Repeated sexual abuse allegations: a problem for primary care providers

Sexual abuse of children is a problem of epidemic proportions in the United States. Primary care providers, including pediatric nurse practitioners, are increasingly presented with the problem of alleged sexual abuse in their patients, and primary care providers typically find it difficult to perform medical evaluations of children for sexual abuse. Having a child present repeatedly with sexual abuse concerns that cannot be substantiated is a stressful and frustrating experience for primary care providers. A case study is presented that illustrates the complexity and difficulty of one such case. A review of the literature will discuss the impact of divorce and Munchausen syndrome by proxy on repeated allegations of sexual abuse. Implications for practice are discussed, and a plan that addresses repeated sexual allegations in primary care settings is outlined.