ORIGINAL ARTICLES

Child sexual abuse (CSA) has not previously been regarded as important in the overall transmission of HIV infection to children.1,2 However, with both CSA3,4 and HIV infection on the increase, the risk of acquiring HIV infection through CSA is real, and several reports of such transmission have been documented.5,6 The incidence in children of HIV acquired by CSA is unknown, but the prevalence in Africa among sexually abused children, mainly with penetrative injuries, ranges from 1 % (2/200 children) in Cape Town, South Africa, to as high as 33.8 % (24/71 children) in Cameroon.5,7 The author has experience of at least 10 children who became HIV-infected almost certainly through sexual abuse over the past 10 years. Risk of HIV transmission by sexual abuse The risk of transmission during sexual abuse depends o