Rape is a type of sexual assault usually involving sexual intercourse or other forms of sexual penetration perpetrated against a 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. The term rape is sometimes used interchangeably with the term sexual assault.The rate of reporting, prosecuting and convicting for rape varies considerably in different jurisdictions. Internationally, the incidence of rapes recorded by the police during 2010 varied between 0.2 in Azerbaijan per 100,000 people and 92.9 per 100,000 people in Botswana with 6.3 per 100,000 people in Lithuania as the median. According to the American Medical Association (1995), sexual violence, and rape in particular, is considered the most underreported violent crime. Rape by strangers is usually less common than rape by persons the victim knows, and several studies argue that male-on-male and female-on-female prison rapes are common and may be the least reported forms of rape.When part of a widespread and systematic practice during international conflict, 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; in addition to psychological harm resulting from the act, rape may cause physical injury, or have additional effects on the victims, such as the acquiring of sexually transmitted infections or becoming pregnant. Furthermore, following a rape, a victim may face violence or threats thereof from the rapist, and, in some cultures, from the victim's own family and relatives.