The purpose of this 20-month prospective study conducted in the dermatology department of Lomé Teaching Hospital was to determine the prevalence of sexual abuse in pre-adolescent children with anogenital warts. From May 1997 to December 1998, a total of 16 cases of anogenital warts were diagnosed in children under the age of 12 years. Sexual abuse was discovered in 8 cases. All 8 cases involved girls (mean age, 6.1 +/- 1.9 years). The mode of acquisition involved self-infection from non anogenital warts in three cases and contamination by the mother in three cases. In two cases the mode of acquisition could not be identified. The alleged abuser was a member of child's family in 3 cases, a household employee working at the child's home in three cases, a teacher in 1, and a neighbor in 1. Syphilitic tests were negative in all children. However HIV infection was detected and the contaminator was identified in one 10-year-old girl. The results of this study document the correlation between anogenital warts and sexual abuse. In Black Africa, the consequences of child sexual abuse, which is not uncommon especially in major cities, are aggravated by the high prevalence of HIV infection.