Child sexual abuse in India: A systematic review

Engaging Parents in Child-Focused Child Sexual Abuse Prevention Education Strategies: A Systematic Review

Parents are their children's first teachers and there are long-standing calls for their involvement in child sexual abuse prevention. In this rapid systematic review, we asked the following questions: what rationales are used to justify parental involvement in child-focused child sexual abuse (CSA) prevention programs? what approaches are used for parental engagement in child-focused CSA prevention programs? and what are the facilitators and barriers to parental involvement in child-focused CSA prevention programs? We searched CINAHL, Cochrane, ERIC, Medline, PsycInfo, Scopus, and SocINDEX in May 2021. A total of 57 papers met our inclusion criteria, comprised of 50 empirical studies, and 7 program descriptions. Rationales for parental involvement included monitoring and shaping parental attitudes toward CSA program delivery in schools; reinforcing children's learning at home; promoting parent-child communication about CSA prevention; building parent capacity to respond to child disclosures; and supporting program delivery for preschoolers. Types of parental involvement included the following: communication, learning at home, volunteering, decision-making, and collaboration with the community. Barriers to parent involvement included ineffective program engagement modalities, and parental fears and misconceptions.

Thoracolumbar fracture-dislocation in a two-year-old female child following child abuse: A case report and literature review

Child abuse is a matter of serious concern that can often result in devastating injuries. Incidence of spinal injuries from child abuse has been reported in <1-3 % of spinal injury cases. In the present study, a case of thoracolumbar translational injury (AO type C) is presented following an incidence of child abuse in a 2-year-old female. After successful management with operative fixation, the child showed a remarkable recovery in her neurological function with ambulatory power.

Legal Complexities of Adolescent Relationships: A Study of Protection of Child Sexual Offense Cases in India

Introduction The Protection of Children from Sexual Offences (POCSO) Act in India prohibits sexual engagement among individuals under 18 years old. However, societal variables also affect many teenagers' consensual sexual activities. Little research has been conducted on the legal ramifications for consenting to sexual action under the POCSO Act. This study examined consensual sexual assault cases under the POCSO Act and their possible outcome. Methodology Five years of medicolegal records from a tertiary hospital were analyzed for sexual assault victims aged <18 years. Descriptive statistics were used to analyze victim demographics, literacy, sexual acts, reporting patterns, and accused-victim relationships. Result A total of 410 instances of sexual assault were recorded, and 29% involved victims between the ages of 16 and 18. Most victims (73.9%) in this age range were literate, and 85.7% provided consent for sexual relations. Parents or guardians reported all cases, and most of the accused were victims' friends. Discussion The POCSO Act offers legal safeguards for sexual abuse and exploitation. However, their use in adolescent sexual consent has raised concerns. The Law Commission of India's refusal to reassess the POCSO Act's age barrier for sexual consent emphasizes the need for a child-centric approach to negotiating complex teenage relationships. Conclusion Balancing legal obligations and developmental needs is essential to addressing consensual sexual acts under the POCSO Act. While sensitively implementing the law, stakeholders must focus on their children's best interests and healthy development. Child-friendly environments and support systems empower victims and reduce trauma in teenage relationships.

Child sexual abuse and its determinants among children in Addis Ababa Ethiopia: Systematic review and meta-analysis

Child sexual abuse is a significant public health concern and a breach of basic human rights affecting millions of children each year globally. It is typically not reported by victims, hence it remains usually concealed. Except for single studies with varying reports, there is no national studies conducted on child sexual abuse in Ethiopia. Therefore, this review determined the pooled magnitude and determinants of sexual abuse among children in Ethiopia. Potential articles were searched from PubMed, Science Direct, Scopus, and Web of science using relevant searching key terms. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger's test and funnel plot. Cochran's chi-squared test and I2 values were used to assess heterogeneity. A random-effects model was applied during meta-analysis. The pooled prevalence of sexual abuse among 5,979 children in Ethiopia was 41.15% (95% CI: 24.44, 57.86). Sex of children (OR: 2.14, 95%CI: 1.12, 4.06), smoking (OR: 4.48, 95%CI: 1.26, 76.79), khat chewing (OR: 3.68, 95%CI: 1.62, 21.93), and alcohol use (OR: 4.77, 95%CI: 2.22, 10.25) were the determinants of child sexual abuse. The main perpetrators of sexual abuse against children were neighbors, boy/girlfriends, family members, school teachers, and stranger person. Child sexual abuse commonly took place in the victim's or perpetrator's home, school, and neighbor's home. This review revealed that the magnitude of child sexual abuse in Ethiopia was relatively high and multiple factors determined the likelihood of sexual violence against children. Thus, policy-makers and concerned stakeholders should strengthen comprehensive sexual and reproductive health education to reduce the magnitude and consequences of child sexual abuse. Moreover, support with special attention should be given to children with mental illness and physical disabilities.

Child sexual abuse, mental health, and legislation in India and Thailand: A cross-country comparison

INTRODUCTION

Child sexual abuse (CSA) is a serious public health issue in India and Thailand. To identify potential barriers for addressing CSA in these countries, it is necessary to explore and compare research, laws, and policies in these two countries.

MATERIAL AND METHODS

The Scopus and PubMed databases were searched for published literature on "Child Sexual Abuse" AND "India" OR "Thailand" concerning research focus, prevalence, factors, and policies or interventions on CSA. Main legislations related to CSA were compared using a predefined outline. Additionally, authors compared and analysed current legislation in relation to the United Nations Convention on the Rights of the Child (UNCRC).

RESULTS

Published literature (n = 64) included original articles (n = 26), reviews (n = 36), editorials or letters to the editor (n = 2). No collaboration on CSA between the two countries was found. Several differences in the main legislation (e.g., punishment, services) of India and Thailand were observed, both between countries and in relation to the UNCRC.

CONCLUSION

Our findings suggest that CSA is mostly under-researched in both countries in terms of services, policy and legislation. There is a need for cross-country, multidisciplinary, and collaborative research on CSA in both India and Thailand.

Prevalence of HIV, hepatitis B virus, hepatitis C virus, drug use, and sexual behaviors among street children in Iran: A systematic review and meta-analysis

Background and Aims

Street children face a disproportionately higher risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) due to high-risk sexual and drug use practices. We aimed to estimate the prevalence of these infections and related risk behaviors among street children in Iran.

Methods

We searched PubMed, Web of Science (ISI), Embase, Scopus, and Google Scholar for the English-language records and Iranian databases, including SID, Magiran, and IRANDOC for the Farsi-language records up to September 18, 2022. Random effects analysis was used to obtain prevalence estimates for each condition. Homogeneity across included studies was assessed using I 2.

Results

We extracted data from 18 eligible studies, representing 5646 children (83.2% boys), with a mean age of 10.2 (range: 5-18). The prevalence of HIV, HBV, and HCV were 0.79% (95% confidence intervals [CIs]: 0.0-5.56), 1.97% (95% CI: 1.01-3.19), and 1.88% (95% CI: 0.74-3.46), respectively. The prevalence of lifetime drug use and sexual abuse was 8.32% (95% CI: 4.83-12.62) and 10.18% (95% CI: 3.02-20.67) among street children, respectively.

