Sexually transmitted diseases in sexually abused girls and adolescents.
OBJECTIVE
The clinical evaluation for suspected child sexual abuse often includes sexually transmitted disease testing. In spite of the high prevalence of sexual abuse, however, most abused children will not have a sexually transmitted disease identified. The low prevalence of sexually transmitted diseases in this population requires special care by the clinician to exclude false-positive test results and to provide appropriate guidance to child protection workers.


RESULTS
The likelihood of sexual transmission varies for specific infectious agents and the transmission of infectious agents such as human papillomavirus is complex. Concern about the low positive predictive value of many tests for sexually transmitted diseases in this population is again being demonstrated and clinicians are asked to be cautious in interpreting test results.


CONCLUSIONS
Clinicians are mandated reporters of suspected child abuse. Treatment of sexually transmitted diseases may need to be delayed pending confirmatory testing of the initial results. HIV postexposure prophylaxis should be considered within hours of the exposure.
Shapiro
Robert Allan
RA
Mayerson Center for Safe and Healthy Children, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA. robert.shapiro@cchmc.org
Makoroff
Kathi Lynn
KL
D002648:Child; D002650:Child Abuse, Sexual; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission