Pediatric Acquired Immunodeficiency Syndrome: Testing as a Barrier to Recognizing the Role of Child Sexual Abuse

Gutman et al¹ have made an important contribution in considering barriers to the recognition of sexually abused children at risk for human immunodeficiency virus (HIV) infection. The review is comprehensive and detailed in its recommendations for removal of barriers. However, several of the citations from the literature are not precise and, thus, some conclusions are questionable. While the authors cite a survey of child abuse assessment and protective services for children tested for HIV infection, their statement that there are no prevalence data on HIV infection of sexually assaulted children is not entirely accurate. The survey reported that 28 HIV-infected children having sexual abuse as the exclusive risk were detected from among 5622 HIV antibody tests during 113 198 sexual abuse assessments.² Although subject to possible bias, the estimated prevalence rate was 3.55 per 1000 HIV antibody tests conducted and 0.25 per 1000 sexual abuse assessments conducted.

The