Sexual Abuse and HIV Transmission

Abstract

The acquired immunodeficiency syndrome (AIDS) and sexual abuse are major public health concerns. Despite an alarming increase in the incidence of these conditions and a well-developed literature, many clinicians ignore them. The issue of human immunodeficiency virus (HIV) transmission by sexual abuse has not been given the same direct attention as other modes of spreading HIV. Although an alarmist view may be unwarranted, the lethality of AIDS makes HIV transmission a dangerous behavior that may fall under the Tarasoff principle. When a clinician becomes aware of sexual abuse involving the potential transmission of HIV, a dilemma develops: What actions should the clinician take? What are the legal obligations of the clinician to the perpetrator of sexual abuse, the victim, and society? How does the clinician resolve the many ethical issues surrounding reporting suspected sexual abuse or possible HIV transmission to proper authorities, versus the confidentiality of the patient–doctor relationship? The poli...