Sexually transmitted diseases in sexually abused children

Over a 4-year period, 409 cases of suspected sexual abuse of children were reviewed to study sexually transmitted disease (STD). Sexually transmitted disease was identified in 54 (13%) of the 409 children: 46 cases of gonorrhea, six cases of syphilis, four cases of trichomoniasis, and three cases of condyloma acuminata. Nine of the 46 children with cultures positive for gonorrhea did not have a history of discharge. Four of the six children with syphilis also had a gonococcal infection. One child with syphilis had condyloma. Only one child had clinical features of syphilis. Sexually transmitted disease was more likely to be transmitted by an extended family member or a nonfamily member than by a father/stepfather (P less than .001). Laboratory tests that identify sexually transmitted disease may aid in the diagnosis of sexual abuse.