The first comprehensive population based study of the rate of new cases of sexually transmitted infections presenting in children under thirteen years of age has been published in Archives of Disease in Childhood. The study concludes that sexually transmitted infections in children ought to raise immediate concerns as almost all of the cases are likely to be a result of sexual abuse.
The study confirms the incidence of STIs is low – less than one per million children – but the majority of those are likely to be a result of abuse:
- 15 news cases of STIS in under-13s were reported over two years
- Three of these cases of sexual abuse were confirmed in court or case conference
- Abuse was suspected in a further seven cases based on clinical factors, family or social history.
The study found that identified cases were investigated and managed well, and recognises the importance of current guidance on the management of sexually transmitted infection in young children and the need to maintain a high index of suspicion for sexual abuse.
Dr Richard Reading, who led the research team and also chairs the scientific committee of the British Paediatric Surveillance Unit (BPSU), says that sexually transmitted infections in children, although rare, are generally well investigated:
“Sexually transmitted infections in children are uncommon but often indicate sexual abuse. We need to identify sexual abuse in order to protect children, and these infections can have long term consequences on children’s health which need proper investigation and treatment.
“We found very few cases, less than one per million children. Almost all of the cases had other features to suggest they had been sexually abused. This is important from a legal perspective because it contests that these conditions may be spread in non-sexual ways. Our findings do not support that, except in some very rare cases where some of these infections may affect only the eye.
“These findings will be useful for doctors, social workers, police and lawyers who work together to safeguard children from the risk of sexual abuse.”
Gonorrhoea, chlamydia, syphilis and trichomonas in children under 13?years of age: national surveillance in the UK and Republic of Ireland, Richard Reading, Karen Rogstad, Gwenda Hughes, Geoff Debelle, Arch Dis Child, DOI:10.1136/archdischild-2013-304996, published online 25 April 2014.