingness and ability to
report and describe a rape. Biological evidence such as semen, blood, vaginal secretions,
saliva, and vaginal epithelial cells (typically collected by a rape kit) may be identified and
genetically typed by a crime lab. The information derived from the analysis can often help
determine whether sexual contact occurred, provide information regarding the circumstances
of the incident, and be compared to reference samples collected from patients and
suspects.[68]

Conviction
In the United Kingdom, figures on reported rape cases show an ongoing decline in the
conviction rate, putting it at an all time low of 5.6% in 2002. The government has expressed
its concern at the year-on-year increase in attrition of reported rape cases, and pledged to
address this "justice gap" (Home Office, 2002a).[7] In 2003, a study by Rape Crisis Network
Europe found that Ireland had the lowest rate of conviction for rape (1%) among 21 European
states

Prevention and treatment
Main article: Initiatives to prevent sexual violence
As sexual violence affects all parts of society, the response to sexual violence is
comprehensive. The responses can be categorized as: individual approaches, health care
responses, community-based efforts and actions to prevent other forms of sexual violence.
Recovery from sexual assault is a complicated and controversial concept,[70] but support
groups, usually accessed by "umbrella" organizations (see List of anti-sexual assault
organizations in the United States) are prevalent, including some on-line.

Sexual assault may be prevented by secondary school,[71] college,[72][73] and workplace
education programs.[74] At least one program for fraternity men produced "sustained
behavioral change."[72][75]

Statistics
Main article: Rape statistics
See also: Estimates of sexual violence
More than 250,000 cases of rape or attempted rape are recorded by police annually in 65
countries.[76]
In 2007, 40% of the 90,427 forcible rapes reported were cleared by arrest or "exceptional
means." Exceptional means refers to situations where the person refuses to provide
information or assistance necessary to obtain an arrest, the defendant dies before being
arrested, or the defendant cannot be extradited from another state.[77]
Most rape research and reporting to date has been limited to male-female forms of rape.
Research on male-male and female-male rape is beginning to be done. According to
psychologist Dr. Sarah Crome, fewer than one in ten male-male rapes are reported. As a
group, males who have been raped by either gender often get little services and support, and
legal systems are often ill equipped to deal with this type of crime.[78] Denov (2004) states
that societal responses to the issue of female perpetrators of sexual assault "point to a
widespread denial of women as potential sexual aggressors that could work to obscure the
true dimensions of the problem."[79] Due to these reasons, it is likely being substantially
under-reported, with the probable cause being the double standard.[80] Some legal codes on
rape do not legislate against women raping men, as rape is generally defined to include the
act of penetration on behalf of the rapist.[81] In 2007, the South Africa police investigated
instances of women raping young men.[82] Little research has been done on female-female
rape.
The humanitarian news organization IRIN claims that an estimated 500,000 rapes are
committed annually in South Africa,[83] once called ‗the world‘s rape capital.‘[84] The country
has some of the highest incidences of child and baby rape in the world with more than 67,000
cases of rape and sexual assaults against children reported in 2000, with welfare groups
believing that unreported incidents could be up to 10 times higher.[

False accusation
Main article: False accusation of rape
The largest and most rigorous study was commissioned by the British Home Office and based
on 2,643 sexual assault cases (Kelly, Lovett, and Regan, 2005). Of these, 8% were classified
by the police department as false reports. However, the researchers noted that some of these
classifications were based simply on the personal judgments of the police investigators and
were made in violation of official criteria for establishing a false allegation. Closer analysis
of this category applying the Home Office counting rules for establishing a false allegation
and excluding cases where the application of the cases where confirmation of the designation
was uncertain reduced the percentage of false reports to 3%. The researchers concluded that

