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Sexually transmitted diseases in sexually abused girls and adolescents

Shapiro, Robert Allan; Makoroff, Kathi Lynn

Current Opinion in Obstetrics and Gynecology: October 2006 - Volume 18 - Issue 5 - p 492–497
doi: 10.1097/
Adolescent and pediatric gynecology

Purpose of review 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.

Recent findings 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.

Summary 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.

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, Ohio, USA

Correspondence to Robert Allan Shapiro, MD, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA Tel: +1 513 636 0037; fax: +1 513 636 0204; e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.