Epidemiology of adult sexually transmitted disease agents in children being evaluated for sexual abuse

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Abstract
This prospective study describes the epidemiology of adult sexually transmitted disease agents in 1538 children ages 1 to 12 years being evaluated for possible sexual abuse. Infections with these agents were related to the presence or absence of a history of sexual contact.Neisseria gonorrhoeae(GC) was found in 2.8% (41 of 1469); human papillomavirus presenting as condyloma acuminata, 1.8%Chlamydia trachomatis, 1.2% (17 of 1473);Treponema pallidum(syphilis), 0.1% (1 of 1263); and herpes simplex virus, 0.1%. Overall a history of sexual contact was present in 83% of children withN. gonorrhoeae; condyloma acuminata, 43%Chlamydia trachomatis, 94%; syphilis, 0%; and herpes simplex virus, 50%. Selected vaginal discharges were examined forTrichomonas vaginalisand bacterial vaginosis. In children comprehending questions regarding sexual contact (i.e. were “verbal”), 89% withN. gonorrhoeae, 100% withChlamydia trachomatisand 63% with condyloma acuminata had a history of sexual contact, indicating that in “verbal” children any infection withN. gonorrhoeaeorC. trachomatiswas highly associated with sexual contact.

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