"one cannot take all police designations at face value" and that "[t]here is an over-estimation
of the scale of false allegations by both police officers and prosecutors." Moreover, they
added:
The interviews with police officers and complainants‘ responses show that despite the focus
on victim care, a culture of suspicion remains within the police, even amongst some of those
who are specialists in rape investigations. There is also a tendency to conflate false
allegations with retractions and withdrawals, as if in all such cases no sexual assault occurred.
This reproduces an investigative culture in which elements that might permit a designation of
a false complaint are emphasized (later sections reveal how this also feeds into withdrawals
and designation of 'insufficient evidence'), at the expense of a careful investigation, in which
the evidence collected is evaluated.[85][86]
Another large-scale study was conducted in Australia, with the 850 rapes reported to the
Victoria police between 2000 and 2003 (Heenan & Murray, 2006). Using both quantitative
and qualitative methods, the researchers examined 812 cases with sufficient information to
make an appropriate determination, and found that 2.1% of these were classified by police as
false reports. All of these complainants were then charged or threatened with charges for
filing a false police report.[87]
FBI reports consistently put the number of "unfounded" rape accusations around 8%. The
unfounded rate is higher for forcible rape than for any other Index crime. The average rate of
unfounded reports for Index crimes is 2%.[88] However, ―unfounded‖ is not synonymous with
false allegation[89] and as Bruce Gross of the Forensic Examiner explains,
This statistic is almost meaningless, as many of the jurisdictions from which the FBI collects
data on crime use different definitions of, or criteria for, "unfounded." That is, a report of
rape might be classified as unfounded (rather than as forcible rape) if the alleged victim did
not try to fight off the suspect, if the alleged perpetrator did not use physical force or a
weapon of some sort, if the alleged victim did not sustain any physical injuries, or if the
alleged victim and the accused had a prior sexual relationship. Similarly, a report might be
deemed unfounded if there is no physical evidence or too many inconsistencies between the
accuser's statement and what evidence does exist. As such, although some unfounded cases of
rape may be false or fabricated, not all unfounded cases are false.

War rape
Main article: War rape
In 1998, Judge Navanethem Pillay of the International Criminal Tribunal for Rwanda said:
From time immemorial, rape has been regarded as spoils of war. Now it will be considered a
war crime. We want to send out a strong message that rape is no longer a trophy of war.
—[118]

La vuelta del malón (The return of the raiders) by Ángel Della Valle (1892).
Rape, in the course of war, dates back to antiquity, ancient enough to have been mentioned in
the Bible.[119] The Israelite, Persian, Greek and Roman armies reportedly engaged in war
rape.[120] The Mongols, who established the Mongol Empire across much of Eurasia, caused
much destruction during their invasions.[121] Documents written during or after Genghis
Khan's reign say that after a conquest, the Mongol soldiers looted, pillaged and raped.[122]
Rogerius, a monk who survived the Mongol invasion of Hungary, pointed out not only the
genocidal element of the occupation, but also that the Mongols especially "found pleasure" in
humiliating women.[123]
The systematic rape of as many as 80,000 women by the Japanese soldiers during the six
weeks of the Nanking Massacre is an example of such atrocities.[124] During World War II an
estimated 200,000 Korean and Chinese women were forced into prostitution in Japanese
military brothels, as so-called "Comfort women".[125] French Moroccan troops known as
Goumiers committed rapes and other war crimes after the Battle of Monte Cassino. (See
Marocchinate.)[126] French women in Normandy complained about rapes during the liberation
of Normandy.[127][128] Soldiers raping women and girls was common in many areas occupied
by the Red Army. A female Soviet war correspondent described what she had witnessed:
"The Russian soldiers were raping every German female from eight to eighty. It was an army
of rapists."[129]
It has been alleged that an estimated 200,000 women were raped during the Bangladesh
Liberation War by the Pakistani army[130] (though this has been disputed by Indian academic
Sarmila Bose[131]), and that at least 20,000 Bosnian Muslim women were raped by Serb
forces during the Bosnian War.[132] Wartime propaganda often alleges, and exaggerates,
mistreatment of the civilian population by enemy forces and allegations of rape figure
prominently in this. As a result, it is often very difficult, both practically and politically, to
assemble an accurate view of what really happened.

