Yale University School of Medicine, Yale-New Haven Children's Hospital, 840 Howard Avenue, first floor, New Haven, CT 06504, USA.
Curr Opin Pediatr. 2010 Feb;22(1):94-9. doi: 10.1097/MOP.0b013e32833502ad.
Sexual abuse is unfortunately common in the United States. The presence of a sexually transmitted infection in a child or adolescent should prompt an evaluation to exclude sexual abuse.
The present article reviews the demographics of sexual abuse, the prevalence of specific sexually transmitted infections, such as Neisseria gonorrhoeae, Chlamydia trachomatis, HIV, human papillomavirus (HPV) and herpes simplex virus (HSV) and which children and adolescents are at highest risk for contracting such infections. The use of nonculture methods, such as nucleic acid amplification tests (NAATs), to evaluate prepubertal children for N. gonorrhoeae or C. trachomatis, and the use of HIV postexposure prophylaxis are discussed.
Any child or adolescent with a sexually transmitted infection should be evaluated for sexual abuse. Specific infections in prepubertal children, such as Neisseria gonorrhoeae or Chlamydia trachomatis, are due to abusive contact and should be reported to Child Protective Services. As the modes of transmission of anogenital infections with HPV and HSV are unclear, an evaluation for sexual abuse should be done. Although transmission of HIV after sexual abuse is rare, HIV postexposure prophylaxis must be administered in a timely fashion, and adequate outpatient support provided to facilitate compliance and follow-up.
性虐待在美国很常见。儿童或青少年感染性传播感染时，应进行评估以排除性虐待。
本文综述了性虐待的人口统计学特征、淋病奈瑟菌、沙眼衣原体、艾滋病毒、人乳头瘤病毒（HPV）和单纯疱疹病毒（HSV）等特定性传播感染的流行情况，以及哪些儿童和青少年感染这些感染的风险最高。讨论了使用核酸扩增试验（NAAT）等非培养方法评估淋病奈瑟菌或沙眼衣原体的青春期前儿童，以及使用艾滋病毒暴露后预防。
任何患有性传播感染的儿童或青少年都应评估是否存在性虐待。淋病奈瑟菌或沙眼衣原体等青春期前儿童的特定感染是由虐待性接触引起的，应向儿童保护服务机构报告。由于 HPV 和 HSV 的肛门生殖器感染的传播方式尚不清楚，应进行性虐待评估。虽然性虐待后感染艾滋病毒的情况很少见，但必须及时给予艾滋病毒暴露后预防，并提供充足的门诊支持，以促进遵守和随访。
