STIs in Children: A Silent Crisis

Children almost always acquire sexually transmitted diseases via sexual abuse, though the definition of ‘child’ in this case tends to mean pre-pubescent.

Symptoms may not be present with infection, so if sexual abuse is suspected, a full swab should be taken from mouth, anus and vagina to check. These swabs can also prove sexual abuse if there are question marks.

Unchecked disease can cause infertility and pelvic inflammatory disease which no young girl needs to be slapped with before she even knows what it is.

Kids can catch exactly the same STIs as everyone else. The most common STIs in children are still the most common for us all – herpes, chlamydia, gonorrhoea.

1. A review¹ carried out in 209 of 536 children (485 female) found:

15 of the girls had chlamydia
Gonorrhoea was found in 16
Trichomoniasis was found in 5 of 85 girls
1 out of 384 had syphilis
0 had HIV infection
5 had HSV-2 culture (genital herpes)
7 of 283 girls had antibody evidence of HSV-2 infection
40 of 485 girls and 0 of 51 boys had 1 sexually transmitted infection
Girls with vaginal discharge were more likely to test positive for an STI (13 of 53) than other girls (27 of 432)
10 girls with STIs had normal physical evaluations
Most girls (67.5 per cent) that had normal or non-specific findings on anogenital examination had a confirmed STI

The researchers concluded that the prevalence of STIs in sexually victimised children is around ten per cent, with most having normal or non-specific findings on physical examination.

2. A 1982 review² of 409 suspected sexual abuse cases found:

Over a four-year period, there were 409 cases of suspected child abuse reviewed in regards to sexually transmitted infections (STIs). STIs were identified in 54 of the children (13 per cent).

46 cases of gonorrhoea, 9 of which had no history of discharge
6 cases of syphilis, of which 4 children also had gonorrhoea and 1 had the wart virus, and only one child showed symptoms
4 cases of trichomoniasis
3 cases of condyloma acuminata (wart virus)
The review found that an STI was most likely to be transmitted by an extended family member or a non-family member, rather than a father or stepfather.

References

1.
Girardet RG, Lahoti S, Howard LA, et al. Epidemiology of Sexually Transmitted Infections in Suspected Child Victims of Sexual Assault. Pediatrics. Published online July 1, 2009:79-86. doi:10.1542/peds.2008-2947
2.
Hammerschlag MR. Sexually transmitted diseases in sexually abused children: medical and legal implications. Sexually Transmitted Infections. Published online June 1, 1998:167-174. doi:10.1136/sti.74.3.167