Abstract
Objectives
Systematic reviews on prevalence estimates of child sexual abuse (CSA) worldwide included studies with adult participants referring on a period of abuse of about 50 years. Therefore we aimed to describe the current prevalence of CSA, taking into account geographical region, type of abuse, level of country development and research methods.
Methods
We included studies published between 2002 and 2009 that reported CSA in children below 18 years. We performed a random effects meta-analysis and analyzed moderator variables by meta-regression.
Results
Fifty-five studies from 24 countries were included. According to four predefined types of sexual abuse, prevalence estimates ranged from 8 to 31 % for girls and 3 to 17 % for boys. Nine girls and 3 boys out of 100 are victims of forced intercourse. Heterogeneity between primary studies was high in all analyses.
Conclusions
Our results based on most recent data confirm results from previous reviews with adults. Surveys in children offer most recent estimates of CSA. Reducing heterogeneity between studies might be possible by standardized measures to make data more meaningful in international comparisons.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
In references ** included as secondary source
In references * included as primary source
References
Andrews G, Corry J, Slade T, Issakidis C, Swanston H (2004) Child sexual abuse. In: Ezzati M, Lopez D, Rodgers A, Murray CJL (eds) Comparative quantification of health risks, vol 2. World Health Organization, Geneva, pp 1850–1940
Bolen RM, Scannapieco M (1999) Prevalence of child sexual abuse: a corrective metanalysis. Soc Serv Rev 73(3):281–313. doi:10.1086/514425
Briere J (1992) Methodological issues in the study of sexual abuse effects. J Consult Clin Psychol 60(2):196–203. doi:10.1037/0022-006X.60.2.196
Decker MR, Raj A, Silverman JG (2007a) Sexual violence against adolescent girls: influences of immigration and acculturation. Violence Against Women 13(5):498–513. doi:10.1177/1077801207300654
Dhaliwal GK, Gauzas L, Antonowicz DH, Ross RR (1996) Adult male survivors of childhood sexual abuse: prevalence, sexual abuse characteristics, and long-term effects. Clin Psychol Rev 16(7):619–639. doi:10.1016/S0272-7358(96)00018-9
Edgardh K (2002) Sexual behaviour in a low-income high school setting in Stockholm. Int J STD AIDS 13(3):160–167. doi:10.1258/0956462021924839
Edgardh K, Ormstad K (2000) Prevalence and characteristics of sexual abuse in a national sample of swedish seventeen-year-old boys and girls. Acta Paediatr 88:310–319. doi:10.1111/j.1651-2227.2000.tb01333.x
Finkelhor D (1994) The international epidemiology of child sexual abuse. Child Abuse Negl 18(5):409–417. doi:10.1016/0145-2134%2894%2990026-4
Finkelhor D, Ormrod RK, Turner HA (2007a) Re-victimization patterns in a national longitudinal sample of children and youth. Child Abuse Negl 31(5):479–502. doi:10.1016/j.chiabu.2006.03.012
Gilbert R, Spatz Widom C, Browne K, Fergusson D, Webb E, Janson S et al (2009) Burden and consequences of child maltreatment in high-income countries. Lancet 373(9657):61–68. doi:10.1016/S0140-6736(08)61706-7
Goldman JDG, Padayachi UK (2000) Some methodological problems in estimating incidence and prevalence in child sexual abuse research. J Sex Res 37(4):305–314. doi:10.1080/00224490009552052
Gorey KM, Leslie DR (1997) The prevalence of child sexual abuse: integrative review adjustment for potential response and measurement biases. Child Abuse Negl 21(4):391–398. doi:10.1016/S0145-2134(96)00180-9
Halperin DS, Bouvier P, Jaffe PD, Mounoud RL, Pawlak CH, Laederach Jea et al (1996) Prevalence of child sexual abuse among adolescents in Geneva: results of a cross-sectional survey. Br Med J 312(7042):1326–1329. doi:10.1136/bmj.312.7042.1326
Higgins J, Thompson S (2002) Quantifying heterogeneity in a meta-analysis. Stats Med 21:1539–1558. doi:10.1002/sim.1186
Higgins J, Thompson S, Deeks J, Altman D (2003) Measuring inconsistency in meta-analyses. Br Med J 327:557–560. doi:10.1136/bmj.327.7414.557
