STIs in children and adolescents

STIs in prepubertal children are uncommon. As in adults, sexually transmitted organisms can be carried asymptomatically. In children considered at risk of sexual abuse, best practice is to exclude sexually transmitted organisms. The presence of a sexually transmitted organism does not prove sexual contact, but may, with other findings, be used for evidential purposes. Some organisms may be transmitted vertically and through non-sexual means, making the significance of diagnosing such infections problematic. Adolescents have the highest prevalences of STIs. With changes in sexual behaviour over the last decade, sexual intercourse under the age of 16 years is often consensual. Issues of coercion should be considered and appropriate action taken in cases where there are concerns. Chlamydia trachomatis remains the most common STI. Young people are more susceptible to contracting STIs, probably through physiology but also sexual behaviour. Confidentiality remains a key consideration for young people using sexual health services.