Conclusion

The estimated prevalence of HIV, HBV, and HCV among street children in Iran was higher than the estimates in the general population. Moreover, drug use and the experience of sexual abuse were prevalent among this population. These findings suggest the need for targeted prevention programs for street children in Iran.

Determinants of alcohol use among young males in two Indian states: A population-based study

OBJECTIVES

There is insufficient evidence about the determinants of alcohol use amongst young people in India and other low-and middle-income countries, despite alcohol's high contribution to disease burden and increasing consumption in this population. We aimed to identify and estimate the determinants of alcohol use in a representative sample of 2716 young men from Bihar and Uttar Pradesh who participated in the 'Understanding the Lives of Adolescents and Young Adults' (UDAYA) study.

METHODS

First, we developed an exploratory conceptual framework of potential alcohol use determinants in the study settings based on available literature. We then estimated the effects of 35 potential alcohol use determinants identified in the conceptual framework (including 14 latent factors identified through exploratory factor analysis) on any alcohol use in the past 3 years and regular alcohol use amongst past three-year drinkers, using mixed-effects logistic models. The determinants explored were operationalised using longitudinal data from the UDAYA study.

RESULTS

Our adjusted models identified 18 determinants for past 3-year alcohol use and 12 determinants for regular use. Distal determinants (e.g., socioeconomic status), intermediate determinants (e.g., parental alcohol use, media use), and proximal determinants (e.g., emotional regulation, early tobacco use) were identified. Geographical variations in both outcomes indicate potential differences in unmeasured community-level determinants (e.g., alcohol availability and acceptability).

CONCLUSIONS

Our findings extend the generalizability of several known determinants across settings, yet highlight the importance of addressing alcohol use in young people as a complex and context-dependent issue. Many identified determinants (e.g., education, media use, poor parental support, early tobacco use) are amenable to intervention through multi-sectoral prevention programs/policies. Such determinants should be the focus of ongoing policy/intervention development efforts in the region, and our revised conceptual framework may inform further research in India or similar South Asian settings.

Development of a Brief Psychological Trauma Intervention for Child Sexual Abuse in India

Despite the alarming increase in incidences of child sexual abuse (CSA) in India, intervention research remains preliminary and generic. Although Cognitive Behavior Therapy (CBT) has been found to be consistently effective in addressing the adverse consequences of CSA, none of the cultural adaptations of CBT have been evidenced in India so far. Hence, the present study was conceived to develop a CSA-focused brief CBT intervention for children between 7 and 13 years of age. Intervention development progressed through four steps: 1) a systematic review of literature; 2) a qualitative study, including focused group discussions, conducted with 19 mental health professionals; 3) development of the intervention; 4) expert evaluation and finalization. We developed the intervention with three key elements: restoring the child's functioning, assisting the child in processing, and managing trauma effectively and initiating the process of growth. The intervention predominantly followed the CBT framework while integrating culturally specified techniques. The intervention contains 8 modules and 18 sub-modules structured around three phases of intervention. The intervention is spread across a minimum of 6 required sessions and a maximum of 12 session held twice weekly for approximately 90-120 min duration. A list of 35 activities corresponding to each phase and sub-module of the present intervention has been designed as an intervention workbook. In conclusion, the newly developed intervention is a manualised, culturally competent, psychological intervention developed within the CBT framework for children aged 7-13 years with experience of CSA. The next phases include piloting intervention for feasibility.

Knowledge, Skills, and Self-Disclosure Following a Sexual Abuse Prevention Program Among Iranian Preschoolers: A Cluster Quasi-Experimental Controlled Study

Standard empirical studies are needed despite three decades of research on child sexual abuse prevention programs (CSAPPs). This study aimed to investigate the effects of CSAPP on the child's sexual safety. A multicenter, random cluster, quasi-experimental controlled survey was conducted in a 1:1 ratio in Tehran, Iran, from May to December 2019 in seventy 5- to 6-years-old children from 10 kindergartens. In groups of 7 to 8, the intervention group participated in four sessions of 45 minutes of face-to-face sexual self-care training, 3 to 4 days apart. The control groups received one session on accident safety. Knowledge, self-protective skills, fear, and self-disclosure were assessed respectively by the "Personal Safety Questionnaire (PSQ)," "What If Situation Test (WIST)," "Fear Assessment Thermometer Scale (FATS)," and researcher-made questions before and 8 weeks after the intervention. At the baseline, children obtained 70% of knowledge and 45% of protective skills scores. After the intervention, knowledge, protective skills, and detection of "appropriate requests" were significantly promoted (p < .001). Detecting "inappropriate requests" did not differ; however, all quadruple skills (Say, Do, Tell, and Report) improved significantly. "Girl sex" and "parents' education" were related factors promoting children's protective skills. Sexual abuse self-disclosure was 4.2% (n = 3), and one child reported child sexual abuse (CSA) only after the intervention. Despite the lack of formal education, children's basic knowledge reflects the importance of parents in preventing CSA. However, the CSAPP significantly improved children's skills and revealed one CSA case. CSAPP should not focus solely on risky scenarios because if children cannot distinguish between safe and unsafe situations, they will experience unnecessary anxiety. Even after recognizing the dangerous conditions, CSA prevention will practically fail without appropriate reactions such as escaping and reporting. CSAPP should emphasize individual rights such as body ownership and assertiveness skills and explain the "danger of known people" with detailed scenarios, especially in collectivistic and traditional societies.

Child Maltreatment, Abuse, and Neglect: An Umbrella Review of Their Prevalence and Definitions

Objective

Child maltreatment (CM) is a recognized public health problem, and epidemiologic data suggest that it is a widespread phenomenon, albeit with widely varying estimates. Indeed, CM as well as child abuse (CA) and neglect (CN) are complex phenomena that are difficult to study for several reasons, including terminological and definitional problems that pose a hurdle to estimating epidemiological rates. Therefore, the main aim of this umbrella review is to revise recent review data on the epidemiology of CM, CA, and CN. A second aim was to revise the definitions used.

Method

A systematic search of three databases was performed in March 2022. Recent reviews (published in the last 5 years: 2017-March 2022) addressing the epidemiological rates of CM, CA, and/or CN were included.

Results

Of the 314 documents retrieved by the selected search strategy, the eligibility assessment yielded a total of 29 eligible documents. Because of the great heterogeneity among them, a qualitative rather than a quantitative synthesis was performed.

Conclusions

The data from this umbrella review show that the different age groups, methods, and instruments used in the literature to collect the data on the epidemiology of CM make it difficult to compare the results. Although definitions appear to be quite homogeneous, CM categorization varies widely across studies. Furthermore, this umbrella review shows that the CM reviews considered do not examine some particular forms of CM such as parental overprotection. The results are discussed in detail throughout the paper.