Human Developmental Report (2009) http://hdr.undp.org/en/statistics/. Accessed 28 Aug 2009
Leventhal JM (1998) Epidemiology of sexual abuse of children: old problems, new directions. Child Abuse Negl 22(6):481–491. doi:10.1016/S0145-2134(98)00014-3
Loney PL, Chambers LW, Bennett KJ, Roberts JG, Stratford PW (1998) Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Dis Can 19(4):170–177
Pereda N, Guilera G, Forns M, Gomez-Benito M et al (2009a) The international epidemiology of child sexual abuse: a continuation of Finkelhor (1994). Child Abuse Negl 33(6):331–342. doi:10.1016/j.chiabu.2008.07.007
Pereda N, Guilera G, Forns M, Gómez-Benito J (2009b) The prevalence of child sexual abuse in community and student samples: a meta-analysis. Clin Psych Rev 29(4):328–338. doi:10.1016/j.cpr.2009.02.007
Rind B, Tromovitch P, Bauserman R (1998) A meta-analytic examination of assumed properties of child sexual abuse using college samples. Psychol Bull 124(1):22–53. doi:10.1037/0033-2909.124.1.22
Ruangkanchanasetr S, Plitponkarnpim A, Hetrakul P, Kongsakon R (2005) Youth risk behavior survey: Bangkok Thailand. J Adolesc Health 36(3):227–235. doi:10.1016/j.jadohealth.2004.01.013
Rucker G, Schwarzer G, Carpenter JR, Schumacher M (2008) Undue reliance on I(2) in assessing heterogeneity may mislead. BMC Med Res Methodol 8:79. doi:10.1186/1471-2288-8-79
Seedat S, Nyamai C, Njenga F, Vythilingum B, Stein DJ (2004) Trauma exposure and post-traumatic stress symptoms in urban African schools. Survey in CapeTown and Nairobi. Br J Psychiatry 184:169–175. doi:10.1192/bjp.184.2.169
Stoltenborgh M, van Ijzendoorn MH, Euser EM, Bakermans-Kranenburg MJ (2011) A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreatment 16(2):79–101. doi:10.1177/1077559511403920
WHO (2004) WHO suggests guidelines for child and sexual abuse prevention and management in Africa (press release)
References of included studies
*Aberle N, Ratkovic-Blazevic V, Mitrovic-Dittrich D, Coha R, Stoic A, Bublic J et al (2007) Emotional and physical abuse in family: survey among high school adolescents. Croat Med J 42:240–248
*Alikasifoglu M, Erginoz E, Ercan O, Albayrak-Kaymak D, Uysal O, Ilter O (2006) Sexual abuse among female high school students in Istanbul, Turkey. Child Abuse Negl 30:247–255. doi:10.1016/j.chiabu.2005.10.012
*Andersson N, Ho-Foster A (2008) 13,915 reasons for equity in sexual offences legislation: A national school-based survey in South Africa. International Journal for Equity in Health 7:20. doi:10.1186/1475-9276-7-20
**Andersson N, Ho-Foster A, Matthis J, Marokoane N, Mashiane V, Mhatre S et al (2004) National cross sectional study of views on sexual violence and risk of HIV infection and AIDS among South African school pupils. Br Med J 329:952–954. doi:10.1136/bmj.38226.617454.7C
*Aslund C, Nilsson KW, Starrin B, Sjoberg RL (2007) Shaming experiences and the association between adolescent depression and psychosocial risk factors. Eur Child Adolesc Psychiatry 16:298–304. doi:10.1007/s00787-006-0564-1
*Assis SG, Avanci JQ, Santos NC, Malaquias JV, Oliveira RVC (2004) Violence and social representation in teenagers in Brazil. Revista Panamericana de Salud Publica/Pan Am J Public Health 16:43–51. doi:10.1590/S1020-49892004000700006
*Audu B, Geidam A, Jarma H (2009) Child labor and sexual assault among girls in Maiduguri, Nigeria. Int J Gynecol Obstet 104:64–67. doi:10.1016/j.ijgo.2008.09.007
*Banerjee SR, Bharati P, Vasulu TS, Chakrabarty S, Banerjee P (2008) Whole time domestic child labor in metropolitan city of Kolkata. Indian Pediatr 45:579–582
*Banyard VL, Cross C (2008) Consequences of teen dating violence: Understanding intervening variables in ecological context. Violence Against Woman 14:998–1013. doi:10.1177/1077801208322058
*Birdthistle IJ, Floyd S, Machingura A, Mudziwapasi N, Gregson S, Glynn JR (2008) From affected to infected? Orphanhood and HIV risk among female adolescents in urban Zimbabwe. AIDS 22:759–766. doi:10.1097/QAD.0b013e3282f4cac7
