Protocolo de atención pediátrica ante la sospecha de abuso sexual infantil en España

Abstract

Sexual abuse in childhood and adolescence is a social and structural problem that affects public health and requires a coordinated healthcare response, with an approach that is sensitive to the trauma the child has experienced and focused on protecting the child. This protocol summarizes the initial clinical management in both emergency departments and pediatric/primary care settings: triage and stabilization, a brief neutral interview, a respectful physical examination, indications and time windows for collecting forensic samples, screening for and prevention of sexually transmitted infections (STI) (including post-exposure prophylaxis for HIV), emergency contraception, vaccination (hepatitis B virus –HBV–/human papillomavirus –HPV–), and a biopsychosocial follow-up plan. It includes practical guidelines based on the time elapsed since the incidents and pubertal age, as well as an operational algorithm that prioritizes health and safety needs over legal considerations. It emphasizes the duty to communicate with the Juvenile Court/Prosecutor's Office, when appropriate, and to coordinate with forensic units in accordance with the common protocols of the National Health System. The objective is to provide students and residents with a brief, practical tool that is consistent with current national and international guidelines.