Sociodemographic and Clinical Characteristics of Child Sexual Abuse Reported to an Urban Public Hospital in Southern India, 2019-22

OBJECTIVES

To describe the profile of child sexual abuse (CSA) reported to a tertiary care hospital.

METHODS

A retrospective analysis of CSA reported in children aged below 18 years from January, 2019 to June, 2022.

RESULTS

Out of the 231 cases of sexual abuse reported, 115 (49.8%) were children below 18 years. Most of the victims were children from 10 to 15 years (37.4%), and there were only two male victims. In 89.6%, the perpetrator was known to the victim. Revictimization was seen in 31%. The reported perpetrators were friends (27%), neighbors (34.8%), strangers (10.4%), or fathers (7.8%). Penetrative abuse was seen in 58.3% of reports. External injuries were seen in 6.96%. Eight victims were pregnant and HIV screening was positive in one victim.

CONCLUSION

Early identification of CSA is important to prevent revictimization. Children from all age groups can be victims of CSA. Perpetrators can hail from all walks of life of the children.

Lifetime and Child Sexual Violence, Risk Factors and Mental Health Correlates Among a Nationally Representative Sample of Adolescents and Young Adults in Haiti: A Public Health Emergency

Very little is known in Haiti and the Caribbean regarding child and lifetime sexual victimization. Using a nationally representative sample of adolescents and young adults aged 15-24, this study aimed to document the prevalence, risk factors and mental health correlates of lifetime and child sexual violence in Haiti. A national cross-sectional surrvey was conducted in Haiti, using a multistage sampling frame, stratified by geographical department, urban or rural setting, gender, and age groups (15-19 and 20-24 years). The final sample included 3586 household participants (47.6% female). A weighted sample of 3945 individuals was obtained and used in the following analyses. Overall rate of lifetime and child sexual violence was, respectively, 27.44% (95% CI 25.94-28.94) and 11.27% (95% CI 10.18-12.35). Lifetime sexual violence rate was significantly higher among female participants (29.02%; 95% CI 27.5-30.55) compared to male (25.73%, 95% CI 24.26-27.2), χ² = 4.63, p < .05, but there was no significant gender difference for child sexual victimization. Experiences of family physical violence, emotional abuse by mother and father, divorce of parents, and other physical violence were strongly associated with higher odds of sexual victimization. Participants who reported having experienced sexual violence are more at risk to meet criteria of PTSD (OR = 1.96, 95% CI 1.66-2.32; p < .0001), depression (OR = 1.73, 95% CI 1.47-2.02; p < .0001), psychological distress (OR =1.72, 95% CI 1.47-2.02; p < .0001), and substance abuse (OR = 1.33, 95% CI 1.13-1.57; p < .0001). Findings demonstrate that sexual violence is a public health emergency in Haiti. They provide evidence for the development of prevention and intervention programs.

The Impacts of Armed Conflicts and Civilian Uprisings on Children's Health

Besides the most common causes of death, children under 14 may suffer from the consequences of disasters and emergencies caused by natural and manmade risks and hazards. These incidents may be prevented by proper risk assessment and the prevention of unnecessary deaths by increasing the safety and well-being of children. An increasing number of manmade incidents are seen in international, non-international, and domestic conflicts when government forces use heavy and light weapons within countries with autocratic leadership. These deaths should be mitigated by holding perpetrators responsible for their deeds and respecting international humanitarian law, human rights, and children's rights.

Facilitators and Barriers to Child Sexual Abuse Interventions: A Qualitative Study of Interventions in Iran

Background: Child sexual abuse is a public health problem in most countries. Sensitization, research, and programs for identifying and preventing child sexual abuse have been carried out at the national level with increased political and social awareness and international commitments to decline its consequences. Objectives: This study investigated the facilitators and barriers to community-based interventions for child sexual abuse. Methods: Semi-structured interviews were conducted between September 2021 and March 2022 with 15 purposefully selected experts. The interviews were audio-recorded, transcribed, and analyzed using the content analysis method. Results: Several barriers and facilitators affected child sexual abuse interventions. The barriers included: (1) sociocultural challenges; (2) legal challenges and gaps; and (3) managerial-structural challenges, while the facilitators were: (1) the improvement of the quality of provided services; and (2) facilitative role of the law. Conclusions: Social interventions for child sexual abuse could consider some items to improve implementation, namely as follow: (1) the intersectional cooperation of organizations and beneficiaries to conduct child abuse interventions for children and their families at the local and national levels; (2) the implementation of empowerment activities for the return of children and parents to the community after child sexual abuse; and (3) the revision of the laws and establishment of more deterrent punishments.

A study on child sexual abuse reported by urban indian college students

Background and Objectives

The prevalence of child sexual abuse (CSA) in India is 18-50% depending on the population studied. To devise strategies for prevention of CSA at the primary care level, we studied the prevalence of CSA amongst college students aged 17-25 years.

Methods

A group of medical students and their friends were sent, an anonymous questionnaire validated by experts via WhatsApp. The questionnaire assessed demography, occurrence of prior CSA and details of the sexual abuse.

Results

About 574 students participated in the study. The majority of respondents were female (380, 66.2%). About 467 (81.2%) of participants were from South India. Of the 380 women and 194 men who consented to participate in the study, 218 (57.3%) and 65 (33.5%), respectively, said that they had been sexually abused in the past (p < 0.00001). The event commonly occurred at 12-14 years (22.6%), but about 53% of victims were <12 years of age. The perpetrator was usually male (93.2%), less than 30 years of age (54%) and a stranger (42.7%). The most common form of CSA from 348 instances in 283 respondents was some form of "bad touch or caresses" (56.6%). About 25.8% of those abused did not speak to anyone about the event. Only 249 respondents (43%) were counselled regarding CSA by their parents.

Conclusions

The prevalence of CSA amongst South Indian college students is 49.3%. The victims were mainly girls <12 years of age and the perpetrators were mainly male (93.2%). Primary Care Physicians can play a greater role in the early detection and prevention of CSA.

Child sexual abuse prevention involving mothers: A Quasi-experimental study with Protection Motivation Theory-based intervention

Child sexual abuse (CSA) is a worldwide problem. The safety of children is everybody's responsibility. Parental and family involvement is crucial in the CSA prevention process. Parental lack of knowledge may increase the risk of abuse among children. Educating parents is crucial as children are mostly dependent on them. The role of mothers in educating children on CSA is of relevance as they are identified as more sensitive and responsible caregivers. The present study aimed to promote knowledge and attitude towards CSA prevention among mothers through a psychoeducation program. A pre- and posttest design (n = 67) was used with an intervention based on Protection Motivation Theory (PMT). A CSA knowledge and attitude scale was developed for the assessment of the participants for the study. There were significant changes in knowledge and attitude among the participants after the intervention. The prevention of CSA will be effective with knowledge gains after the PMT-based intervention. The intervention programs that involve mothers in CSA education have benefits. The findings of this study can be helpful to incorporate public health approaches to devise evidence-based parental programs in community settings.

