Transmission of human genital papillomavirus disease: comparison of data from adults and children.

A substantial body of evidence has demonstrated that the primary means of transmission of genital warts in sexually active adults is through sexual contact. However, the epidemiology and social significance of anal-genital warts in prepubertal children is controversial. Debate continues regarding the frequency with which these lesions have resulted from sexual abuse or transmission by other means. An accurate understanding of the dominant means of transmission of anal-genital warts in children is of particular importance because that understanding influences the extent to which child protective services may become involved following a diagnosis. This paper reviews the evolution of the data on the means of transmission of human papilloma virus disease of the genital tract of adults and compares those data with the information available concerning the transmission of anal-genital human papillomavirus-related disease in children. Methods for the diagnosis of child sexual abuse that have developed in the past decade form one of the bases for the evaluation of studies of the transmission of anal-genital human papillomavirus-related diseases to children.