Sexual transmission of human immunodeficiency virus (HIV) among adults has been recognized for over a decade, but we have yet to accept these words too terrible to hear: children can also acquire HIV infection from sexual contact. In this issue of AJDC, Laura T. Gutman, MD, and colleagues1 explore the barriers to our assessment of sexually abused children for HIV.
Although we have come to accept that every other sexually transmitted disease is transmittable to children by sexual contact, we continue to ignore the possibility of HIV transmission due to sexual abuse. In a recent survey of 63 sexual abuse evaluation centers from areas of the United States with a high prevalence of AIDS, none had a protocol for HIV testing.2 Why have we failed to investigate the possibility of HIV infection in sexually abused children? One reason is that we do not yet have the data to