TABLE 1.

Implications of Commonly Encountered STDs for the Diagnosis and Reporting of Sexual Abuse of Infants and Prepubertal Children

STD ConfirmedSexual AbuseSuggested Action
Gonorrhea*DiagnosticReport
Syphilis*DiagnosticReport
HIV infection§DiagnosticReport
C trachomatis infection*DiagnosticReport
T vaginalis infectionHighly suspiciousReport
C acuminata infection* (anogenital warts)SuspiciousReport
Herpes simplex (genital location)SuspiciousReport
Bacterial vaginosisInconclusiveMedical follow-up
  • * If not perinatally acquired and rare nonsexual vertical transmission is excluded.

  • Although the culture technique is the “gold standard,” current studies are investigating the use of nucleic acid–amplification tests as an alternative diagnostic method in children.

  • To the agency mandated in the community to receive reports of suspected sexual abuse.

  • § If not acquired perinatally or by transfusion.

  • Unless there is a clear history of autoinoculation.