Sexual violence against children: authors, victims and consequences

Platt, Vanessa Borges; Back, Isabela de Carlos; Hauschild, Daniela Barbieri; Guedert, Jucélia Maria

doi:10.1590/1413-81232018234.11362016

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Article • Ciênc. saúde colet. 23 (4) • Apr 2018 • https://doi.org/10.1590/1413-81232018234.11362016 copy

Sexual violence against children: authors, victims and consequences

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The scope of this study was to identify the characteristics of sexual abuse against children including the profiles of the victims and the perpetrators, and associated factors notified in a health service of reference with the database of the Brazilian Case Registry Database, in a city in the south of Brazil. Categorical variables are presented in prevalence with 95% confidence intervals. There were 489 notifications from 2008 to 2014 of confirmed or suspected child sexual abuse. The majority was related to female victims, but the repeated abuse was reported mainly with male victims. In most cases, the abuse took place at the victims’ or perpetrators’ homes and the main perpetrators of abuse were male and acquainted with the victims. Twelve victims have contracted sexually transmitted infections; pregnancies were six, five of them legally terminated. This study highlights that the child sexual abuse profiles were similar in almost all of Brazilian regions, showing that it is possible to have a coordinated national action to prevent this offence.

Key words
Sexual violence; Children

Variables		Female		Male		p-value^a a Chi square test;
Variables		n (%)	CI95%	n (%)	CI95%
n		369 (100.0)	–	120 (100.0)	–
Age^† † Stratification according to Marcondes. ECA: Children and Adolescent Statute. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.
	< 2 years	21(5.7)	3.3 – 8.1	9 (7.5)	2.7 – 12.3	<0.001
	2\|-- 6 years	115 (31.2)	26.5 – 26.3	51 (42.5)	33.5 – 51.5
	6 \|--10 years	81 (21.9)	17.8 – 26.3	37 (30.8)	22.5 – 39.2
	10\|-- 15 years	152 (41.2)	36.1 – 46.2	23 (19.2)	12.0 – 26.3
ECA age
	Child	225 (69.1)	64.6 – 74.0	106 (88.3)	82.5 – 94.2	<0.001
	Adolescent	114 (30.9)	26.2 – 35.6	14 (11.7)	5.8 – 17.5
Skin color/Ethnicity^* * Data without information from all records; NA: not applicable.
	White	251 (77.5)	72.9 – 82.0	82 (79.6)	71.7 – 87.5	NA
	Black	27 (8.3)	5.3 – 11.4	9(8.7)	3.2 – 14.3
	Yellow	1 (0.3)	0.0 – 0.9	1 (1.0)	0.0 – 2.9
	Brown	44 (13.6)	9.8 – 17.8	11 (10.7)	4.6 – 16.7
	Indigenous	1 (0.3)	0.0 – 0.9	–	–
Disability
	No	349 (94.6)	92.3 – 96.9	113 (94.2)	89.9 – 98.4	0.863
	Yes	20 (5.4)	3.1 – 7.7	7 (5.8)	1.6 – 10.1
Number of occurrences^* * Data without information from all records; NA: not applicable.
	Once	137 (51.3)	45.3 – 57.3	33 (41.3)	30.2 – 52.3	0.114
	2 or more	130 (48.7)	42.7 – 54.7	47 (58.8)	47.7 – 69.8

Variables		Female		Male		p-value^a a Chi square test;
Variables		n (%)	CI95%	n (%)	CI95%
n		369(100.0)	–	120(100.0)	–
Gender^* * Data without information from all records; NA: not applicable. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.
	Male	313 (92.8)	90.1 −95.6	95(88.8)	83.9 −95.6	0.382
	Female	13 (3.9)	1.8 – 5.9	8 (7.5)	1.8 – 11.3
	Both	11 (3.3)	1.4 – 5.2	4 (3.7)	0.1 – 7.4
Known to victim
	Yes	233 (63.1)	58.2 −68.1	92 (76.7)	69.0 −84.3	0.006
	No	136 (36.9)	31.9 −41.8	28 (23.3)	15.7 −31.0
Alcohol use by perpetrator^* * Data without information from all records; NA: not applicable. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.
	No	142 (66.1)	59.7 −72.4	52 (76.5)	66.1-86.8	0.107
	Yes	73 (34.0)	27.6 −40.3	16 (23.5)	13.2 −33.9
Number of people involved^* * Data without information from all records; NA: not applicable. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.
	1	277 (85.0)	81.1 −88.9	92 (86.0)	79.3 −92.7	0.798
	2 or more	49 (15.0)	11.1-18.9	15 (14.0)	7.33 −20.7