Child sexual abuse in Iran: a systematic review of the prevalence, risk factors, consequences, interventions and laws

BACKGROUND

Child sexual abuse is a widespread global problem and a violation of human rights. Although many studies have been conducted in this field in the world, the information and knowledge of child sexual abuse in Iran is still limited. This study aims to review the current knowledge in the area of child sexual abuse in Iran, and the related laws.

METHODS

The research systematic review covers the scientific literature and gray literature in Persian and English in Iranian and international databases from the beginning to June 2021 as well as Iranian laws on child protection.

RESULTS

Our study shows that in Iran knowledge on child sexual abuse is limited. The prevalence of child sexual abuse is estimated to be 1.5 to 32.5%; the risk factors for child sexual abuse encompass substance abuse, low literacy and education, parents living separately and divorce, poverty and poor socioeconomic status, and living in large families. The consequences of child sexual abuse are anxiety, depression, and social problems. Effective local interventions focused on parents and abused children have been conducted to raise awareness and prevent psychosocial harms as well as reduce aggression and physical and mental problems of children. Existing laws do not specifically address child sexual abuse.

CONCLUSIONS

The findings showed that knowledge of child sexual abuse in Iran is limited, scattered and inconsistent and there is no suitable definition and tool for measuring child abuse in Iranian studies. National and effective interventions for the prevention of child sexual abuse have not been performed and the consequences of child sexual abuse have also not been well studied. Thus further studies are required to estimate the prevalence of child sexual abuse at the national level and to assess the factors related to child abuse, its consequences, prevention methods and development of existing laws and policies with a special focus on child sexual abuse.

Quality of online news media reports of child sexual abuse in India

BACKGROUND

Media plays an important role in creating awareness and shaping public opinion about child sexual abuse (CSA). Research suggests that sensible media reportage on CSA is important for positive impacts of media. However, most of the studies assessing the quality of CSA news reports are from western countries.

AIM

To systematically assess the pattern of online news media reportage of CSA in India.

METHODOLOGY

A total of 149 news reports on the topic of CSA in India, published online over a one-year period were analyzed. Framing of CSA and other news media characteristics were evaluated.

RESULTS

Framing of CSA was episodic in majority of news reports, with criminal-justice system-related details about individual cases mentioned in about 90% reports. Further, more than two-third news reports did not mention possible causes or reasons of CSA, and possible steps that people could take to prevent CSA. About one-fifth of news reports provided statistics, research findings, or correct information to dispel myths or wrong public stereotypes about CSA. Inclusion of child helpline or contact information of any child welfare/support services was missing in most of the news reports.

CONCLUSION

This is the first study to systematically assess the quality of news media reports on CSA in India. It provides valuable baseline information about existing media practices and helps in identifying areas for further improvement of media reporting on CSA. There is a need to conduct regular workshops with media professionals to provide them adequate training and support for improving media reporting of CSA.

A multidisciplinary approach in pre-pubertal child sexual assault cases - forensic evaluation and suggestions

BACKGROUND

Child sexual assault is highly prevalent in India yet a handful cases are reported under POCSO (Protection against child sexual offenses) Act, 2012. Even though the victims' testimony alone is enough to arrest accused as regulated by the Supreme Court but forensic evidence is still critical for sentencing rapists. A systematic evaluation of such cases will estimate impact of Child sexual assault (CSA) and pinpoint important aspects required for progression of prevention strategies and provision of support.

METHOD AND OBJECTIVE

Present study reviewed cases pertaining pre-pubertal victims (up to 10 years age). Study included simple descriptive analysis of data highlighting significance of different variables in sexual assault cases involving child victims- perpetration, interventions, medical examination and forensic DNA analysis with the aim to improve primary preventive strategies and identify potential setbacks obstructing road to justice.

RESULT

The strengths and weaknesses of pre-pubertal sexual assault assessment were identified. This study analyzed socio-economic backgrounds, age of alleged accused and whether known to the victim. Frequently reported type of abuse was assessed and total reviewed cases that yielded DNA profile from exhibits of victims and alleged accused were determined.

CONCLUSION

As emerged in present study, pre-pubertal CSA is a complicated phenomenon grounded in interplay between societal influences, family support, evidence collection, legal delays, and medical hindrances that greatly affect DNA analysis. Prevalence of CSA is evidently alarming and demands stringent measures to be taken to prevent and control it. Joint and multidisciplinary assessment is important for forensic reporting rather than solo assessment.

Enabling Young People from Informal Urban Communities to Exercise Their Right to Sexual and Reproductive Health: A Practice-Based Study

This qualitative study explores how comprehensive sexuality education located within a broader positive youth development approach informed transformations among young people from informal urban communities in India. A thematic analysis of data obtained from the young people, their parents, and frontline workers revealed that securing the cooperation of families was possible for the program because sexual and reproductive health education was not a stand-alone intervention, but a part of a larger approach seeking to build capacities of young people. The strategic introduction of sexual and reproductive health communication helped the participants to overcome inhibitions about the topic. Enhanced awareness of gender, pubertal changes, gender-based violence, and child sexual abuse was evidenced post participation. Improved agency was manifest through decision making, critical thinking, confidence, mobility, and articulation, especially among girls. Program interventions to enhance sexual and reproductive health awareness of parents and communities and to improve health services and facilities were bolstered through youth engagement. Such contribution by the young reinforced their knowledge and skills, strengthened agency, and cemented family and community support. A holistic program situated within the positive youth development approach thus seemed a pragmatic vehicle to promote comprehensive sexuality education for young people in vulnerable urban communities.

The Prevalence of Sexual Interest in Children and Sexually Harmful Behavior Self-Reported by Men Recruited Through an Online Crowdsourcing Platform

This study examined the feasibility of using crowdsourcing to recruit men who self-report sexual interest in children or sexually problematic behavior involving children. Crowdsourcing refers to the use of the internet to reach a large number of people to complete a specific task. A nonrepresentative sample of men (N = 997) participated in a brief self-report survey examining age of attraction, sexual interest in children, proclivity toward sexual offenses involving children, and history of sexual offending. Almost a quarter of the sample (23.1%) indicated some degree of sexual interest in children, propensity to sexually offend against children, and/or actual offending behavior. We present our data broken down by type of interest or behavior and examine the frequency of these outcomes. Findings are likely to be of value to those considering the viability of crowdsourcing to overcome the limitations or challenges of face-to-face research on stigmatizing interests and behaviors. Findings also contribute to estimating prevalence of self-reported sexual interest in children, and sexual offending behavior toward children, across different countries.

