The presence of an STI in a child after the neonatal period generally is indicative of sexual abuse (17). However, there are exceptions. For example, C. trachomatis acquired during the neonatal period can persist for as long as 2 to 3 years and produce eye and genital infections in young children. While genital warts have been identified in sexually abused children, they have also been seen in children with no other indication of abuse ( 18). In addition, most HBV infections in children result from household exposure to persons who have chronic HBV infection.