Sexual abuse and sexually transmitted infections in children and adolescents.
OBJECTIVE
Sexual abuse is unfortunately common in the United States. The presence of a sexually transmitted infection in a child or adolescent should prompt an evaluation to exclude sexual abuse.


RESULTS
The present article reviews the demographics of sexual abuse, the prevalence of specific sexually transmitted infections, such as Neisseria gonorrhoeae, Chlamydia trachomatis, HIV, human papillomavirus (HPV) and herpes simplex virus (HSV) and which children and adolescents are at highest risk for contracting such infections. The use of nonculture methods, such as nucleic acid amplification tests (NAATs), to evaluate prepubertal children for N. gonorrhoeae or C. trachomatis, and the use of HIV postexposure prophylaxis are discussed.


CONCLUSIONS
Any child or adolescent with a sexually transmitted infection should be evaluated for sexual abuse. Specific infections in prepubertal children, such as Neisseria gonorrhoeae or Chlamydia trachomatis, are due to abusive contact and should be reported to Child Protective Services. As the modes of transmission of anogenital infections with HPV and HSV are unclear, an evaluation for sexual abuse should be done. Although transmission of HIV after sexual abuse is rare, HIV postexposure prophylaxis must be administered in a timely fashion, and adequate outpatient support provided to facilitate compliance and follow-up.
Bechtel
Kirsten
K
Yale University School of Medicine, Yale-New Haven Children's Hospital, 840 Howard Avenue, first floor, New Haven, CT 06504, USA. kirsten.bechtel@yale.edu
D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis*; D006801:Humans; D021141:Nucleic Acid Amplification Techniques; D056990:Post-Exposure Prophylaxis; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000628:therapy / Q000635:transmission
D000890:Anti-Infective Agents