Prevalence of sexually transmitted infections and mental health needs of female child and adolescent survivors of rape and sexual assault attending a specialist clinic

Abstract

Objectives: To determine the prevalence of sexually transmitted infections (STIs) and the mental health needs of female child and adolescent survivors of rape and sexual assault who were referred to a specialist genitourinary medicine (GUM) clinic. Method: Retrospective case notes review of 98 females aged 16 or less, who attended over a 5 year period (1996)(1997)(1998)(1999)(2000). Results: The overall prevalence of STIs was 26%. Among the girls who were aged 0-12 years (n = 16), one had gonorrhoea and another had Trichomonas vaginalis infection. Prevalence of STIs in those aged 13-16 years, who were not sexually active before the index assault, was 24% and in those who gave a history of previous consensual sexual activity it was 39% (p = 0.17). Chlamydial infection was more common among the girls who disclosed previous consensual sexual activity than in those did not disclose previous sexual activity (p = 0.012). The overall prevalence of vaginal candidiasis was 17% and bacterial vaginosis 13%. More than one third of the study population gave a history of previous sexual, physical, or other abuse. 81% reported having current psychological difficulties. Mood changes and sleep disturbances were reported more frequently than other psychological symptoms; 15% attempted self harm. All types of psychological difficulties, except mood changes, were not affected by the time interval between index assault and first presentation to the clinic and the type of assailant. 29% had no involvement with social and mental health services before their attendance at the clinic Conclusions: The prevalence of STIs among female child and adolescent survivors of rape and sexual assault attending a specialist clinic was high. The range of mental health and social difficulties was wide and multiple. The importance of an early assessment for the presence of STIs and mental health difficulties was demonstrated. S exual abuse of children and adolescents is widespread.

Diagnosis of Trichomonas vaginalis in Female Children and Adolescents Evaluated for Possible Sexual Abuse: A Comparison of the InPouch TV Culture Method and Wet Mount Microscopy

“…Similarly, the overall prevalence of STIs is low (5%) in most studies of children and adolescents being evaluated for possible sexual abuse. 2,15,[21][22][23][24] When compared to IP, the reference test, the sensitivity of WM in the present study was 67%, consistent with other published studies comparing these 2 testing methodologies in sexually active adolescent and adult females. 11,12 As previously mentioned, studies evaluating STIs in children often used WM as the only diagnostic method and confined testing to those girls with vaginal discharge.…”

Sexually transmitted infections among women attending a Norwegian Sexual Assault Centre

“…We found a lower C trachomatis prevalence than reported in other studies of postpubertal sexual assault victims 9 11 13 15 16 18 20. Given the diversity of these studies, comparable studies should at least be extracted from the same time period as the present,9–11 15 17 20 ensuring that C trachomatis is diagnosed by NAAT.…”

“…Among victims of sexual assault, prevalence rates between 0% and 33% have been reported for STIs,1 9–18 and between 0% and 14% for BBV markers 1 9 10 12 14 16 19. Studies of sexual assault victims differ regarding which conditions to include, mode of detection, and whether they report the prevalence of STIs/BBV markers from examination at the initial SAC visit,9 10 14 15 19 from follow-up consultations at the same clinic,1 13 18 or from referrals to specialised sexually transmitted diseases (STD) clinics 11 12 16…”

Impact of Rape on Female Sexuality: Review of Selected Literature

“…Exam procedures were varied, inconsistently applied, and included mixed urine test, speculum, and external or vulvovaginal swabs. 4 Overall, 26% of the sample was positive for an STI with a nonsignificant trend for greater rates of STIs in adolescents (13 to 16) reporting a history of previous consensual SI. However, when the sample was restricted to those who received the most comprehensive genital examination, the rate of STIs increased to a high rate of 41%.…”