Value of follow-up examinations of children and adolescents evaluated for sexual abuse and assault

Amy R. Gavril, Nancy D. Kellogg, Prakash Nair

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

OBJECTIVE: The purpose of this study was to determine whether follow-up examinations of suspected victims of child sexual abuse influence medical diagnosis or treatment. METHODS: A retrospective chart review of patients with initial and follow-up examinations (examinations 1 and 2, respectively) over a 5-year study period was conducted. Patient and abuse characteristics, interval between examinations and abuse, and examiner experience levels were collected; examination findings and test results for sexually transmitted infections (STIs) were compared for examinations 1 and 2. RESULTS: Among 727 patients, examination 2 resulted in a change in interpretation of trauma likelihood in 129 (17.7%) patients and identified STIs in 47 (6.5%) patients. Changes in trauma likelihood and detection of additional STIs during follow-up examinations were more likely in adolescent, female, and sexually active patients and those with a history of genital-genital contact, unknown examination 1 findings, or drug-facilitated sexual assault. Although examination 2 was less likely to affect the interpretation of trauma likelihood and STIs in preadolescent patients, a change in interpretation of trauma likelihood was noted for 49 (15.5%) of these patients, and 16 (5.1%) were diagnosed with a new STI on examination 2. The level of clinician experience during examination 1 did affect the likelihood of changes in examination findings during examination 2. CONCLUSIONS: Follow-up examinations by specialists affected the interpretation of trauma and detection of STIs in ∼23% of pediatric patients undergoing sexual abuse assessments.

Original languageEnglish (US)
Pages (from-to)282-289
Number of pages8
JournalPediatrics
Volume129
Issue number2
DOIs
StatePublished - Feb 2012

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Keywords

  • Antibiotic prophylaxis
  • Child abuse
  • Child molestation
  • Condylomata acuminata
  • Gynecologic examination
  • Nucleic acid amplification techniques
  • Sex offenses
  • Sexual
  • Sexual
  • Sexually transmitted diseases

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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