STIs in children

If a sexually transmissible infection (STI) is identified in a child, confirm the diagnosis with another sample or testing method. Most STI tests can produce false-positive results, and these are proportionally more likely in low prevalence groups such as children.

If an STI is confirmed, seek expert advice. These guidelines contain limited advice on the management of STIs in children; see:

• prevention of perinatal transmission of HIV
• congenital syphilis in neonates
• Neonatal herpes simplex infection
• treatment of gonococcal arthritis and disseminated gonococcal infection in children (see Native bone or joint infection caused by other pathogens)
• treatment of pneumonia caused by Chlamydia trachomatis in infants aged 2 weeks to 5 months
• chlamydial conjunctivitis
• gonococcal conjunctivitis.

Identification of an STI in a child may reflect perinatal transmission, accidental transmission or sexual abuse. If sexual abuse is suspected, immediately refer patients for paediatric and forensic expert advice. Hospital paediatric services can often provide initial phone advice and directions for follow-up and care. In some jurisdictions, it is mandatory to report STI diagnoses in children to state authorities.