Variables			Female		Male		p-value^a a Chi square test;
Variables			n (%)	CI95%	n (%)	CI95%
n			369 (100.0)	–	120(100.0)	–
Sexual harassment^* * Data without information from all records; NA: not applicable.							0.003
	Yes		129 (42.6)	37.0 – 48.2	26 (25.7)	17.1 – 34.4
	No		174 (57.4)	51.8 – 63.0	75 (74.3)	65.6 – 82.9
Rape^† † Association of Indecent Assault and Rape. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.
	Yes		232 (62.9)	57.9 – 67.8	34 (28.3)	20.2 – 36.5	0.079
	No		137 (37.1)	32.2 – 42.1	86 (71.7)	63.5 – 79.8
Penetration^* * Data without information from all records; NA: not applicable.
	Yes		115 (56.1)	49.2 – 62.9	58 (72.5)	62.5 – 82.5	0.011
	No		90 (43.9)	37.1 – 50.8	22 (27.5)	17.5 – 37.5
Penetration Type^* * Data without information from all records; NA: not applicable.
	Anal						<0.001
		Yes	38 (16.4)	11.8 – 21.6	55 (69.2)	59.3 – 80.0
		No	189 (83.3)	78.7 – 88.4	24 (30.4)	20.0 – 40.7
	Oral						0.012
		Yes	19 (8.8)	5.0 – 12.5	14 (19.7)	10.2 – 29.2
		No	198 (91.2)	87.5 – 95.0	57 (80.3)	70.8 – 89.8
	Vaginal
		Yes	128 (59.0)	52.4 – 65.6	NA	–
		No	89 (41.0)	34.4 – 47.6

Variables		Female		Male		p-value^a a Chi square test
Variables		n (%)	CI95%	n (%)	CI95%
n		369 (100.0)	–	120(100.0)	–
STI Prophylaxis ^* * Data without information from all records; NA: not applicable. STI: sexually transmitted infection. HIV: Human Immunodeficiency Virus. HBV: Hepatitis B virus. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.						0.069
	Yes	99 (30.7)	25.6 – 35.7	24 (21.6)	13.8 – 29.4
	No	224 (69.6)	64.3 – 74.4	87 (78.4)	70.6 – 86.2
HIV Prophylaxis^* * Data without information from all records; NA: not applicable. STI: sexually transmitted infection. HIV: Human Immunodeficiency Virus. HBV: Hepatitis B virus. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.						0.116
	Yes	94 (29.1)	24.1-34.1	24 (21.4)	13.7 – 29.1
	No	229 (70.9)	65.9 – 75.9	88 (78.6)	70.9 – 86.3
HBV Prophylaxis^* * Data without information from all records; NA: not applicable. STI: sexually transmitted infection. HIV: Human Immunodeficiency Virus. HBV: Hepatitis B virus. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.						0.318
	Yes	71 (22.5)	17.9 – 27.2	20 (18.0)	10.8 – 25.3
	No	244 (77.5)	72.8 – 82.1	91 (82.0)	74.7 −89.2
Blood collection^* * Data without information from all records; NA: not applicable. STI: sexually transmitted infection. HIV: Human Immunodeficiency Virus. HBV: Hepatitis B virus. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.						0.069
	Yes	167 (52.5)	47.0 – 58.0	49 (42.6)	33.4 – 51.8
	No	151 (47.5)	42.0 – 53.0	66 (57.4)	48.2 – 66.6
Collection of semen^* * Data without information from all records; NA: not applicable. STI: sexually transmitted infection. HIV: Human Immunodeficiency Virus. HBV: Hepatitis B virus. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.						0.901
	Yes	33 (10.7)	7.2 – 14.1	12 (11.1)	5.1 – 17.1
	No	276 (89.3)	85.6 – 92.8	96 (88.9)	82.9 – 94.9
Collection of vaginal secretion^* * Data without information from all records; NA: not applicable. STI: sexually transmitted infection. HIV: Human Immunodeficiency Virus. HBV: Hepatitis B virus. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.						NA
	Yes	70 (24.7)	19.6 – 29.7	NA	–
	No	214 (75.3)	70.3 – 80.4	NA
Emergency contraception^* * Data without information from all records; NA: not applicable. STI: sexually transmitted infection. HIV: Human Immunodeficiency Virus. HBV: Hepatitis B virus. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.
	Yes	48 (16.7)	12.3 – 21.0	NA	–	NA
	No	240 (83.3)	79.0 – 87.7	NA
Legal Abortion^* * Data without information from all records; NA: not applicable. STI: sexually transmitted infection. HIV: Human Immunodeficiency Virus. HBV: Hepatitis B virus. CSA: children sexual abuse. HIJG: Joana de Gusmão Children's Hospital. SINAN: Notifiable Disease Information System.
	Yes	5 (3.5)	0.4 – 6.5	NA	–	NA
	No	138 (96.5)	93.5 – 99.6	NA

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[1] Collaborations

VB Platt contributed substantially to the design, planning, data review and interpretation, elaboration of the preliminary version, paper's critical review and approval of the final version of the work. IC Back contributed to the design, data review and interpretation, critical review of content and approval of final version of the work. DB Hauschild contributed to the planning and data review and interpretation. JM Guedert contributed to data interpretation and critical review of content.