*Bonino S, Ciairano S, Rabaglietti E, Cattelino E (2006) Use of pornography and self-reported engagement in sexual violence among adolescents. Eur J Dev Psychol 3:265–288. doi:10.1080/17405620600562359
**Borges G, Benjet C, Medina-Mora ME, Orozco R, Molnar BE, Nock MK (2008) Traumatic events and suicide-related outcomes among Mexico City adolescents. J Child Psychol Psychiatry 49:654–666. doi:10.1111/j.1469-7610.2007.01868.x
**Champion JD, Kelly P (2002) Protective and risk behaviors of rural minority adolescent women. Issues Ment Health Nurs 23:191–207. doi:10.1080/016128402753542965
*Champion JD, Kelly P, Shain RN, Piper JM (2004) Rural Mexican–American adolescent sexual risk behavior. J Rural Health 20:279–285. doi:10.1111/j.1748-0361.2004.tb00040.x
*Chen J (2004) A retrospective survey in child sexual abuse among 565 university students. Chung-Hua Liu Hsing Ping Hsueh Tsa Chih. Chin J Epidemiol 25:873–877
*Chen J, Dunne MP, Han P (2004) Child sexual abuse in China: a study of adolescents in four provinces. Child Abuse Negl 28:1171–1186. doi:10.1016/j.chiabu.2004.07.003
*Chen J, Dunne MP, Han P (2006) Child sexual abuse in Henan province, China: associations with sadness, suicidality, and risk behaviors among adolescent girls. J Adolesc Health 38:544–549. doi:10.1016/j.jadohealth.2005.04.001
*Chen J, Dunne MP, Wang X (2003) Childhood sexual abuse, an investigation among 239 male high school students. Chin Mental Health J 17:345–347
*Cheng-Fang Y, Mei-Sang Y, Ming-Jen Y, Yi-Chinig S, Mei-Hua W, Chu-Mei L (2008) Childhood physical and sexual abuse: prevalence and correlates among adolescents living in rural Taiwan. Child Abuse Negl 32:429–438. doi:10.1016/j.chiabu.2007.06.003
*Dassa SK, Balaka B, Douti NK, Banakinao MY, Kouassi AK, Agbere AR et al (2005a) Study on children maltreatment in families in Togo and thought about educational norms conception. Neuropsychiatr Enfance Adolesc 53:426–431
**Dassa SK, Douti NK, Kpanake L, Koti B, Kuchenhoff B (2005b) Typology of child maltreatment in Togo. Schweizer Archiv für Neurologie und Psychiatrie 156:240–246
*Decker MR, Raj A, Silverman JG (2007b) Sexual violence against adolescent girls: Influences of immigration and acculturation. Violence Against Woman 13:498–513. doi:10.1177/1077801207300654
*Doocy S, Crawford B, Boudreaux C, Wall E (2007) The risks and impacts of portering on the well-being of children in Nepal. J Tropical Pediatr 53:165–170. doi:10.1093/tropej/fmm004
*Eisenberg ME, Ackard DM, Resnick MD (2007) Protective factors and suicide risk in adolescents with a history of sexual abuse. J Pediatr 151:482–487. doi:10.1016/j.jpeds.2007.04.033
*Elbedour S, Abu-Bader S, Onwuegbuzie AJ, Abu-Rabia A, El-Aassam S (2006) The scope of sexual, physical, and psychological abuse in a Bedouin-Arab community of female adolescents: the interplay of racism, urbanization, polygamy, family honor, and the social marginalization of women. Child Abuse Negl 30:215–229. doi:10.1016/j.chiabu.2005.10.010
*Fabijanic S, Flander GB, Karlovic A (2002) Epidemiological study on the incidence of childhood abuse experiences among high school students of Sisacko-Moslavacka County. Paediatria Croatica 46:169–173
**Finkelhor D, Ormrod RK, Turner HA (2007b) Poly-victimization: a neglected component in child victimization. Child Abuse Negl 31:7–26. doi:10.1016/j.chiabu.2006.06.008
**Finkelhor D, Ormrod RK, Turner HA (2007c) Re-victimization patterns in a national longitudinal sample of children and youth. Child Abuse Negl 31:479–502. doi:10.1016/j.chiabu.2006.03.012
**Finkelhor D, Ormrod RK, Turner HA, Hamby SL (2005) Measuring poly-victimization using the Juvenile Victimization Questionnaire. Child Abuse Negl 29:1297–1312. doi:10.1016/j.chiabu.2005.06.005
*Haavet OR, Straand J, Hjortdahl P, Saugstad OD (2005) Do negative life experiences predict the health-care-seeking of adolescents? A study of 10th-year students in Oslo, Norway. J Adolesc Health 37:128–134. doi:10.1016/j.jadohealth.2004.08.031
*Harrison PA, Narayan G (2003) Differences in behavior, psychological factors, and environmental factors associated with participation in school sports and other activities in adolescence. J Sch Health 73:113–120. doi:10.1111/j.1746-1561.2003.tb03585.x