A young ethnic Chinese woman who was in one of the Imperial Japanese Army's "comfort
battalions" is interviewed by an Allied officer. August 1945, Rangoon, Burma.
Commenting on rape of women and children in recent African conflict zones UNICEF said
that rape was no longer just perpetrated by combatants but also by civilians. According to
UNICEF rape is common in countries affected by wars and natural disasters, drawing a link
between the occurrence of sexual violence with the significant uprooting of a society and the
crumbling of social norms. UNICEF states that in Kenya reported cases of sexual violence
doubled within days of post-election conflicts. According to UNICEF rape was prevalent in
conflict zones in Sudan, Chad and the Democratic Republic of Congo.[133] It is estimated that
more than 200,000 females living in the Democratic Republic of the Congo today have been
raped in recent conflicts.[134][135][136] A recent study says more than 400,000 women are raped
in the DRC annually.[137]
In 1998, the International Criminal Tribunal for Rwanda found that systematic rape was used
in the Rwandan genocide. The Tribunal held that "sexual assault [in Rwanda] formed an
integral part of the process of destroying the Tutsi ethnic group and that the rape was
systematic and had been perpetrated against Tutsi women only, manifesting the specific
intent required for those acts to constitute genocide."[138] An estimated 500,000 women were
raped during the 1994 Rwandan Genocide.[139]
The Rome Statute, which defines the jurisdiction of the International Criminal Court,
recognizes rape, sexual slavery, enforced prostitution, forced pregnancy, enforced
sterilization, "or any other form of sexual violence of comparable gravity" as crime against
humanity if the action is part of a widespread or systematic practice.[140][141]
Rape was first recognized as crime against humanity when the International Criminal
Tribunal for the former Yugoslavia issued arrest warrants based on the Geneva Conventions
and Violations of the Laws or Customs of War. Specifically, it was recognised that Muslim
women in Foča (southeastern Bosnia and Herzegovina) were subjected to systematic and
widespread gang rape, torture and enslavement by Bosnian Serb soldiers, policemen and
members of paramilitary groups after the takeover of the city in April 1992.[142]
The indictment was of major legal significance and was the first time that sexual assaults
were investigated for the purpose of prosecution under the rubric of torture and enslavement
as a crime against humanity.[142] The indictment was confirmed by a 2001 verdict of the

International Criminal Tribunal for the former Yugoslavia that rape and sexual enslavement
are crimes against humanity. Amnesty International stated that the ruling challenged the
widespread acceptance of the torture of women as an intrinsic part of war.[143]

See also

iscredited HIV/AIDS origins theories
From Wikipedia, the free encyclopedia
Jump to: navigation, search
This article contains hypotheses not currently accepted by the majority of the scientific
community. For the majority view within the scientific community, see History of HIV/AIDS.

Various alternate theories and other such hypotheses have arisen to speculate about the
origins of HIV/AIDS. These alternative ideas range from suggestions that AIDS was the
inadvertent result of experiments in the development of vaccines, to claims that human
immunodeficiency virus was developed by scientists working for the U.S. government. While
a few reputable mainstream scientists once investigated some of these theories as reasonable
hypotheses, this is no longer the case, as continuing research has invalidated the alternative
ideas. The current scientific consensus is that AIDS originated in Africa in the mid-1930s
from the closely related Simian Immunodeficiency Virus.[1]

Man-made or iatrogenic origins of AIDS
Nobel Peace Prize laureate and environmental activist Wangari Maathai was asked by
a Time magazine interviewer if she stood by a previous alleged claim that "AIDS is a
biological weapon manufactured by the developed world to wipe out the black race".
Maathai responded, "I have no idea who created AIDS and whether it is a biological
agent or not. But I do know things like that don't come from the moon. (...) I guess
there is some truth that must not be too exposed."[2] Maathai subsequently issued a
written statement in December 2004: "I neither say nor believe that the virus was
developed by white people or white powers in order to destroy the African people.
Such views are wicked and destructive."[3]
Jakob Segal, a former biology professor at Humboldt University in then-East
Germany, proposed that HIV was engineered at a U.S. military laboratory at Fort
Detrick, by splicing together two other viruses, Visna and HTLV-1. According to his
theory, the new virus, created between 1977 and 1978, was tested on prison inmates
who had volunteered for the experiment in exchange for early release. He further
suggested that it was through these prisoners that the virus was spread to the

