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Table 8 – STI Treatment Guidelines

Implications of commonly encountered sexually transmitted or sexually associated infections for diagnosis and reporting of sexual abuse among infants and prepubertal children

Table 8
Infection		Evidence for sexual abuse	Recommended action
Gonorrhea*		Diagnostic	Report†
Syphilis*		Diagnostic	Report†
HIV§		Diagnostic	Report†
Chlamydia trachomatis*		Diagnostic	Report†
Trichomonas vaginalis*		Diagnostic	Report†
Anogenital herpes		Suspicious	Consider report†,¶
Condylomata acuminata (anogenital warts)*		Suspicious	Consider report†,¶,**
Anogenital molluscum contagiosum	Inconclusive		Medical follow-up
Bacterial vaginosis	Inconclusive		Medical follow-up

Sources: Adapted from Kellogg N; American Academy of Pediatrics Committee on Child Abuse and Neglect. The evaluation of child abuse in children. Pediatrics 2005;16:506–12; Adams JA, Farst KJ, Kellogg ND. Interpretation of medical findings in suspected child abuse: an update for 2018. J Pediatr Adolesc Gynecol 2018;31:225–31.

* If unlikely to have been perinatally acquired and vertical transmission, which is rare, is excluded.

^†Reports should be made to the local or state agency mandated to receive reports of suspected child abuse or neglect.

^§ If unlikely to have been acquired perinatally or through transfusion.

^¶ Unless a clear history of autoinoculation exists.

** Report if evidence exists to suspect abuse, including history, physical examination, or other identified infections. Lesions appearing for the first time in a child aged >5 years are more likely to have been caused by sexual transmission.

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