Sexual assault is a frequently occurring violent crime. Sexually transmitted diseases (STDs) may be acquired during assault. Reported rates of gonorrhea and syphilis in adult victims range from 6% to 12% and from 0% to 3%, respectively. The risk of acquiring other STDs cannot be quantified, although the risk of infection with Chlamydia trachomatis appears highest. In abused children, gonococcal and chlamydial infections are the most frequent findings. In both adults and children, postassault infections with viral agents of STDs, including herpes simplex viruses, hepatitis B virus, and human immunodeficiency virus, have been described. Sensitive, competent care for victims of sexual abuse includes evaluation for STDs soon after the assault and during follow-up.
PIP: This article focuses on the detection and management of sexual assault and sexually transmitted diseases (STDs) in adults and children. Sexual assault is a violent crime affecting both men and women and children of all ages. Sexual abuse can take many forms with rape being the most common form of sexual assault among adults. Among children, sexual assault ranges from fondling to oral and genital contact. Studies showed that the rates of gonorrhea and syphilis in adult victims range from 6% to 12% and from 0% to 3%, respectively. As to other STDs, the risk of acquiring Chlamydia trachomatis infection appears highest. Although the general prevalence of STDs among abused children remained low, studies indicated that gonococcal and chlamydial infections are frequent in this group. Moreover, post-assault infections with herpes simplex viruses, hepatitis B viruses, and HIV have been described in both adults and children. Due to the risk of STDs, prompt, sensitive, and competent care for assaulted victims is necessary which include an evaluation for STDs right after the assault and during follow-up. For adult victims, treatment should be given during the initial evaluation for any infections identified at that time. Treatment of abused children follows the same principles as treatment of adult victims but drug dosage is adjusted depending on body weight.