Sangita D Kamath1*, Jakka Sridevi2, Vijaya Jojo3 and B S Rao4
1 Consultant, Department of Medicine, Tata Main Hospital, India
2 Specialist, Department of Pathology, Tata Main Hospital, India
3 Specialist, Department of Ophthalmology, Tata Main Hospital, India
4 Senior Consultant and Head, Department of Medicine, Tata Main Hospital, India
*Corresponding Author: Sangita D Kamath, Consultant, Department of Medicine, Tata Main Hospital, India.
Received: June 07, 2017; Published: June 16, 2017
Citation: Sangita D Kamath., et al. “A Case Report on Choroidal Metastases from Adenocarcinoma of Lung – Tip of the Iceberg!”. Acta Scientific Paediatrics 3.3 (2020):00-00.
Background: Child sexual abuse has been implicated in most of adult psychopathologies including depression, post-traumatic stress disorders, eating disorders and even suicide. However, it remains a hidden truth due to stigmatization and cultural expectations in our environment.
Objective: To determine the prevalence of sexual abuse and determine the factors associated with sexual abuse amongst secondary school students in Port Harcourt, South-South Nigeria.
Method: This study was a cross sectional study amongst secondary school students conducted in Port Harcourt from September to December 2018. A structured, self-administered questionnaire was distributed to 1162 secondary school students from 6 public secondary schools selected through Multistage Sampling technique. Questions asked covered socio-demographics, knowledge on sexual abuse, exposure to different forms of sexual abuse, age at first abuse, gender of perpetrator and consequence of the abuse. Data was analyzed using SPSS version 21.
Results: One thousand one hundred and sixty-two students were recruited in the study. There were 590 females and 572 males giving a male to female ratio of 1: 1.1. They were aged 10 – 20 years with a mean age of 14. 8 ± 2.1 years. Overall, 422 (38.9%) of the subjects had experienced at least one or more forms of sexual abuse whilst 710 (61.1%) had never. Of these, 234 (51.8%) were females whilst 218 (48.2%) were males, however, this gender difference was not statistically significant (χ2 = 0.3, p = 0.588). 146 (32.4%) of these abuses were by exposure to pornographic pictures and movies, 136 (30.1%) were by using an object or his or her fingers into their anus or vagina, whilst 48 (10.6%) was by forceful sexual intercourse with penetration. Majority (41.9%) of the sexual abuse were first experienced between ages 8 – 12 years and dropped at ages 15 – 16 years. Three hundred and fifty-two (77.9%) of the subjects were abused by male perpetrators whilst 100 (22.1%) were by female perpetrators. This gender difference was statistically significant (χ2 = 74.2, p = 0.000). Of these perpetrators, 61% were persons known to the subjects and only (16%) were strangers.
Conclusion: The prevalence of sexual abuse and forceful penetration of 38.9% and 10.6% respectively found in this study is high, with a changing pattern of an increasing male prevalence. Sexual education should be inculcated into the School Health Programme in the foundation school years with a mandatory reporting system in order to educate and protect these adolescents both in school and at home.
Keywords: Sexual Abuse; Secondary School; Factors; Southern Nigeria
Child sexual abuse has been defined as the involvement in sexual activity that he or she does not fully comprehend and is unable to give informed consent to [1]. It includes acts, forceful or otherwise, of inappropriate sexual solicitation, genital touching or fondling, exposure of a child by an older person, intercourse through oral, anal or vaginal penetration and attempted intercourse [2]. Children may be sexually abused by both adults and other children (who are by virtue of their age or stage of development) in a position of responsibility, trust or power over the child victim [1-3].
The WHO estimated that about150 million girls experienced sexual violence with physical contact in 2002 [4]. Most perpetrators of sexual abuse are males and are often known to their victims [5]. While it is generally acknowledged that sexual abuse is pervasive in all countries and at all levels of society, available statistics concerning the prevalence of sexual abuse in children around the world in and in sub-Saharan Africa in particular are very limited [4-6].
United Nations International Children’s Fund (UNICEF) reported in 2015 that one in four girls and one in ten boys in Nigeria had experienced sexual violence before the age of 18 [7]. According to a survey by Positive Action for Treatment Access, over 31.4 percent of girls said that their first sexual encounter had been rape or forced sex of some kind [8]. Globally, India has the world’s largest number of child sexual abuse: For every 155th minute a child, less than 16 years is raped, for every 13th hour a child under 10, and one in every 10 children sexually abused at any point of time [9]. However, a meta-analysis done in 2009 had showed that the highest prevalence was seen in Africa (34.4%) [10,11] with Europe, America, and Asia with prevalence rates of 9.2%, 10.1%, and 23.9%, respectively [10]. In Nigeria, most studies have been done in different parts with varying methodology thus giving varying prevalent rates [12-16]. Most studies have reported a higher prevalence in girls than in boys with most sexual perpetrators (95%) known to the child and even highly trusted by them. (relatives, neighbours, step- parents, highly trusted people) [4,13-15]. The trauma of sexual abuse leaves long term psychological and medical problems, some of which puts the adolescent at more risk for repeated sexual abuse.