population at large. After the end of the cold war however the former KGB agents
Wassili Nikititsch Mitrochin and Oleg Gordijewski revealed independently of each
other, that the Fort Detrick hypothesis was a propaganda operation devised by the
KGB's First Chief Directorate under the codename "infektion". Later it was also
supported by the section X of East Germany's Hauptverwaltung Aufklärung as
admitted by its officer Günther Bohnensack. It is not entirely clear whether Segal
pursued the hypothesis independently on his own accord or whether he was simply
following orders. Segal himself always denied the latter and kept pursuing the
hypothesis even after the operation had been canceled and the cold war had ended. It
is known that Segal was in close contact with Russian KGB officers and Mitrochin
mentioned him as a central asset of the operation.[4][5]
Alan Cantwell, in self-published books entitled AIDS and the Doctors of Death: An
Inquiry into the Origin of the AIDS Epidemic and Queer Blood: The Secret AIDS
Genocide Plot, says that HIV is a genetically modified organism developed by U.S.
Government scientists and that it was introduced into the population through Hepatitis
B experiments performed on gay and bisexual men between 1978–1981 in major U.S.
cities. Cantwell claims that these experiments were directed by Wolf Szmuness, and
that there was an ongoing government cover-up of the origins of the AIDS epidemic.
Similar theories have been advanced by Robert B. Strecker, Matilde Krim and Milton
William Cooper.
Leonard G. Horowitz, author of the self-published works Emerging Viruses: AIDS &
Ebola. Nature, Accident or Intentional? and Death in the Air: Globalism, Terrorism
and Toxic Warfare, advances the theory that the AIDS virus was engineered by such
U.S. Government defense contractors as Litton Bionetics for the purposes of biowarfare and "population control."
Smallpox vaccine theory
In 1987 there was some consideration given to the possibility that the "Aids epidemic
may have been triggered by the mass vaccination campaign which eradicated
smallpox". An article[6] in the Times suggested this, quoting an unnamed "adviser to
WHO" with "I believe the smallpox vaccine theory is the explanation to the explosion
of Aids". It is now thought that the smallpox vaccine causes serious complications for
people who already have impaired immune systems, and the Times article described
the case of a military recruit with "dormant HIV" who died within months of
receiving it. But no citation was provided regarding people who did not previously
have HIV. (HIV is now considered to be a contraindication for the smallpox vaccine both for an infected person and their sexual partners and household members.[7][8])
Some conspiracy theorists propose an expanded hypothesis in which the smallpox
vaccine was deliberately 'laced' with HIV.[9]
In contrast, a research article was published in 2010 suggesting that it might have
been the actual eradication of smallpox and the subsequent ending of the mass
vaccination campaign that contributed to the sudden emergence of HIV, due to the
possibility that immunization against smallpox "might play a role in providing an
individual with some degree of protection to subsequent HIV infection and/or disease
progression".[10][11] Regardless of the effects of the smallpox vaccine itself, its use in
practice in Africa is one of the categories of un-sterile injection that may have
contributed to the spread and mutation of the immunodeficiency viruses.[12]

The OPV AIDS hypothesis asserts that the oral polio vaccine was developed in
chimpanzee tissues contaminated with a strain of simian immunodeficiency virus
(SIV), and that an experimental mass vaccination program introduced the virus into
the human population. Edward Hooper, a journalist who written extensively about this
theory, claims that this area that was given the large-scale polio vaccine became the
epicenter of the AIDS epidemic.[13] This theory has been refuted by a study that
demonstrates that the polio vaccine was not prepared using chimpanzee cells, but
rather macaque cells.[14] A large trial of an oral polio vaccine took place near
Kisangani in the late 1950s, but the strain of SIV present in local chimpanzees is
phylogenetically distinct from all strains of HIV.[15] Frozen samples of the frozen
suspect vaccine have also been analyzed and HIV related nucleic acids and
chimpanzee mitochondrial DNA was not detected.[16] HIV has been present in human
populations since before the oral polio vaccine was developed, most likely since the
1930s.[17][18][19]

Alternative ideas regarding causation, origin or treatment
See also: AIDS denialism and AIDS in Africa
The Duesberg hypothesis promoted by biologist Peter Duesberg argues that AIDS is
not caused by HIV, but rather that HIV is a harmless passenger virus, and that AIDS
is caused by non-infectious agents like illegal drug usage.[20] According to Peter
Duesberg despite the fact that HIV causes AIDS, we only find HIV antibodies in
patients. Furthermore he states that in patients dying of AIDS, HIV is present in less
than 1 out of the 500 T-cells that become infected. Furthermore, he points out that
there is yet no vaccine, no prevention, and not one single AIDS patient has been
cured. Also, HIV is said to be the cause of the 26 AIDS defining diseases yet they can
also occur without HIV.[21] The scientific consensus is that the Duesberg hypothesis
has been discredited.[22]
Thabo Mbeki, former President of South Africa, along with other prominent members
of the ruling African National Congress party, has argued that AIDS is the result of
poverty, chronic disease, malnutrition and other environmental factors.[23] Mbeki
based his views on the discredited beliefs of AIDS denialists, especially Peter
Duesberg. It has been suggested that the ANC leadership adopted this position as a
political expedient, intended to deflect criticism that the ANC had not done enough to
fight AIDS in South Africa.[24] In 2000, two statements by government spokespeople,
(one later retracted), placed the financial cost of treating pregnant HIV positive
women and the subsequent cost to the state of raising the child as central in the
decision of whether to provide anti-retroviral drug treatment.[25] Also in 2000, the
Johannesburg Mail & Guardian reported that in a leaked text for a speech Mbeki was
to give to an ANC caucus, Mbeki claimed that the CIA and Western drug companies
were secretly promoting the view that HIV causes AIDS in order to increase sales of
anti-HIV drugs.[26]