*Hasnain N, Kumar D (2006) Psychological well-being of women reporting sexual abuse in childhood. J Indian Acad Appl Psychol 32:15–19
*Helweg-Larsen K, Boving Larsen H (2006) The prevalence of unwanted and unlawful sexual experiences reported by Danish adolescents: results from a national youth survey in 2002. Acta Paediatr 95:1270–1276. doi:10.1080/08035250600589033
*Kim HS, Kim HS (2005) Incestuous experience among Korean adolescents: prevalence, family problems, perceived family dynamics, and psychological characteristics. Publ Health Nurs 22:472–482. doi:10.1111/j.0737-1209.2005.220604.x
**Larsen HB, Helweg-Larsen K (2003) Childhood sexual abuse and psychological disturbance in a national youth sample. Nordisk Psykologi 55:79–93
*Leung PWS, Wong WCW, Chen WQ, Tang CSK (2008) Prevalence and determinants of child maltreatment among high school students in Southern China: a large scale school based survey. Child Adolesc Psychiatr Mental Health 2:27
*Lien L, Rikard Haavet O, Thoresen M, Heyerdahl S, Bjertness E et al (2007) Mental health problems, negative life events, perceived pressure and the frequency of acute infections among adolescents—results from a cross-sectional, multicultural, population-based study. Acta Paediatr 96:301–306. doi:10.1111/j.1651-2227.2007.00084.x
*Mitchell KJ, Wolak J, Finkelhor D (2008) Are blogs putting youth at risk for online sexual solicitation or harassment? Child Abuse Negl 32:277–294. doi:10.1016/j.chiabu.2007.04.015
*Moran PB, Vuchinich S, Hall NK (2004) Associations between types of maltreatment and substance use during adolescence. Child Abuse Negl 28:565–574. doi:10.1016/j.chiabu.2003.12.002
*Ndetei DM, Ongecha-Owuor FA, Khasakhala L, Mutiso V, Odhiambo G, Kokonya DA (2007) Traumatic experiences of Kenyan secondary school students. J Child Adolesc Mental Health 19:147–155. doi:10.2989/17280580709486650
**Olshen E, McVeigh KH, Wunsch-Hitzig RA, Rickert VI (2007) Dating violence, sexual assault, and suicide attempts among urban teenagers. Arch Pediatr Adolesct Med 161:539–545. doi:10.1001/archpedi.161.6.539
*Orozco R, Borges G, Benjet C, Medina-Mora ME, Lopez-Carrillo L (2008) Traumatic life events and posttraumatic stress disorder among Mexican adolescents: results from a survey. Salud Publica Mex 50:S29–S37
*Polanczyk GV, Zavaschi ML, Benetti S, Zenker R, Gammerman PW (2003) Sexual violence and its prevalence among adolescents, Brazil. Rev Saude Publica 37:8–14. doi:10.1590/S0034-89102003000100004
*Rosenberg HJ, Jankowski MK, Sengupta A, Wolfe RS, Wolford GL, Rosenberg SD (2005) Single and multiple suicide attempts and associated health risk factors in New Hampshire adolescents. Suicide Life Threat Behav 35:547–557. doi:10.1521/suli.2005.35.5.547
*Sears HA, Sandra Byers E, Lisa Price E (2007) The co-occurrence of adolescent boys’ and girls’ use of psychologically, physically, and sexually abusive behaviours in their dating relationships. J Adolesc 30:487–504. doi:10.1016/j.adolescence.2006.05.002
*Sesar K, Zivcic-Becirevic I, Sesar D (2008) Multi-type maltreatment in childhood and psychological adjustment in adolescence: questionnaire study among adolescents in Western Herzegovina Canton. Croat Med J 49:243–256. doi:10.3325/cmj.2008.2.243
*Swahn MH, Bossarte RM (2007) Gender, early alcohol use, and suicide ideation and attempts: findings from the 2005 Youth Risk Behavior Survey. J Adolesc Health 41:175–181. doi:10.1016/j.jadohealth.2007.03.003
*Taquette SR, Andrade RB, Vilhena MM, Paula MC (2005) Comparative study between female adolescents with and without sexually transmitted diseases. Rev Assoc Med Bras (1992) 51:148–152. doi:10.1590/S0104-42302005000300015
*Thurman TR, Brown L, Richter L, Maharaj P, Magnani R (2006) Sexual risk behavior among south african adolescents: is orphan status a factor? AIDS Behav 10:627–635. doi:10.1007/s10461-006-9104-8