It is therefore imperative to study these vulnerable group of children in order to provide initiatives and live saving skills with the schools as prime sites for dissemination of these solutions. The aim of this study is to determine and assess the factors associated with sexual abuse amongst secondary school students in Port Harcourt, South-South Nigeria.
This study was a cross sectional study amongst secondary school students conducted in Port Harcourt from September to November 2018. A structured, self -administered questionnaire was distributed to 1,162 Secondary school students from 6 public secondary schools selected through Multistage Sampling technique amongst students aged 10 – 20 years. The schools were first stratified into all boys, all girls and mixed schools, and six secondary schools (2 all girls, 2 all boys and 2 mixed) were selected by simple random sampling. The study was conducted in Port Harcourt city, Southern Nigeria over a period of ten weeks. It is an urban city, highly industrialized and oil and gas exploration is the mainstay of the economy.
Permission was obtained from the Rivers State Ministry of Education and from the Head teachers of the 6 selected schools and the parents or guardians and assent from the selected students. This study was carried out on school days as all schools were day schools and the subjects were self interviewed on relevant information. Information sought included socio-demographic status, exposure to any form of sexual abuse, age at first exposure, any history of repeated exposures, assailant’s gender and relationship, any prior knowledge of sexual assault and any help sought after the assault. Students in the selected schools, who gave assent for the study, and whose parents or guardians gave consent, made up the study population.
Ethics Committee of Rivers State University Teaching Hospital and the Administrative heads of the schools gave approval for the study.
Informed consent was obtained from the parents and assent from the students.
Data entry and analysis was done using SPSS software version 21.0 (IBM Corporation, Atlanta, GA, USA). Data analysis was by univariate and bivariate measures. Univariate analysis was based on frequency distribution of selected sociodemographic variables that are related to the study in the dataset. Bivariate analysis was employed to show the association between the variables including age, gender, parental living, and sexual abuse. Chi-square test was used to show this association, and in all cases, a probability value (p - value) of < 0.05 was regarded as statistically significant.
A total of 1,162 students were recruited in the study. There were 590 (50.8%) females and 572 (49.2%) males giving a male to female ratio of 1:1.1. They were aged between 10 - 20 years with a mean age of 14.8 ± 2.1 years.
Table 1 shows the socio-demographic characteristics of the subjects. Majority (49.8%) of the subjects were aged between 15 - 19 years, whilst 46.4% were aged 10 - 14 years and only 1.4% were aged 20 years. Of the subjects, 502 (43.2%) of them lived with their parents whilst 660 (56.8%) lived with other relatives (aunties, uncles, siblings and guardians). Majority of the students (59.4%) were in senior secondary schools whilst 40.6% were in junior secondary school.
Overall, 422 (38.9%) of the subjects had experienced at least one or more forms of sexual assault whilst 710 (61.1%) had never. Of those who had experienced these, 234 (51.8%) were females whilst 218 (48.2%) were males, as shown in figures 1 and 2 respectively. This gender difference was not statistically significant (χ2 = 0.3, p = 0.588).
Of these perpetrators, 153 (33.8%) were care givers/family relatives, 123 (27.2%) were neighbours, 104 (23%) were friends/ peers, whilst only 72 (16%) were strangers.
Table 1: Socio-demographic characteristics of respondents.
Figure 1: Prevalence of sexual abuse amongst the students.
Figure 2: Gender prevalence of sexual abuse amongst the students.
Table 2 shows that 146 (32.4%) of the sexual abuse were by exposure to pornographic pictures and movies, 136 (30.1%) were by using an object or his or her fingers into their anus or vagina whilst 48 (10.6%) was by forceful sexual intercourse with penetration.
Table 2: Mode of Sexual Abuse experienced by the study subjects.
Of the students who experienced one or more forms of sexual abuse 86 (19%) occurred first between the ages of 6 - 7 years and gradually increased to 96 (21.3%) at 11 - 12 years then gradually decreased to 86 (19%) at 15 – 16 years as shown in table 3.
Table 3: Age at first sexual abuse of the subjects.
