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Genital infection in young delinquent girls.

Juveniles who have been brought before a Magistrate's court are, in most cases, sent to a Remand home for a short period to allow a full investigation to be carried out. The home at which the examinations described here were carried out is especially intended for girls between the ages of 14 and 17 years. The magistrates may, at their discretion, request that a girl be examined to see if she is pregnant or has contracted any venereal disease. A venereologist attends the home twice a week to carry out these special examinations. Assistance is given by a nurse who is employed fulltime at the home. The procedure adopted is as follows. Shorty after the girls have been admitted, the nurse talks to them and explains the nature and purpose of the examination. It is made quite clear that this will not be carried out unless the girl herself is willing to cooperate. If she is under 16 years of age, written consent from the parent or guardian is also obtained. After these preliminaries, the girl is brought to see the venereologist at the next session. Besides being asked for the usual details of medical history, menstrual history, and sexual experience, each girl is asked directly if she has ever noticed any vaginal discharge. A genital examination is then made, with particular attention to the condition of the hymen, signs of genital and pelvic infection, and signs of pregnancy. Smears and cultures for the diagnosis of gonorrhoea are taken from the urethra and cervix, or from the vagina if the hymen appears to be intact. A specimen of vaginal secretion is taken to detect the presence of trichomonads. All these tests are repeated after an interval of a few days. Smears for the detection of Candida albicans are not made as a routine in every case. Rectal examination is not made unless there is some particular indication, as it is considered that this would not be well tolerated and the number of girls refusing examination would be increased. Serological tests for syphilis are carried out in every case. Between January 1, 1965, and December 31, 1968, 2,002 girls were admitted to the Home. A Court Order requesting the special examination was made in 680 cases, 32 per cent. of the number admitted. In addition, 82 girls were examined at either their own request or that of the general practitioner who sees every girl on admission. Five girls refused to see the venereologist at all and 43, when interviewed, refused to be examined. Full examination was carried out in 716 cases, 93 9 per cent. of the total number in which it was recommended.