Prevalence of Conspiracy Beliefs
An anonymous telephone survey in the United States was conducted to identify the
conspiracy beliefs regarding HIV and AIDS that are the most prevalent. The survey

found that the majority somewhat or strongly believed that ―a lot of information about
AIDS is being withheld from the public‖ and over half somewhat or strongly believed
that ―there is a cure for AIDS, but it is being withheld.‖ Almost 60% disagreed that,
"the government is telling the truth about AIDS." Over 40% somewhat or strongly
agreed that, "people who take the new medicines for HIV are human guinea pigs for
the government." [27] According to Phil Wilson, executive director of the Black AIDS
Institute in Los Angeles, conspiracy theories are becoming a barrier to the prevention
of AIDS since people start to believe that no matter what the measures they take are,
they can still be prone to contracting this disease. This makes them less careful when
engaging in practices that put them at risk because they believe there is no point.[28]

Discrimination and stigmatization
In most countries, even those where sex work is legal, sex workers of all kinds feel that they
are stigmatized and marginalized, and that this prevents them from seeking legal redress for
discrimination (for e.g., racial discrimination by a strip club owner, dismissal from a teaching
position because of involvement in the sex industry), non-payment by a client, assault or
rape. Activists also believe that clients of sex workers may also be stigmatized and
marginalized, in some cases even more so than sex workers themselves. For instance, in
Sweden, Norway and Iceland, it is illegal to buy sexual services, but not to sell them (the
client commits a crime, but not the prostitute).[3]

Pornography debates
During the 1970s and 1980s the main topic of feminist discourse was pornography, sex work,
and human trafficking in regards to women‘s sexuality. This led to the birth of mobilizing for
sex workers‘ rights in America. Carol Leigh is credited for coining the term "sex work" in the
early 1980s and it was later popularized by a book published in 1989 called Sex Work.[4]
Around this time feminist debates centered upon the role that pornography played in
women‘s rights. The feminists involved in these debates had opposite views on ways to
eliminate sexual violence against women in which feminists were generally either classified
as liberal feminists or radical feminists. A third group of feminists is called pro-sex or sex
positive feminism and this view is said to be the true defense of pornography.[5]

Radical feminist
The argument of the radical side rests upon the premise that pornography depicts women as
subordinates and perpetrates violence against women.[6] Some of the main anti-porn feminists
involved in the debates included Page Mellish, Andrea Dworkin, and Catherine MacKinnon.
Andrea Dworkin believes that the oppression of women occurs through sexual subordination
and that in order for gender equality to exist, subordination must be eliminated. Thus, she
states that pornography was an antagonist to equality.[6] Similarly, Catherine MacKinnon
states that pornography is an act of sexual violence.[7] On the grounds that pornography
violated women‘s civil rights, she and Dworkin proposed a law named the ‗Antipornography
Civil Rights Ordinance‘ that allowed women to seek reparations for damages done by
pornography through civil courts. Likewise, Page Mellish, the founder of Feminists Fighting
Pornography (FFP), believed that issues facing feminists were rooted in pornography.