**Turner HA, Finkelhor D, Ormrod R (2006) The effect of lifetime victimization on the mental health of children and adolescents. Soc Sci Med 62:13–27. doi:10.1016/j.socscimed.2005.05.030
*Turner HA, Finkelhor D, Ormrod R (2007) Family structure variations in patterns and predictors of child victimization. A J Orthopsychiatry 77:282–295. doi:10.1037/0002-9432.77.2.282
**Wells M, Mitchell KJ (2008) How do high-risk youth use the Internet? Characteristics and implications for prevention. Child Maltreatment 13:227–234. doi:10.1177/1077559507312962
*Witkowska E, Menckel E (2005) Perceptions of sexual harassment in Swedish high schools: experiences and school-environment problems. Eur J Pub Health 15:78–85. doi:10.1093/eurpub/cki119
*Wolitzky-Taylor KB, Ruggiero KJ, Danielson CK, Resnick HS, Hanson RF, Smith DW et al (2008) Prevalence and correlates of dating violence in a national sample of adolescents. J Am Acad Child Adolesc Psychiatry 47:755–762. doi:10.1097/CHI.0b013e318172ef5f
*Worku D, Gebremariam A, Jayalakshmi S (2006) Child sexual abuse and its outcomes among high school students in southwest Ethiopia. Trop Doct 36:137–140. doi:10.1258/004947506777978325
*Yang SC, Zhang YL, Huang GP, Guo GY (2004) A preliminary study on manner of child abuse. Chin J Clin Rehabil 8:2994–2995
**Ybarra ML, Diener-West M, Markow D, Leaf PJ, Hamburger M, Boxer P (2008) Linkages between internet and other media violence with seriously violent behavior by youth. Pediatrics 122:929–937. doi:10.1542/peds.2007-3377
*Ybarra ML, Espelage DL, Mitchell KJ (2007) The co-occurrence of internet harassment and unwanted sexual solicitation victimization and perpetration: associations with psychosocial indicators. J Adolesc Health 41:31–41. doi:10.1016/j.jadohealth.2007.09.010
*Ybarra ML, Leaf PJ, Diener-West M (2004) Sex differences in youth-reported depressive symptomatology and unwanted Internet sexual solicitation. J Med Intern Res 6:49–70. doi:10.2196/jmir.6.1.e5
*Yen C-F, Yang M-S, Yang M-J, Su Y-C, Wang M-H, Lan C-M (2008) Childhood physical and sexual abuse: prevalence and correlates among adolescents living in rural Taiwan. Child Abuse Negl 32:429–438. doi:10.1016/j.chiabu.2007.06.003
*Young A, Grey M, Abbey A, Boyd CJ, Mccabe SE (2008) Alcohol-related sexual assault victimization among adolescents: prevalence, characteristics, and correlates. J Stud Alcohol 69(1):39–48
*Ystgaard M, Reinholdt NP, Husby J, Mehlum L (2003) Deliberate self harm in adolescents: results from the Norwegian part of the multi-centre study ‘Child and Adolescent Self-harm in Europe’ (CASE). J Norwegian Med Assoc 123:2241–2286
*Zolotor AJ, Theodore AD, Chang JJ, Berkoff MC, Runyan DK (2008) Speak softly—and forget the stick: corporal punishment and child physical abuse. Am J Prev Med 35: 364–369. doi:10.1016/j.amepre.2008.06.031
*Zoroglu SS, Tuzun U, Sar V, Tutkun H, Savas HA, Ozturk M, Alyanak B, Kora ME (2003) Suicide attempt and self-mutilation among Turkish high school students in relation with abuse, neglect and dissociation. Psychiatry Clin Neurosci 57:119–126. doi:10.1046/j.1440-1819.2003.01088.x
Acknowledgments
We thank Bruno da Costa for translating the article written in Portuguese and Elisabeth Kiraly for the one in Hungarian. We are grateful to all the experts around the world who took the time to respond to our request for additional information on CSA in their geographical region. A list of the people contacted can be obtained from the corresponding author. We would also like to thank the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) for providing the contact details of most of the experts. This study was initiated and funded by the UBS Optimus Foundation.
Conflict of interest
None declared.
Author information
Authors and Affiliations
Corresponding author
Appendix
Rights and permissions
About this article
Cite this article
Barth, J., Bermetz, L., Heim, E. et al. The current prevalence of child sexual abuse worldwide: a systematic review and meta-analysis. Int J Public Health 58, 469–483 (2013). https://doi.org/10.1007/s00038-012-0426-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-012-0426-1