The review found that health-care providers' recognition of and response to a patient's childhood sexual abuse history can be vital for improved health-care delivery and patient health outcomes. There are specific, patient-informed strategies for health-care providers in terms of facilitation of abuse disclosure and the creation of a safe nonthreatening environment that includes listening to and responding sensitively and appropriately to adverse health effects related to the abuse. Specific impacts of childhood sexual abuse on adult health vary widely among survivors. This requires that each case be examined and treated distinctively based on specific health related factors and causes. Of particular importance for health care providers in interacting with and treating adult survivors of child sexual abuse is knowledge of the process of traumatic stress and associated implications including; individualized triggers, dissociation, somatization (bodily symptoms of emotional distress), stimulus and conditioned responses, and the ebb and flow of recovery. Health-care providers must also be sensitive to power-control issues in interacting with the patient. An authoritarian posture must be relinquished in treating adult survivors of childhood sexual abuse in favor of partnership with the patient in all medical decisions, conducting physical exams, and making referrals. Training for health-care practitioners in the sensitive and knowledgeable care of adult survivors of child sexual abuse would equip them with state-of-the-art knowledge, strategies, and practices in delivering health care to such patients. 37 references