Sexual Assault and Sexually Transmitted Infections in Adults, Adolescents, and Children

• Published in: Clinical infectious diseases Vol. 61; no. suppl 8; pp. S856 - S864
• Main Authors: Sena, Arlene C., Hsu, Katherine K., Kellogg, Nancy, Girardet, Rebecca, Christian, Cindy W., Linden, Judith, Griffith, William, Marchant, Anne, Jenny, Carole, Hammerschlag, Margaret R.
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 15-12-2015
• Subjects: Adolescent; Adult; Centers for Disease Control and Prevention (U.S.); Child; Child Abuse, Sexual - prevention & control; Child Abuse, Sexual - therapy; Chlamydia Infections - diagnosis; Chlamydia Infections - epidemiology; Chlamydia Infections - microbiology; Chlamydia Infections - transmission; Disease Management; Female; Gonorrhea - diagnosis; Gonorrhea - epidemiology; Gonorrhea - microbiology; Gonorrhea - transmission; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - transmission; HIV Infections - virology; Humans; Male; Medical treatment; Papillomavirus Vaccines - administration & dosage; Pathogens; Post-Exposure Prophylaxis; Practice Guidelines as Topic; Sex crimes; Sex Offenses - prevention & control; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - microbiology; Sexually Transmitted Diseases - therapy; STD; Survivor; United States - epidemiology; Young Adult; United States; United States > US; sexually transmitted infections; sexual assault; child sexual abuse
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/cid/civ786

Survivors of sexual assault are at risk for acquiring sexually transmitted infections (STIs). We conducted literature reviews and invited experts to assist in updating the sexual assault section for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases (STD) treatment guidelines. New recommendations for STI management among adult and adolescent sexual assault survivors include use of nucleic acid amplification tests (NAATs) for detection of Trichomonas vaginalis by vaginal swabs; NAATs for detection of Neisseria gonorrhoeae and Chlamydia trachomatis from pharyngeal and rectal specimens among patients with a history of exposure or suspected extragenital contact after sexual assault; empiric therapy for gonorrhea, chlamydia, and trichomoniasis based on updated treatment regimens; vaccinations for human papillomavirus (HPV) among previously unvaccinated patients aged 9–26 years; and consideration for human immunodeficiency virus (HIV) nonoccupational postexposure prophylaxis using an algorithm to assess the timing and characteristics of the exposure. For child sexual assault (CSA) survivors, recommendations include targeted diagnostic testing with increased use of NAATs when appropriate; routine follow-up visits within 6 months after the last known sexual abuse; and use of HPV vaccination in accordance with national immunization guidelines as a preventive measure in the post–sexual assault care setting. For CSA patients, NAATs are considered to be acceptable for identification of gonococcal and chlamydial infections from urine samples, but are not recommended for extragenital testing due to the potential detection of nongonococcal Neisseria species. Several research questions were identified regarding the prevalence, detection, and management of STI/HIV infections among adult, adolescent, and pediatric sexual assault survivors.