The identification of a sexually transmitted disease in a child beyond the neonatal period has both medical and legal implications. Gonorrhea and syphilis are almost exclusively transmitted sexually and are useful markers of sexual abuse in children. However, exceptions do occur;eg, rectal and genital infection withChlamydia trachomatisin young children may be due to persistent perinatally acquired infection, which may persist for up to 3 years. Infection due to human papillomavirus (condylomata acuminata) presents a similar problem, because the period of latency after perinatal acquisition may be 2 years or longer. Other sexually transmitted diseases, such as bacterial vaginosis, may be acquired nonsexually and have been identified in both abused and nonabused children. When the only evidence of sexual abuse is the isolation of an organism or the detection of antibodies, the findings should be carefully confirmed. Any laboratory report may be required in pending legal action. The identification of gonorrhea andC. trachomatisshould be by culture only, with confirmation by standard recognized techniques.