Cotton fiber ball as an unusual cause of vaginal discharge in a 5-year-old child

Vaginal discharge in children can be due to many causes. Foreign body in vagina is an unusual cause. Foul-smelling, blood-stained vaginal discharge should raise the suspicion of foreign body in vagina. Magnetic resonance imaging (MRI), vaginal examination under general anesthesia may detect foreign bodies in vagina. We found a cotton fiber ball in vagina, probably caused by the child's teddy bear as a cause of vaginal discharge in a 5-year-old child. A repeat MRI suggested foreign body in the vagina and vaginal exploration under general anesthesia helped for the removal of cotton fiber ball, which led to complete clearance of the vaginal discharge in the child.

Evaluation of Juvenile and Adolescent Sexual Abuse Victims: A Retrospective Study

OBJECTIVE

This study aimed to evaluate the sociodemographic characteristics and the mental, anogenital, and physical examination findings of child and adolescent sexual abuse victims and to discuss them in the light of the literature.

MATERIALS AND METHODS

This study included a total of 134 children and adolescent cases between the ages of 0 and 18 who were victims of sexual abuse, from among the reports prepared in the Forensic Medicine Clinic of Bolu Abant Izzet Baysal Training and Research Hospital between 2015 and 2019.

RESULTS

This study included 134 cases: 113 (84.3%) were female and 21 (15.7%) were male. The mean age was 13 ± 3.4 years (min: 3, max: 17). The average age of the defendants was 25.6 ± 13 years (min: 12, max: 75), and all the defendants were male. The defendants were strangers in 60 cases (4.8%). Sexual abuse mostly occurred as vaginal penetration in 46 cases (34.3%). Sixty-nine (51.5%) cases were exposed to abuse more than once. Depression due to sexual abuse developed in 14 (10.4%) of the cases.

CONCLUSION

Considering that many child abuse victims have normal examination findings, it should not be forgotten that the interview and psychiatric examination with the child are as valuable as the genital examination.

Lifetime child sexual abuse assessed at age 18: A survey of college students from Kerala, India

Estimates of child sexual abuse (CSA) during adolescence may undercount exposure and retrospective recollection in adulthood may be prone to recall bias. Thus, a more accurate and CSA may be possible if the question is examined in a large sample of 18 years old. This study examined the prevalence and psychosocial correlates of CSA among college-going 18 years olds. This is a cross-sectional survey of college students. 1424 students from 58 colleges selected by cluster random sampling completed a self-administered questionnaire incorporating standardized instruments. Prevalence rates were calculated. Chi-square test was used to compare categorical variables and binary logistic regression analysis was used to examine the correlates of CSA. CSA was reported by 13.2% and significantly more common among males compared to females (18.4% vs. 10.4%, P < 0.05). In the full model of binary logistic regression analysis, students who reported sexual abuse were significantly more likely to report psychological distress and suicidal thoughts. The finding was replicated even when male and female students were analyzed separately. To conclude, CSA is common among college students. With an increasing number of young people enrolling in colleges in India, timely interventions on campuses are important to reduce the psychological morbidity in this population.

Gender Differences in Childhood Maltreatment: A Comparative Study of Nightmare Sufferers and Non-sufferers

Child maltreatment has been identified as a significant problem, both within India and outside. According to UNICEF, over the last decade, there has been a growing recognition about this, but the problem has remained unresolved largely due to being underreported and undocumented. Previous research in this area has reported inconsistent gender differences across the world. Besides, there are shreds of evidence to suggest that childhood maltreatment would be associated with nightmares later in life, but a handful of studies exist in this context. Moreover, there is a paucity of research concerning the interaction effect of gender and group (nightmare sufferer vs non-sufferer) on childhood maltreatment. Owing to the insufficient research and inconsistent findings, the present study aimed to investigate gender differences in childhood maltreatment among nightmare sufferers as compared to non-sufferers. A total of 120 participants were selected from New Delhi. The results of two-way ANOVA suggest that the nightmares later in life would be associated with the abuse and neglect experienced during childhood as nightmare sufferer group reported having higher rates of child abuse and neglect than non-sufferers. It also suggests that male participants in general experience childhood maltreatment more than females; however, emotional abuse was experienced by males only if they belonged to the nightmare sufferer group.

Current of Child Sexual Abuse in Asia: A Systematic Review of Prevalence, Impact, Age of First Exposure, Perpetrators, and Place of Offence

BACKGROUND: Child sexual abuse (CSA) is a serious global problem and challenge for all people because it increases the risk of various issues. AIM: This study investigated the CSA in Asian countries focusing on prevalence rates, impact, victim’s age of first exposure, type of CSA, perpetrator, and places of CSA offence. METHODS: We searched PubMed, Medline, ProQuest, ScienceDirect, CINAHL, Academic Search Complete, ClinicalKey, PsycINFO, Google Scholar, and manual search for studies published between January 2011 and November 2020. Only articles related to CSA in Asia were included in this review. RESULTS: The results showed that prevalence of CSA ranged from 2.2% - 94% for girls and 1.7% - 49.5% for boys. The prevalence rates for non-contact abuse were 12.6% - 56.5% for girls and 0.7% - 68.7% for boys; contact abuse was 5.3% - 67.2% for girls and 2.2% - 53.3% for boys; penetrating abuse was 0.5% - 88.24% for girls and 1.7% - 57.1% for boys. The findings reported most victims’ age of first exposure was preteen. The rate of the violation occurring in the victim’s house was 6.1% - 41.9%; most CSA perpetrators are known by victims. This study reported adverse impacts on CSA victims such as psychological, health, and physical disorders, and changes in behavior. In addition, other findings were found, including recovery, perceptions, values, causes, and expectations of victims of CSA. CONCLUSIONS: The incidence of CSA in Asia is still high and the age of the first victims is early adolescence. The majority of victims are women who already know the perpetrator, and taboo cultural factors are thought to play a role in increasing CSA in Asia. The results indicate the need to develop CSA prevention efforts that involve culture.

Descriptive Analysis of the Characteristics of Proven Cases of Sexual Abuse in Victims With Intellectual Disabilities and Children With Typical Development in Spain

Children and people with intellectual disability (ID) are considered to be highly vulnerable and in need of special protection against sexual abuse (SA). The objective of this work was to analyze the characteristics of cases of SA in children with typical development and in people with ID in Spain. To do so, 25 cases of each type that had been investigated by specialized groups of the Judicial Police of the Spanish Civil Guard and that had been classified as proven and confirmed by police and forensic-medical evidence were analyzed. The results allowed the establishment of the typical minor victim profile as Spanish female (76%), with an average age of 8.64 years. Typical victim with ID was characterized as being of Spanish, aged 20.28 years on average, without prior sexual experience, and similar percentages of males (40%) and females (60%). In both cases, the aggressor usually acted alone, was known to the victim, had an average age of 42 years, and without a history of sexual offenses. The most common child sexual crime was SA with penetration, practiced repeatedly, using strategies such as the use of force, authority, rewards, or secrecy. Victims with ID suffered sexual abuse with penetration, using force, authority, threats or blackmail. Finally, 36% of minors not disclose the events by only 8% of victims with ID. Spontaneity was found in the 40% first disclosure in both victims, with greater police evidence and greater recognition of guilt on behalf of the aggressors against victims without disabilities. Minors took an average of 26.26 days to report the facts, and victims with ID of 64.94. It is necessary to know more about these types of offenses to design appropriate prevention and detection programs.

Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort

BACKGROUND

Adverse childhood experiences (ACEs) increases vulnerability to externalising disorders such as substance misuse. The study aims to determine the prevalence of ACEs and its association with substance misuse.

METHODS

Data from the Consortium on Vulnerability to Externalising Disorders and Addictions (cVEDA) in India was used (n = 9010). ACEs were evaluated using the World Health Organisation (WHO) Adverse Childhood Experiences International Questionnaire whilst substance misuse was assessed using the WHO Alcohol, Smoking and Substance Involvement Screening Test. A random-effects, two-stage individual patient data meta-analysis explained the associations between ACEs and substance misuse with adjustments for confounders such as sex and family structure.

RESULTS

1 in 2 participants reported child maltreatment ACEs and family level ACEs. Except for sexual abuse, males report more of every individual childhood adversity and are more likely to report misusing substances compared with females (87.3% vs. 12.7%). In adolescents, family level ACEs (adj OR 4.2, 95% CI 1.5-11.7) and collective level ACEs (adj OR 6.6, 95% CI 1.4-31.1) show associations with substance misuse whilst in young adults, child level ACEs such as maltreatment show similar strong associations (adj OR 2.0, 95% CI 1.1-3.5).

CONCLUSION

ACEs such as abuse and domestic violence are strongly associated with substance misuse, most commonly tobacco, in adolescent and young adult males in India. The results suggest enhancing current ACE resilience programmes and 'trauma-informed' approaches to tackling longer-term impact of ACEs in India.

FUNDING

Newton Bhabha Grant jointly funded by the Medical Research Council, UK (MR/N000390/1) and the Indian Council of Medical Research (ICMR/MRC-UK/3/M/2015-NCD-I).

Adverse Childhood Experiences & mental health - the urgent need for public health intervention in India

Global evidence has demonstrated that Adverse Childhood Experiences (ACEs) up to age 18 significantly increases the risk of mental and physical health for an adult. The research linking ACE with health and well-being has confirmed a dose-response relationship between the number of ACEs experienced and the extent of the impact on wellbeing. The source of ACE is the family, community, and the immediate environment, and it causes long-term risk for mental health with the potential to carry it over beyond the present generation. The findings are consistent across the developed and developing countries, and the evidence highlights the need for new elements beyond the 10 ACE elements in the pathbreaking original study. India needs urgent intervention on ACE prevention and management with 0.4 billion children and adolescents, with one out of seven Indians with mental health issues. Firstly, this commentary reviews global research and summarizes the limited evidence available in India on ACE elements' impact on mental health. And, secondly, it proposes a multi-pronged approach to identify, manage and prevent the mental health implications of ACE in India to preempt a significant public health challenge.

Prevalence of child maltreatment in India and its association with gender, urbanisation and policy: a rapid review and meta-analysis protocol

INTRODUCTION

India is home to 20% of the world's children and yet, little is known on the magnitude and trends of child maltreatment nationwide. The aims of this review are to provide a prevalence of child maltreatment in India with considerations for any effects of gender; urbanisation (eg, urban vs rural) and legislation (Protection of Children from Sexual Offences (POCSO) Act 2012).

METHODS AND ANALYSIS

A rapid review will be undertaken of all quantitative peer-reviewed studies on child maltreatment in India between 2005 and 2020. Four electronic databases will be systematically searched: PubMed, EMBASE, Cochrane and PsychInfo. The primary outcomes will include all aspects of child maltreatment: physical abuse, sexual abuse, emotional abuse, emotional neglect and physical neglect. Study participants will be between 0 and 18 years and will have reported maltreatment experiences using validated, reliable tools such as the Adverse Childhood Experiences Questionnaire as well as child self-reports and clinician reports. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological appraisal of the studies will be assessed by the Newcastle-Ottawa Quality assessment scale. A narrative synthesis will be conducted for all included studies. Also, if sufficient data are available, a meta-analysis will be conducted. Effect sizes will be determined from random-effects models stratified by gender, urbanisation and the pre-2012 and post-2012 POCSO Act cut-off. I² statistics will be used to assess heterogeneity and identify their potential sources and τ² statistics will indicate any between-study variance.

ETHICS AND DISSEMINATION

As this is a rapid review, minimal ethical risks are expected. The protocol and level 1 self-audit checklist were submitted and approved by the Usher Research Ethics Group panel in the Usher Institute (School of Medicine and Veterinary Sciences) at the University of Edinburgh (Reference B126255). Findings from this review will be disseminated widely through peer-reviewed publications and in various media, for example, conferences, congresses or symposia.

PROSPERO REGISTRATION NUMBER

CRD42019150403.

Child Sexual Abuse in Pakistan Schools: A Non-Systematic Narrative Literature Review

The current non-systematic narrative review of literature sought to explore the need for research into child sexual abuse (CSA) in Pakistan's schools. The limited literature that exists suggests that CSA is a pervasive problem in Pakistan as it is in neighboring India, and indeed, throughout the world. Government agencies and schools in Pakistan appear to be in their infancy in terms of recognizing and responding to CSA. High-profile media cases, however, have led to some promising child safety changes. The current narrative review identified the need for studies with methodological rigor to identify the nature and extent of children who have experienced CSA in Pakistan. Future studies also need to explore how best to conceptualize school-based abuse prevention in Pakistan. Recommendations are made for practice and research.

The Need to Act: Incest as a Crime Given Low Priority—A View with India as an Example

Background: Incest is a form of sexual activity that occurs within family or kinship systems. It is prohibited by religion and law in most countries as well as by social mores or taboos. Data from various parts of the world indicate, however, that it appears to be a relatively common event, although there is reason to believe that the actual frequency is unknown. Most available data focus upon children as victims, although we note that incest also occurs between adult family members. Methods: A systematic review was performed using PRISMA guidelines. With a focus upon India, the search tools of Academic Search Complete, Google Scholar and PUBMED were used to identify articles that legally defined incest; frequency; barriers to disclosure; the dynamics of incest and social norms. Results: The available data were very limited, making a systematic review unachievable within the narrow confines of incest. Conclusions: The literature is sparse. This led to a discussion of definitional issues; barriers to disclosure; and challenges with measuring the problem of incest and the impact of social norms. Questions of law and efforts at reform were also considered. The article considers what steps might be appropriate.

