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Issues in Correctional HIV Care: Pedophiles and the Sexual Transmission of HIV to Children

NCJ Number
American Jails Volume: 21 Issue: 2 Dated: May/June 2007 Pages: 33-36
Abe M. Macher M.D.
Date Published
May 2007
Following summaries of 11 case histories in which child sexual abuse involved the offender’s transmission of HIV-infection to the child victim, this article provides an overview of the prevalence of child sexual abuse throughout the world and the management of incarcerated pedophiles.
The 11 case histories show that in addition to inflicting physical and psychological trauma on child victims of sexual abuse, perpetrators are exposing their child victims to sexually transmitted diseases, including HIV-infection. Surveys to determine the prevalence of child sexual abuse conducted in 21 countries, including the United States and Canada, show that reported rates of child sexual abuse range from 7 percent to 36 percent for girls and 3 percent to 29 percent for boys. In the United States, hundreds of thousands of children are sexually abused each year. In 1991, Gutman and his colleagues reported that among 96 children who tested positive for HIV and were monitored by the Duke University pediatric AIDS services, 14 were confirmed to have been sexually abused; 4 acquired HIV-infection from sexual abuse; and for 6 children, sexual abuse was a possible source of their HIV-infection. The typical pedophile abuses many children. In a study by Abel and his colleagues, nonincestuous pedophiles averaged approximately 20 victims if the victims were girls and 150 victims if the victims were boys. Treatment of incarcerated pedophiles challenges the correctional health care system. Therapy must be comprehensive in treating psychiatric disorders and substance abuse in addition to pedophilia. For the HIV-infected pedophile, postrelease continuity of antiretroviral therapy is a critical measure in preventing subsequent HIV transmission to children in the community. For pedophiles being supervised in the community, there must be an effective communication and collaboration between criminal justice and mental health professionals. 17 notes