Guideline

Responding to children and adolescents who have been sexually abused: WHO clinical guidelines

Year of Publication

2017

Issuing Institution

World Health Organization

Links

WHO IRIS

Recommendations

12 included recommendations

HIV post-exposure prophylaxis (PEP) should be offered, as appropriate, to children and adolescents who have been raped involving oral, vaginal or anal penetration with a penis, and who present within 72 hours of the incident.

Status

Maintained

Recommended in favor

Strong

RESPONDING TO CHILDREN AND ADOLESCENTS WHO HAVE BEEN SEXUALLY ABUSED. A 28-day prescription of antiretroviral drugs (ARVs) should be provided for HIV post exposure prophylaxis, following initial risk assessment.

Status

Updated

Recommended in favor

Strong

Certainty of evidence

Low

RESPONDING TO CHILDREN AND ADOLESCENTS WHO HAVE BEEN SEXUALLY ABUSED. A triple-therapy regimen (i.e. with three drugs) of ARVs is preferred but a two-drug regimen is also effective.

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

Very low

Adherence counselling should be an important element in the provision of HIV PEP to (children and adolescents) survivors of sexual assault or rape.

Status

Updated

Recommended in favor

Strong

Certainty of evidence

Very low

Offer emergency contraception to girls who have been raped involving peno-vaginal penetration and who present within 120 hours (5 days) of the incident.

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

Presumptive (or prophylactic) treatment for gonorrhoea, chlamydia and syphilis is suggested for children and adolescents who have been sexually abused involving oral, genital or anal contact with a penis, or oral sex, particularly in settings where laboratory testing is not feasible

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

Very low

For children and adolescents who have been sexually abused and who present with clinical symptoms, syndromic case management is suggested for vaginal/urethral discharge (gonorrhoea, chlamydia, trichomoniasis), and for genital ulcers (herpes simplex virus, syphilis and chancroid), particularly in settings where laboratory testing is not feasible.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

RESPONDING TO CHILDREN AND ADOLESCENTS WHO HAVE BEEN SEXUALLY ABUSED. Psychological debriefing should not be used in an attempt to reduce the risk of post-traumatic stress, anxiety or depressive symptoms.

Status

Updated

Recommended against

Strong

Certainty of evidence

Very low

Cognitive behavioural therapy (CBT) with a trauma focus should be considered for children and adolescents who have been sexually abused and are experiencing symptoms of post-traumatic stress disorder.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

When safe and appropriate to involve at least one nonoffending caregiver, cognitive behavioral therapy with a trauma focus should be considered for both: (i) children and adolescents who have been sexually abused and are experiencing symptoms of PTSD; and (ii) their non-offending caregiver(s).

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

Low

RESPONDING TO CHILDREN AND ADOLESCENTS WHO HAVE BEEN SEXUALLY ABUSED. Psychological interventions, such as Cognitive behavioural therapy, may be offered to children and adolescents with behavioural disorders, and caregiver skills training to their non-offending caregivers.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Low

RESPONDING TO CHILDREN AND ADOLESCENTS WHO HAVE BEEN SEXUALLY ABUSED. Psychological interventions, such as CBT and interpersonal psychotherapy (IPT) may be offered to children and adolescents with emotional disorders, and caregiver skills training to their non-offending caregivers.

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

Low