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.