Mellish allied with conservatives in 1992 to fight for the passing of the ‗Pornography
Victims‘ Compensation Act‘ which was modeled after Dworkin and MacKinnon‘s
ordinance.[8]

Liberal feminist
Contrarily, the liberal side, believe that women have rights over what they do with their body
so they are free to participate in pornography if they chose to. The main thing that these
feminists fight for is anti-censorship regardless of whether they agree with pornography or
not.[5] On this side of the debate are feminists such as Gayle Rubin and Lynn Chancer. Rubin
argues that anti-pornography laws could negatively harm sexual minorities such as
gays/lesbians, sex workers, and feminists because they would create new problems and
modes of abuse resulting from the anti-pornography side's use of a limited amount of porn
that demonstrates the most extreme cases of violence such as sadomasochism.[9][10] Likewise,
Chancer argues that it is possible for such imagery to be able to circulate consensually and
lawfully while genuine feelings of pleasure are being experienced without women feeling
subordinated.[11] She also states that some of these feminists believe that pornography is
negatively affecting women by leading to violence against women when in actuality it is not.
Thus, she concludes that radical feminists are looking at pornography as a quick fix to a
much larger societal problem.[12]

Sex positive feminist
Sex positive feminists believe that no form of sexual expression should be vilified except that
which is not consensual.[13] One of the main advocates of this feminist perspective is Carol
Queen. She argues that radical feminists probably generalize too widely as far as women are
concerned and do not take into consideration more complicated circumstances such as
sadomasochism and prostitution. Elisa Glick also states that configurations of power within
relationships do not prevent women from exercising it and that they can be used to enable
women to exercise it.[14]

Sex wars
These pornography debates gave leeway to the debates referred to by feminist scholars as the
Sex Wars. These debates began in the 1980s and centered upon ways that women were
depicted in heterosexual sexual relations. The main premise of the anti-pornography
movement rests upon the argument that pornography is degrading and violent towards
women. These feminists also believe that pornography encourages men to behave violently
towards women.[6] However, liberal feminists argued that this argument does not take into
account the pleasure that women can experience and states that these arguments could
backfire against women and leave them actually more subordinated.[9] Thus, the debates
began to become centralized on the role of dominance within heterosexual relationships and
how this dominance is transferred to other areas of women‘s lives. These theories of male
sexuality and female objectification and sexuality are controversial because they framed more
modern debates about human trafficking in which coerced workers need to be distinguished
from voluntary workers.[15]

Human trafficking

A more contemporary debate that has materialized as a result of the movement focuses more
on human trafficking. Current debates center on whether the best way to protect women
would be through abolition, criminalization, decriminalization, or legalization.
Legalization

Current policies aimed at reducing human trafficking are referred to as "rescue missions" by
sex worker advocates because they state that laws that call for the abolition and
criminalization of prostitution tend to result in large-scale raids that do not distinguish
between coerced sex workers and those who voluntarily enter sex work.[16] Furthermore,
liberal feminists such as Ronald Weitzer and Gayle Rubin argue that by saying that sex work
is inherently violent, a ―moral panic‖ has been created that influences political
discourse.[10][17] Therefore, liberal feminists believe that this has led to the construction of a
trafficking victim that may actually be a woman migrating for work. These feminists argue
that this can backfire because it does not protect those women who voluntarily enter into sex
work.[16]
Criminalization

On the other hand, opponents against the movement such as Melissa Farley and Janice
Raymond argue that sex work should be criminalized and abolished because the legalization
of it can increase human trafficking. The New UN Trafficking Protocol by Raymond argues
that countries with legalization and decriminalization are where a lot of victims are trafficked
to under the guise of migrants so they still do not have protection. Raymond also argues that
it is impossible to separate the exploitation done to local prostitutes from the exploitation
done to trafficked prostitutes because the experiences are so similar. Thus, to end sex slavery,
the report declares that everyone involved in sex work would need to be criminalized so that
it could be abolished.[18] Similarly, Farley has argued that sex work is a profession that a
woman only voluntarily enters if they do not have any other choice.[19] Thus, she concludes
that women still are not able to feel empowered by the work.

Legality of prostitution
There are two main categories in which most activists fall regarding the formation of policies
that protect sex workers from violence: abolitionism and/or criminalization, and legalization
and/or decriminalization.[20]

