TABLE 2.

Recommended tests for STIs in children

Infection	Reportable as sexual abuse	Site(s) and specimen(s)	Recommended test(s)
N. gonorrhoeae	Diagnostic	Vagina, urethra (males), rectum, pharynx	Culture on selective media, isolates confirmed by at least 2 methods that use different principles; NAATsb may be used, but some NAATs may cross-react with other Neisseria species; specimens should be retained for additional testing; NAATs are not approved for rectal or pharyngeal specimens
C. trachomatis	Diagnostica	Vagina, urethra (males), rectum, urine (if NAAT is used)	Culture (tissue culture, confirmation by staining with FA-conjugated species-specific monoclonal antibody with visualization of characteristic intracytoplasmic inclusions); NAATsb may be used if culture is not available; specimens should be retained for further testing; NAATs are not approved for rectal specimens
Syphilis	Diagnostica	Serum, active lesions	Serology (initial screening with nontreponemal test, confirmation with treponemal test); dark-field microscopy to identify treponemes in lesions
HSV	Suspicious	Lesions on vagina, urethra (males), rectum	Culture; screening using serology is not recommended
T. vaginalis	Highly suspicious	Vagina	Examination of vaginal wet mount; culture
HPV	Suspicious	Vagina, urethra (males), rectum	Physical examination; biopsy and HPV typing of lesions
HIV	Diagnostica	Serum	EIA, followed by Western blot, viral load

^aIf perinatal acquisition can be ruled out.

^bData on the use of NAATs in children are limited to SDA and TMA with vagina and urine from females.