title: Sexual Assault and Sexually Transmitted Infections in Adults, Adolescents, and Children.
abstract: Survivors of sexual assault are at risk for acquiring sexually transmitted infections (STIs). We conducted literature reviews and invited experts to assist in updating the sexual assault section for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases (STD) treatment guidelines. New recommendations for STI management among adult and adolescent sexual assault survivors include use of nucleic acid amplification tests (NAATs) for detection of Trichomonas vaginalis by vaginal swabs; NAATs for detection of Neisseria gonorrhoeae and Chlamydia trachomatis from pharyngeal and rectal specimens among patients with a history of exposure or suspected extragenital contact after sexual assault; empiric therapy for gonorrhea, chlamydia, and trichomoniasis based on updated treatment regimens; vaccinations for human papillomavirus (HPV) among previously unvaccinated patients aged 9-26 years; and consideration for human immunodeficiency virus (HIV) nonoccupational postexposure prophylaxis using an algorithm to assess the timing and characteristics of the exposure. For child sexual assault (CSA) survivors, recommendations include targeted diagnostic testing with increased use of NAATs when appropriate; routine follow-up visits within 6 months after the last known sexual abuse; and use of HPV vaccination in accordance with national immunization guidelines as a preventive measure in the post-sexual assault care setting. For CSA patients, NAATs are considered to be acceptable for identification of gonococcal and chlamydial infections from urine samples, but are not recommended for extragenital testing due to the potential detection of nongonococcal Neisseria species. Several research questions were identified regarding the prevalence, detection, and management of STI/HIV infections among adult, adolescent, and pediatric sexual assault survivors.
authors.affiliation: Institute for Global Health and Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill.
authors.forename: Arlene C
authors.initials: AC
authors.lastname: Seña
authors.affiliation: Division of STD Prevention, Bureau of Infectious Diseases, Massachusetts Department of Public Health, Jamaica Plain.
authors.forename: Katherine K
authors.initials: KK
authors.lastname: Hsu
authors.affiliation: Division of Child Abuse Pediatrics, Department of Pediatrics, University of Texas Health Science Center at San Antonio.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kellogg
authors.affiliation: Division of Child Protection Pediatrics, Department of Pediatrics, University of Texas Health Science Center at Houston.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Girardet
authors.affiliation: Child Abuse and Neglect Prevention, Children's Hospital of Philadelphia, Pennsylvania.
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Christian
authors.affiliation: Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, Massachusetts Massachusetts Sexual Assault Nurse Examiner Program, Massachusetts Department of Public Health, Boston.
authors.forename: Judith
authors.initials: J
authors.lastname: Linden
authors.affiliation: Women's Emergency Services, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas.
authors.forename: William
authors.initials: W
authors.lastname: Griffith
authors.affiliation: Massachusetts Sexual Assault Nurse Examiner Program, Massachusetts Department of Public Health, Boston.
authors.forename: Anne
authors.initials: A
authors.lastname: Marchant
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, University of Washington, Seattle.
authors.forename: Carole
authors.initials: C
authors.lastname: Jenny
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Hammerschlag
mesh_terms: D000293:Adolescent; D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002650:Child Abuse, Sexual / Q000517:prevention & control / Q000628:therapy; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D019468:Disease Management; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission / Q000821:virology; D006801:Humans; D008297:Male; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D056990:Post-Exposure Prophylaxis; D017410:Practice Guidelines as Topic; D012742:Sex Offenses / Q000517:prevention & control; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: child sexual abuse; sexual assault; sexually transmitted infections