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HIV Transmission and Childhood Sexual Abuse-Reply

Michael T. Osterholm, PhD, MPH; Kristine L. MacDonald, MD
JAMA. 1988;259(15):2236. doi:10.1001/jama.1988.03720150017012.
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In Reply.  —Drs Fuller and Bartucci raise legitimate concerns about child sexual abuse by child molesters infected with HIV. In Minnesota, we are aware of at least one situation where a man with AIDS had previously sexually assaulted his own son, thus illustrating the potential for HIV transmission in this setting.1 Because of concerns about HIV transmission, we concur with a recent national recommendation that protocols for evaluation of a child who has been sexually abused should include consideration of HIV transmission.2Drs Fuller and Bartucci suggest that all HIV-infected patients should be carefully queried about child molestation. Readers may infer from this that an association exists between adult HIV infection and child molestation. While pediatric HIV infection may result from child molestation, in our experience— through providing follow-up counseling to more than 500 HIV-infected persons—it is a rare occurrence. However, we do believe that physicians need to


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