HUMAN-IMMUNODEFICIENCY-VIRUS (HIV), HUMAN PAPILLOMAVIRUS (HPV), AND SEXUAL ABUSE

Study Objective: To make clinicians aware of the possibility of childr en being coinfected with human immunodeficiency virus (HIV) and human papillomavirus (HPV) and discuss the clinical dilemmas and legal impli cations. Design and Participants: Two illustrative case reports of chi ldren simultaneously infected by HIV and HPV and evaluated for sexual abuse. Setting: The patients were evaluated in the Child Abuse Pediatr ic Clinic at the Columbia Presbyterian Medical Center, New York City. Interventions: The patients were treated with topical 5% 5-fluorouraci l cream.Results: Sexual abuse transmission of HIV was strongly suggest ed in one patient. Sexual abuse transmission of HPV could not be prove n in either case. Conclusions: Genital condyloma may be a clinical man ifestation of progressive immunosuppression secondary to vertically or sexually acquired HIV infection in children. Legal issues of children with sexually transmitted diseases need to be addressed in the future .