Abolitionism and/or criminalization
Early reformers identified the key problem with prostitution as male lust that lured innocent
women into a depraved life as prostitutes.[20] Thus, abolitionist proponents believe that
prostitution is an exploitative system that is harmful to the women involved.[21] Therefore,
these activists believe that in order to prevent violence against women, customers, pimps and
panderers should be punished so that the entire institution can be demolished.[22] Because this
policy approach is built upon the idea that women are helpless victims, opponents of this
view believe that it is paternalistic and not empowering to women.[20]
A study by Melissa Farley, a well-known criminalization proponent, and colleagues, suggests
that violence is an intrinsic part of prostitution in which the chances of experiencing violence

increases along with the number of years involved in prostitution. This study also concludes
that prostitution tends to be multi-traumatic in all forms.[23] Farley and colleagues also used
the Netherlands as an example of a country to support the idea that legalized prostitution can
still inflict harm on those involved. They stated that over 90% of the sex workers tend to
show symptoms of PTSD. Therefore, these proponents advocate for abolitionism and
criminalization as a method of protecting sex workers.[23]
Criminalization proponents believe that the way to protect women from interpersonal
violence is to punish both sex workers and customers for partaking in the buying and selling
of sex.[20]
Support for criminalization

Many proponents of abolitionism and/or criminalization of prostitution commonly use ten
reasons based on studies done on the effects of prostitution in countries where it is legalized
and/or decriminalized.[24]
Prostitution is a gift to pimps, traffickers, and the sex industry.
Prostitution promotes sex trafficking.
Prostitution expands the sex industry instead of controlling it.
Prostitution increases clandestine, illegal, and street prostitution because many women
don’t participate in health checks or registration and don’t want to be controlled by
businessmen.
Prostitution increases child prostitution.
Prostitution doesn't protect women in prostitution.
Prostitution makes it socially acceptable for men to buy sex and women are viewed as sexual
commodities that men are encouraged to partake in.
Prostitution does not promote women’s health because the condom-use policy is not strictly
enforced.
Prostitution does not enhance women’s choice.
Prostitutes do not want the sex industry legalized or decriminalized.[24]

Legalization and/or decriminalization
Legalization and/or decriminalization proponents, on the other hand, believe that the selling
and buying of sex exchange will continue no matter what. Therefore, the only way to
effectively prevent violence is to acknowledge this and for government to build policies and
laws that deal with the issue through regulation of the business.[20]
Legalization/Decriminalization proponents believe that a system that prohibits prostitution
creates an oppressive environment for prostitutes.[25] Proponents of this view also recommend
that policies are built that places restrictions on trafficking and exploitation of sex workers.[26]
Support for decriminalization

The legalization of sex work often entails additional restrictions and requirements placed on
sex workers as well as registering with official government offices. Additionally, many
activists favor decriminalization over legalization. Decriminalization involves a focus on
laws which protect the rights of sex workers, such as those against coercion into or to stay in
sex work, while all consensual sexual contact between adult sex workers and adult clients
would not be criminalized.[20]

Roanld Weitzer, a well-known proponent for the legalization/decriminalization of
prostitution, stated that the use of nonscientific evidence about prostitution has contributed to
a "moral panic" because opponents commonly use the argument that prostitution is inherently
violent and unable to be regulated. However, he also claims that other governments have
been able to reject this notion and find ways to regulate it and uses Nevada as an example.
.[17]
Below are some of the main premises that the pro-legalization and pro-decriminalization of
prostitution movement rests upon.[27]
Prostitution is a transaction where no one is harmed and the persons involved are
consenting adults.
Prostitution is a free choice.
Sex work is no more moral or immoral than other jobs.
Sex trafficking and coercion into the industry can be effectively reduced if sex work is
legalized and/or decriminalized.
Decriminalization and/or legalization can protect sex workers from violence most effectively.
The spread of diseases can be hindered through the legalization and/or decriminalization of
prostitution.
The rates of rape could decrease if prostitution were legalized and/or decriminalized.
Sex work could become a legal business and human rights and worker's rights could be
enforced by effective regulation.
Prostitution is a career option in which the free market is being taken advantage of and
women’s claims over their own bodies.
The criminalization of sex workers only exacerbates problems that they are already facing.
Therefore, the decriminalization and/or legalization can be a starting point to addressing
these issues.[27]

Employment
Depending on regional law, sex workers' activities may be regulated, controlled, tolerated, or
prohibited.
For example, prostitution is illegal in many countries, but it is fully legalized in several
jurisdictions, including Netherlands, Germany, some Australian states, and several counties
in the state of Nevada.

Strip club employment issues
Dancers in strip clubs are independent contractors that face many problems that they are
unable to rectify because of their inability to organize to challenge the current systems of
strip clubs.
Entry fees

In the UK, a study was conducted which inquired about dancers‘ experiences to get a better
understanding to determine whether or not it could be costly for women to work some nights.
It stated that often when the club offered promotions with gimmicks, dancers would be

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