Human immunodeficiency virus transmission by child sexual abuse
L. T. Gutman, K. K. St Claire, C. Weedy, M. E. Herman-Giddens, B. A. Lane, J. G. Niemeyer and R. E. McKinney Jr
Department of Pediatrics, Duke University Medical Center, Durham, NC 27710.
During 1987-1989, 14 (14.6%) of the 96 children who tested positive for the
human immunodeficiency virus (HIV) and were followed up by the Duke
University (Durham, NC) pediatric acquired immunodeficiency syndrome team
were confirmed to have been sexually abused. Every sexually abused child
was evaluated for each of five modes of HIV transmission, and in nine
children the pathway was identified. Four of the study children acquired
HIV from child sexual abuse and in six, abuse was a possible source.
Transmission by child sexual abuse was the most frequent of the proven
modes of acquisition of HIV in this population. The other proven modes of
acquisition were vertical transmission (n = 3) and HIV-contaminated blood
transfusion (n = 2). Twelve males were identified (n = 8) or suspected (n =
4) of being perpetrators. Three knew themselves to have HIV at the time of
an assault and eight were aware that the child had HIV at the time of an
assault. There was no indication from any child that "safe sex" precautions
had been observed. Children with HIV infection had multiple risk factors
for abuse or neglect. The sociological descriptors of the lives of the 14
abused children showed multiple known risk factors for sexual abuse that
also overlapped with known risk factors for or sequelae of the acquisition
of HIV infection. These included drug abuse and alcoholism in the home,
prostitution of a parent, lack of parenting, poverty, and chronic illness
of the child. Prevention efforts should recognize that children as well as
adults are at risk for sexually transmitted HIV infection.
HIV post-exposure prophylaxis provided at an urban paediatric emergency department to female adolescents after sexual assault
Merchant et al.
Emerg. Med. J. 2004;21:449-451.
ABSTRACT
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National guideline for the management of suspected sexually transmitted infections in children and young people
Thomas et al.
Arch. Dis. Child. 2003;88:303-311.
ABSTRACT
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National guideline for the management of suspected sexually transmitted infections in children and young people
Thomas et al.
Sex. Transm. Infect. 2002;78:324-331.
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Human Immunodeficiency Virus Postexposure Prophylaxis for Adolescents and Children
Merchant and Keshavarz
Pediatrics 2001;108
:e38-e38.
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The Medical Evaluation of the Sexually Abused Child: Lessons From a Decade of Research
Atabaki and Paradise
Pediatrics 1999;104:178-178.
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Sexual Abuse of Children: Intersection With the HIV Epidemic
Lindegren et al.
Pediatrics 1998;102:e46-46.
ABSTRACT
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The Association Between Childhood Sexual Abuse and Prevalence of HIV-Related Risk Behaviors
Lodico and DiClemente
CLIN PEDIATR 1994;33:498-502.
HIV INFECTION FROM SEXUAL ABUSE
JWatch General 1991;1991:7-7.
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