Checklist for the Management of Sexual Abuse in Children

Forms (hard copies of all completed forms to be kept in the Rainbow Clinic File for future reference)

• Form 22
• SAP 308 Consent Form
• RMMCH Child Abuse Medical Report Form (preferably) OR J88 Form

Evidence

• Sexual Assault Evidence Collection Kit (If acute - < 72 hours) – obtainable from SAPS
• Swabs – Gonococcus/Chlamydia/Trichomonas (for NAAT and MC&S) + NHLS lab form + STI request form
• Clothing (acute cases)
• Photographs – if relevant (consent for photographs is on the SAP 308 form)

Investigations

• Pregnancy test – Tanner stage 3 or greater
• Bloods – HIV/Treponema pallidum antibody test (TPAT)/Hepatitis B
• Urine Dipstick

Treatment

• PEP HIV Prophylaxis – for acute sexual abuse cases (< 72 hours)
• Pregnancy prophylaxis
• Sexually transmitted infection treatment/prophylaxis

Referral
Consider if child requires admission!
If not admitted, ensure that child is referred as an out-patient to:

• Social Worker
• Psychology
• Rainbow Clinic (for follow-up appointment only if discussed with Dr Cartwright)

Form 22 (original or copy – see above), original Medical Report and SAECK must be handed over to Police officer or Social worker. Hard copies are to be handed to Dr Cartwright for filing in Rainbow Clinic file for future reference.

Follow up

• After 1 week – all acute cases
  • FBC if on AZT prophylaxis
  • Check adherence to prophylaxis
  • Follow-up on all results and clinical assessment of the child
• Repeat HIV, TPAT and Hepatitis B at 6 weeks, 3 months and 6 months

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 Step by Step Guide to the Management of Child Abuse; Rainbow Clinic, RMMCH; Version: July 2023; Checklist for the Management of Sexual Abuse in Children