Drs Gellert and Berkowitz raise important issues that have just begun to be the subject of medical discussion. Regarding the uncertainty of the prevalence of HIV infection in children who are being evaluated for sexual abuse, Drs Gellert and Berkowitz cite data from their survey of HIV infection during sexual abuse assessments.1 The HIV assays were performed for 5% (5622/113 198) of reported children. The study did not specify how many HIV assays were repeated following the initial assessment. That important study documented the emerging awareness that HIV may be a sexually transmitted disease in children. However, it did not provide reliable prevalence data because the small number of tests would have impeded recognition of subclinical infection.2 In addition, there is no way to know whether the children selected for testing were representative of the entire spectrum of abused children.
Drs Gellert and Berkowitz raise
Gutman LT, Herman-Giddens ME, McKinney R. Pediatric Acquired Immunodeficiency Syndrome: Testing as a Barrier to Recognizing the Role of Child Sexual Abuse-Reply. Arch Pediatr Adolesc Med. 1994;148(7):767-768. doi:10.1001/archpedi.1994.02170070104023