Childhood Sexual Abuse: A Public Health Concern

Abstract

Childhood sexual abuse (CSA) is one of the serious form
of child abuse that includes sexual activity with a minor1.
CSA happens when a child engage in sexual activity for
which he or she cannot give consent, developmentally
unprepared and unable to comprehend. In recent years, this
topic has been received much attention due to its magnitude
and sequel. CSA is a significant public health problem across
the world, owing to its widespread occurrence with grave
lifelong consequences. According to World Health
Organization (WHO), CSA is a gross violation of rights of
children and adolescents and defines CSA as “the involvement
of a child in sexual activity that he or she does not fully
comprehend and is unable to give informed consent to, or
for which the child is not developmentally prepared, or else
that violate the laws or social taboos of society” 2.
The term CSA doesn’t mean necessarily a physical contact
between a perpetrator and a child. It includes different form
of touching and non-touching activities such as; exhibitionism
or exposing oneself or an adult sexual activity to a minor,
attempted intercourse, intercourse, fondling of genitals,
pornography, use of the child for prostitution or pornography,
obscene phone calls, text messages or digital interaction1,3.
Childhood Sexual Abuse - The Dynamics:
As compare to the adult sexual abuse, the CSA is very
different dynamically, that make a unique phenomenon.
Victims of CSA can’t be handled in the same way as in case
of adult sexual abuse4.
The characteristics features of CSA includes:
- Perpetrator seldom used physical force or violence;
instead gain child’s trust and hid the abuse
- The perpetrator is usually a known, reliable or trusted
caregiver.
- Perpetrators develops relationship with child over
time as gradual process of sexualizing
- It often happens over weeks or years
- Occurs frequently as repeated episodes with increase
invasiveness with time
- Most of the cases of CSA are interfamilial or incest.
Who are more susceptible for victimization?
Epidemiological evidence showing that rates for CSA
according to age and gender are different6. For children age
0 – 7 years, CSA rates are equal for boys and girls, but with
increasing age the girls experience CSA at higher rates7,8.
On the contrary, rates for CSA in boys decreases with age,
however rate is as same as girls till the age of 76.
A variety of factors have been recognized that make individual
children susceptible to abuse sexually. The key factors are
believed to be:9
- Female sex
- Unaccompanied children
- Foster care children
- Step children
- Adopted children
- Handicapped children (mentally or physically)
- Low socioeconomic
- Past abuse history
- Parents separation/single parents
- Cognitive/psychological vulnerability
- Mental disorder, or drug/alcohol dependency in parents
- Social isolation