STIs in children and adolescents

The issue of sexually transmitted infections (STIs) in children is a complex area as there are many diverse issues to consider, including both the age and developmental stage of the child, as well as diverse methods of transmission (sexual and non-sexual), and whether sexual transmission is consensual, abusive or exploitative. One has to bear in mind not only the child's own rights but also the family context and the public interest. The definition of a child varies and the same term may be applied to an infant and to a 17-year-old adolescent. The presentation, diagnosis and management of STIs in all age groups are considered. The various methods of transmission of STIs in children and young people, and their relationship to child sexual abuse are poorly researched, but can be an indicator of child sexual abuse (CSA). The need for assessment for CSA and the conflict between child protection and the rights of young people to a confidential sexual health service are all key issues when dealing with STIs in the young.