Roles of Emotional Reactions and Potency in Coping with Abusive Experiences of Indian Adolescent

Victimized children's perceptions of the severity of abusive incidents have been found to be associated with their willingness to disclose. However, the relationship between perceptions, disclosure, and coping processes of abused Indian adolescents, has rarely been studied. To explore the roles of emotional reactions associated with disclosure, and potency on individuals' perception of the severity of abusive incidents, reluctance to disclose, and posttraumatic stress symptoms. A randomly selected sample, consisting of 324 adolescents (aged 12 to 16) in Kolkata, India was included. Of these, 170 adolescents disclosed incidents of abuse last year. Data were analyzed by conditional process modeling. A moderated mediation analysis (n = 170) revealed that the overall perception of the severity of abusive incidents predicted greater reluctance to disclose (B = .63, p < .0001) through heightened emotional reactions, especially with a higher potency level (B = .07, p < .05; B = .1, p < .05). Potency moderated (B = -.02, p = .01) the effect of reluctance on posttraumatic stress symptoms. When tested on the entire sample (324) the results replicated the sub-sample (170). Adolescents revealed similar results irrespective of their exposure. The reluctance to disclose abuse is discussed from an Indian cultural and societal perspective.

Child Sexual Abuse and Pregnancy: A Systematic Review of the Literature

BACKGROUND

Child sexual abuse is related to many negative outcomes but less known is the effect on pregnancy and childbirth.

OBJECTIVE

This review critically examined the literature on the occurrence of child sexual abuse and outcomes associated with this abuse during pregnancy and childbirth.

METHODS

Five databases were searched over 50 years using an iterative approach and the terms pregnancy, sexual abuse/assault, childbirth/labour, identifying 49 studies.

RESULTS

The prevalence of child sexual abuse in pregnant women ranged from 2.63% to 37.25 with certain characteristics more common with a higher (e.g., specific questions, low income) or lower (broad questions, higher education) prevalence. Compared to women with no history of abuse, child sexual abuse survivors may have more concerns with their care, greater health complaints, fear childbirth and have difficulties with delivery. They also had a higher likelihood of PTSD symptomology and anxiety, consumed more harmful substances (e.g., alcohol, cigarettes, and drugs) and had greater concerns with their appearance, poorer health, sleep and may also have a higher risk of re-victimisation.

CONCLUSIONS

The balance of evidence suggests that compared to non-abused women, women with a child abuse history have more adverse experiences with pregnancy, childbirth, and care, with their abuse history, likely contributes to harmful behaviours and psychopathology. However, variability in operationalisation and measurement of abuse may contribute to these findings so tentative conclusions are drawn. Future research should examine the generalisability of the findings (relating to scale limitations) and recommendations for screening (e.g., sensitive items, scoring). Clinical implications of the findings point to the need for early identification of women with a child abuse history as such women require trauma-sensitive care and consideration. A useful tool is the Pregnancy-related Anxiety Scale which provides insights into specific areas of concern.

Sexual assault cases at a tertiary referral hospital in urban Ethiopia: One-year retrospective review

INTRODUCTION

Sexual assault is an important health and social problem affecting young girls. The aim of the study is therefore to do a one-year retrospective review of documents of alleged sexual assaults managed at Saint Paulo's Hospital Millennium Medical College (SPHMMC) to determine survivors' characteristics, circumstances of the assault, and treatment offered.

METHODS

This is a hospital-based one-year retrospective review of alleged sexual assault cases. The case records of survivors were retrieved, reviewed and information extracted analyzed using SPSS version 17. Characteristics of victims of the sexual assault, clinical presentation, and management provided were described by frequency and percentage distribution.

RESULT

A total of 170 cases of alleged sexual assault who received care during the study period were identified. Around 96% of the survivors were female while there were 6 male cases. The mean age of the victims was 13 yrs. with a range from 2 to 25 yrs. About 23.6% of the victims were less than 10 years. Half of the victims were assaulted by neighbors (45%) followed by strangers (36.5%). The interval between the incident and presentation to the hospital ranged from 2 hours to 93 days (2224 hours) with an average of 98 hours. Most (93.0%) had one or more physical examination findings at presentation. Serology tests for HIV, Hepatitis B, and Syphilis were done in 97.3%, 88.7%, and 84.5% cases respectively. Urine pregnancy tests were done in 62.5% of the cases. Prophylaxis against HIV and STI prophylaxis was provided to 42% and 45% respectively. Social support/counseling was provided to 61% of the victims and legal evidence (certificate) was provided to 45.5% of the cases.

CONCLUSION AND RECOMMENDATIONS

Although it is largely not reported by the victims, sexual assault is a grievous offense still happening constantly. Children and young girls remain the most vulnerable. There is inadequate forensic evidence collection, legal and medical care. There is also a delay in presentation to hospital by victims. Therefore, there is a need to have standardized protocols for comprehensive evaluation and care of the survivors. It is also imperative that a multidisciplinary approach like a one-stop clinic should be utilized to provide effective and efficient medical, social, psychological, and legal services. Finally, it is very necessary to increase public awareness and preventive interventions are required particularly to protect the vulnerable age group to enhance their safety.

Overview of child sexual and substance abuse among children in Ethiopia

BACKGROUND

Child sexual abuse is common typically concealed while substance abuse is unhidden in their nature of practice globally.

OBJECTIVE

The study aims to express the overview of child sexual and substance abuse among children in Ethiopia.

METHOD

A facility-based cross-sectional study design with simple random sampling method was used to recruit study participants, after the allocation of sample size to the study institutions. Both descriptive and inferential statistics were used to describe the variables and to show the association of factors.

RESULTS

A total of 450 children participated in the study. The mean age of the study participants was 13.67. More than 38% of the study participants were of age below the mean age. The majority of 61.3% of the study population were living with their parents. Factors associated with child sexual abuse were sex (AOR = 2.92; 95% CI; 1.84,4.63), alcohol intake (AOR = 2.53; 95% CI; 1.461, 4.36), chewing chat (AOR = 3.84; 95% CI; 1.68, 8.75), cigarette smoking (AOR = 3.83; 95% CI; 1.67-8.81), age (AOR = 4.38 (95% CI: 2.90, 6.62), educational level (AOR = 0.64 (95% CI: 0.44, 0.93), living conditions (AOR = 4.44; 95%CI: 0.73, 26.87), and conflict between parents AOR = 2.50 (95% CI: 1.43, 4.35). Moreover, the age and educational level of the study participants were statistically significant at P < 0.05.

CONCLUSION

The study concluded that a significant proportion of children who participated in the study experienced sexual abuse and/or substance abuse. Therefore, there should be an intrusion to reverse the prevalent children's sexual and/or substance abuse in the country.

Childhood Trauma Linked to Adult Waterpipe Smoking: A Survey of Health Science Students in Iran

Background

Explaining the risk and protective factors of waterpipe tobacco smoking (WTS) is the most important principle in designing preventive interventions. This study examined the relationship between self-reported childhood abuse and WTS among health science students in Iran.

Methods

This cross-sectional study was conducted among 776 health science students in Kerman City, located in southeast of Iran, who were selected by quota sampling approach. The study was performed using two valid short instruments for measuring WTS and child abuse including physical, emotional, and sexual abuse using a self-report method.

