Utilisation and outcomes of sexually transmitted infection services following child sexual abuse: Insights from Saint Mary's Sexual Assault Referral Centre

Background: Child sexual abuse (CSA) is a major determinant of sexually transmitted infections (STIs). While the absence of an STI does not mean absence of assault, data on the prevalence, timing and outcomes of STI screening in CSA are lacking. Objective: To explore the utilisation of STI services for children at Saint Mary's Sexual Assault Referral Centre (SARC) and investigate characteristics that are associated with timing of STI screening. Participants and setting: 843 (719 females) children (age, 0-17 years) were included, who attended Saint Mary's SARC in Manchester, UK between 2012 and 2015. Methods: We grouped children into those where the STI screen was performed during the forensic medical examination (FME) and those where the STI screen was performed subsequently. We used logistic regression models to estimate odds ratios for the STI screen during FME. Results: 65% of participants had an STI screen at time of FME, while the remaining 35% were advised to attend their local Genitourinary Medicine (GUM). 1.5% of the sample tested positive for an STI. Participants with learning disabilities, who had been affected by domestic violence, who were previously consensually sexually active or if alcohol was related to the incident, had significantly lower odds of STI screen during FME. Participants on the child protection/in-need plan had significantly increased odds of STI screen during FME. Conclusions: Most participants referred to the GUM service were previously consensually sexually active adolescents. This study suggests several characteristics might be associated with the likelihood of children reporting CSA within the forensic window. These are in addition to previously known determinants such as age.

Automated summary

This study explored the utilization of STI services for children in cases of child sexual abuse and found that children with learning disabilities, affected by domestic violence, with prior consensual sexual activity, or alcohol-related incidents were less likely to undergo STI screening during the forensic medical examination. Additionally, children on protection/in-need plans had increased odds of STI screening during the examination.