Prevalence of sexually transmitted infections and mental health needs of female child and adolescent survivors of rape and sexual assault attending a specialist clinic
- 1Department of Genitourinary Medicine, Luton and Dunstable Hospital NHS Trust, Lewsey Road, Luton LU4 0DZ, UK
- 2Department of Child and Adolescent Psychiatry, Royal London Hospital, Barts and London NHS Trust, Whitechapel, London, UK
- 3Ambrose King Centre, Royal London Hospital, Barts and the London NHS Trust, Whitechapel, London, UK
- Correspondence to: Dr M Kawsar Department of Genitourinary Medicine, Luton and Dunstable Hospital NHS Trust, Lewsey Road, Luton LU4 0DZ, UK;
- Accepted 17 September 2003
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 (1996–2000).
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.
Funding: not needed.
Ethical approval obtained from East London and the City Health Authority research committee.
Mental health needs of sexually abused girls presenting to a specialist genitourinary medicine clinic was presented at the Fourth European Conference Association for Child Psychology and Psychiatry 2000, London (Poster). Prevalence of sexually transmitted infections was presented at the ISSTDR and IUSTI conference, 2001, Berlin (Poster No 31, abstract: Int J STDs AIDS2001;(suppl 2):.)