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HIV Post-Exposure Prophylaxis in Children and Adolescents Presenting for Reported Sexual Assault

NCJ Number
227142
Journal
Child Abuse and Neglect Volume: 33 Issue: 3 Dated: March 2009 Pages: 173-178
Author(s)
Rebecca G. Girardet; Scott Lemme; Tiffany A. Biason; Kelly Bolton; Sheela Lahoti
Date Published
March 2009
Length
6 pages
Annotation
This study examined records of all children tested for HIV for prevalence of infection to clarify prescribing practices for HIV post-exposure prophylaxis (PEP) at a specific institution.
Abstract
Of the 4,235 cases of reported sexual abuse, 1,751 involved HIV testing and 303 were eligible to receive HIV-PEP. Despite an estimated incidence of HIV-infection (689-786 per 100,000), the prevalence of HIV infection among the 223 children whose most recent episode of sexual assault occurred at least 6 months prior to clinic presentation was zero. Only one child in the series had a true positive test for HIV-infection. Prior studies of HIV-PEP have shown that it is cost-effective when offered to targeted high-risk populations, including men and women following receptive anal intercourse with an HIV-infected individual, and among gay men following receptive anal intercourse with partners of unknown HIV status. HIV-PEP has not been shown to be cost-effective when offered to lower-risk groups which include the majority of sexually assaulted children. The disclosure by the one HIV-positive child “bleeding from the buttocks” presumably represented trauma from anal sodomy, which was no longer visible on examination 3 weeks after the assault. Approval was obtained from the Committee for the Protection of Human Subjects at the University of Texas Houston Health Sciences Center to review medical records at a pediatric sexual abuse clinic of all children ages 0-19 years tested for HIV during a 38-month period from 2001 to 2004. Tables, figure, and references

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