Findings

The prevalence of ever use and current use (last 30 days) of WTS among participants was 49.6% and 33.4%, respectively. The initiation age of WTS in 60% of students was < 18 years. Child sexual abuse (CSA) was [odds ratio (OR) = 3.05, 95% confidence interval (CI): 2.06-4.52, P < 0.001] the main predictor for WTS among students.

Conclusion

Protecting children during childhood to prevent them from becoming victims may be an essential primordial preventive strategy for WTS.

Prevalence of childhood trauma among adults with affective disorder using the Childhood Trauma Questionnaire: A meta-analysis

BACKGROUND

Childhood trauma is associated with major depressive disorder (MDD) and bipolar disorder (BD) in adults. However, no meta-analysis was performed on the prevalence of different types of childhood trauma in adults with affective disorders, using the Childhood Trauma Questionnaire (CTQ).

METHODS

Four databases were used to search articles regarding the prevalence of childhood emotional abuse (CEA), childhood physical abuse (CPA), childhood sexual abuse (CSA), childhood physical neglect (CPN), and childhood emotional neglect (CEN) in patients with MDD and BD using the CTQ.

RESULTS

A total of 17 and 11 articles were found analyzing patients with MDD and BD, respectively. A pooled prevalence rate of 33.0% and 30.0% for CEA, 17.0% and 18.0% for CPA, 19.0% and 22.0% for CSA, 37.0% and 31.0% for CEN, and 31% and 30.0% for CPN was found in patients with MDD and BD respectively. A difference in 95% confidence interval in the CSA rate between men and women was found in patients with MDD in the gender subgroup and in the rate of some types of childhood trauma in the continent subgroup in both patient types.

LIMITATIONS

A limited number of articles were included in some continents, thus, the heterogeneity in the meta-analysis was generally high.

CONCLUSION

The prevalence of CEA, CEN, and CPN in patients with affective disorders was relatively high, whereas that of CPA and CSA was relatively low. These childhood traumas might be affected by continent and gender.

Violência sexual contra crianças e adolescentes: uma análise da prevalência e fatores associados

RESUMO Objetivo: Analisar a prevalência e os fatores associados à violência sexual contra crianças e adolescentes, residentes no município de Petrolina/Pernambuco. Método: Estudo do tipo ecológico, realizado com os dados de crianças e adolescentes vítimas de violência sexual, coletados no Sistema de Informação de Agravos de Notificação e analisados conforme estatística descritiva e inferencial, com regressão logística múltipla. Resultados: Foram registrados 1.232 casos de violência sexual contra crianças e adolescentes, com uma prevalência de 30,6%. A violência sexual apresentou maior chance de ocorrência para vítimas do sexo feminino (Odds Ratio = 11,39), em sua própria residência (Odds Ratio = 1,96), sendo o pai o agressor com mais chance de praticar o ato violento (Odds Ratio = 8,97). O consumo de álcool pelo agressor aumentou a chance para o desfecho (Odds Ratio = 2,26). Conclusão: A prevalência da violência sexual e os fatores associados apontam para a necessidade de implementação de práticas humanizadas dentro de uma rede integrada de serviços de saúde com os demais sistemas públicos, visando a promoção, proteção e defesa dos direitos de crianças e adolescentes.

Has the Kama Sutra Not Made a Difference? Making Psychologists in India Explore Sexual Functioning and Master Sex Therapy

There is no dearth of web-based scientific information on sexuality and related matters, and it is shared in private social groups. Yet there appears to be a resistance on the part of psychologists in India in exploring the sexual functioning of clients. This article explores the possible reasons for the neglect that prevails and the consequences. Since, psychologists who are qualified in helping avoid addressing the sexual concerns of the people, it leads to widespread “malpractice” by the quacks. Neglect in identifying the underlying sexual problems that are manifested as various somatoform disorders and other medically unexplainable symptoms leads to emotional distress of the clients and increases the health costs. Hesitation and the “taboo” of the psychologists hinder the therapeutic contact between the therapists and the clients and, hence, people do not disclose their sexual concerns and problems. Personal discomfort of psychology trainees due to “unfinished business,” inadequate input on the role of sexual functioning and the inadequate exposure to people with sexual concerns may have contributed to this impasse. Supervised training of upcoming psychologists would help improve the quality of sexual life of people of all ages and prevent children and adolescents from sexual abuse. The need for using the ancient Indian masterpiece of sexual science, Kama Sutra, in getting over the taboo is also recommended.

The relationship between social skills and misconduct with their teachers in high school students in the City Aligudarz 2018

Whereas adolescence is one of the most emotional periods in every person life so having social skills and increasing awareness cause persons have beneficial and effective relationships with other people and avoid socially absurd behavior. On the other hand, with the reduction of social behavior student's communicational and the social aspects of growth will be improved: physical, psychological, mental and social. Hence, the aim of this study was to look at the relationship between students' social skills at the second level of high school with their teachers in Aligoudarz Province, Iran. The present study is a descriptive quantitative study of the correlation type. Statistical samples included 200 boy and girl students in the second level of high school in Aligoudarz Province which were selected in a multistage random manner. Data collection included a three-part questionnaire which included demographic information, social skills and a researcher-created questionnaire about parents' disorders which was supplemented by students and analyzed by statistical descriptive and inferential and SPSS 16 software. The findings of this study showed that there relation between students' social skills and relationships with their teachers, hence by increasing students' social skill training it can avoid disorder and help in their health education.

Ethical and definitional considerations in research on child sexual violence in India

BACKGROUND

While critically important, child sexual violence (CSV) research poses numerous ethical and safety challenges. Recently, the studies dedicated to understanding and addressing CSV in India have been on the rise, but no published ethical guidelines to direct such research currently exist. To help inform ethical and safety recommendations for the design, conduct, and reporting of future CSV research in India and similar settings, we systematically reviewed the ethics and safety practices reported in recent Indian CSV literature.

METHODS

A multi-tiered approach was used to understand current ethical practices and gaps: 1) systematic review of Indian CSV studies published over the past decade, 2) examination of existing guidelines on related topics to develop an ethical framework, 3) development of an ethics checklist based on the recommendations from the surveyed guidelines, and 4) application of the checklist to each of the reviewed studies.

RESULT

Our search yielded 51 eligible studies. From each, data from 6 major thematic areas was extracted: informed consent, confidentiality, selection, training, and protection of study team members, validity of CSV measurement methods, measures to minimize participant harm, and participant compensation. Several gaps were noted: only two-thirds reported approval by ethics committees, obtaining informed consent, and assured participants of confidentiality. Only 25% (13/51) reported assessing ongoing CSV risk and providing necessary support services, none noted whether ongoing CSV was reported to authorities (required by Indian law), and none reported safeguards to protect staff from the effects of conducting CSV research. Further, 43% (22/51) limited surveillance of CSV to one form of abuse and/or used a "loaded term," increasing the potential for underreporting.

CONCLUSIONS

Through enhancing understanding of current ethical practices and gaps in CSV research in India, this systematic review informs reporting protocols and future guidelines for CSV research in India and other similar settings.