title: Prevalence of sexually transmitted infections and mental health needs of female child and adolescent survivors of rape and sexual assault attending a specialist clinic.
abstract: OBJECTIVE
  To determine the prevalence of sexually transmitted infections (STIs) and the mental health needs of female child and adolescent survivors of rape and sexual assault who were referred to a specialist genitourinary medicine (GUM) clinic.
  
  
  METHODS
  Retrospective case notes review of 98 females aged 16 or less, who attended over a 5 year period (1996-2000).
  
  
  RESULTS
  The overall prevalence of STIs was 26%. Among the girls who were aged 0-12 years (n = 16), one had gonorrhoea and another had Trichomonas vaginalis infection. Prevalence of STIs in those aged 13-16 years, who were not sexually active before the index assault, was 24% and in those who gave a history of previous consensual sexual activity it was 39% (p = 0.17). Chlamydial infection was more common among the girls who disclosed previous consensual sexual activity than in those did not disclose previous sexual activity (p = 0.012). The overall prevalence of vaginal candidiasis was 17% and bacterial vaginosis 13%. More than one third of the study population gave a history of previous sexual, physical, or other abuse. 81% reported having current psychological difficulties. Mood changes and sleep disturbances were reported more frequently than other psychological symptoms; 15% attempted self harm. All types of psychological difficulties, except mood changes, were not affected by the time interval between index assault and first presentation to the clinic and the type of assailant. 29% had no involvement with social and mental health services before their attendance at the clinic
  
  
  CONCLUSIONS
  The prevalence of STIs among female child and adolescent survivors of rape and sexual assault attending a specialist clinic was high. The range of mental health and social difficulties was wide and multiple. The importance of an early assessment for the presence of STIs and mental health difficulties was demonstrated.
authors.affiliation: Department of Genitourinary Medicine, Luton and Dunstable Hospital NHS Trust, Lewsey Road, Luton LU4 0DZ, UK. mokawsar@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Kawsar
authors.forename: A
authors.initials: A
authors.lastname: Anfield
authors.forename: E
authors.initials: E
authors.lastname: Walters
authors.forename: S
authors.initials: S
authors.lastname: McCabe
authors.forename: G E
authors.initials: GE
authors.lastname: Forster
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D002650:Child Abuse, Sexual; D003268:Contraception Behavior; D004739:England / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D001523:Mental Disorders / Q000209:etiology* / Q000628:therapy; D020380:Needs Assessment; D015995:Prevalence; D011902:Rape; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000523:psychology; D017741:Survivors