Of the subjects abused, majority of them 208 (46%) were abused once, 200 (44.3%) were abused more than once whilst 44 (9.7%) were still being abused.
In the present study, the overall prevalence of Sexual abuse was 38.9%. This prevalence rate is similar to the 35.1% and 36% reported by Meichium., et al. [17] and Ajuwon., et al. [18] amongst Swiss and Nigerian adolescents respectively. However, this prevalence rate is higher than the 25.7% reported by David., et al. [19] amongst adolescents in a community in Lagos, South West Nigeria and the 10.2% reported by Chinawa., et al. [20] in South East Nigeria. Different methodology between the different studies may be responsible for the varying prevalence rates. Adolescents are likely to shy away from disclosure if information on sexual abuse is sought through an open interviewer administered survey. Also, it is important to note that variations in adolescent sexual abuse across geographical areas could either reflect true differences in incidence or be affected by how disclosure and reporting of cases are perceived in different cultures. Not withstanding, the reasons for non-reporting are complex and multifaceted [21]. These reasons may include factors such as the age of the abused child, the relationship between the perpetrator and the abused, and the likely consequences of the disclosure [22].
In this study, there were different forms of sexual assault with a higher prevalence of the subjects (32.4%) haven been exposed to different forms of pornographic images and videos, whilst 10.6% were involved in forceful sexual intercourse with penetration. Similar findings have been reported by Meichum., et al. [17] and Anderson., et al. [23] amongst Swiss and South African pupils and Manyike., et al. [12] amongst adolescents in North East Nigeria. It is important to point out here the impact of pornography as a form of adolescent sexual abuse in this study. This is worrisome and may likely increase in the future as most of these images were aided and circulated to these young ones via different social media platforms and on the phones of the perpetrators in an unsuspecting manner. There are lots of studies about the effects of pornography on adolescents. There have been studies that seem to demonstrate arousal of perpetrators from viewing child pornography, particularly pedophile. It is not known if pornography makes them act on their arousal, but it seems to be part of the constellation about what causes them to abuse [24]. It’s also found that viewing violent or sexual materials can affect attitudes involving adult rape. There is also a link between viewing violent pornography and repeat abuse by perpetrators, however the causation between the two is not known [24].
Similarly, reported incidence of rape in this study of 10.6% is similar to the previous findings of Ajuwon., et al. [18] in which 9% reported rape. However, Achunike and Kitause [25] and Folayan., et al. [26] have expressed the epidemic nature of sexual abuse most especially rape among Nigerian young girls.
The findings of this study showed that 51.8% of the victims of sexual assault were females. This finding has again shown the high incidence of the occurrence of sexual abuse among adolescent girls. Many studies in Nigeria have reported a higher incidence of sexual abuse among adolescent girls [15,26-30]. compared to other age groups, and this has been attributed to their developmental stage. The findings also indicated that sexual abuse of adolescent girls is increasing among this population. In other countries, the trend of increasing rate of sexual abuse amongst adolescent girls has also been documented [31,32].
Similarly, reported incidence of rape in this study of 10.6% is also similar to the findings of Ajuwon., et al. [18] in which 9% reported rape. However, Achunike and Kitause [25] and Folayan., et al. [26] have also expressed the epidemic nature of sexual abuse most especially rape among Nigerian young girls.
It is worrisome to note that the proportion of males sexually abused of 48.2% obtained in the present study is high, raising concerns about an almost proportional increase of male sexual abuse amongst adolescents in our environment. It therefore, highlights the existence of male sexual abuse in our communities which has hitherto been considered to occur mainly in developed countries. Thus, sexual abuse of boys may not be uncommon, but perhaps under recognized, under surveyed and therefore under reported. Moreover, most studies have concentrated on adolescent females without exploring these assaults on the males. A report by Ajuwon., et al. [18] amongst adolescents in North East Nigeria revealed more males than females reported sexual coercion. One possible explanation given was the religious context in which the survey was conducted, as in many parts of northern Nigeria women are kept in purdah, i.e. exclusion and when it is absolutely necessary for them to leave the home such as visiting a health facility or attend school they put on a veil and are not expected to have any direct contact with males. It therefore becomes worrisome that in our environment where the present study was conducted, both males and females are getting exposed to almost a similar risk without any protective factors. A scenario which over time if not curbed, could put more and more adolescents at a constant risk of sexual abuse.
In this study, sexual abuse was reported to have occurred as early as 6 years with a steady increase in incidence and peaking at 12 years with 21.3%. This is similar to reports by Manyike., et al. [12] who reported more sexual for those above 12 years and least between 7 - 12 years. Hassan., et al. reported that [15] 61.8% of the cases of sexual assault seen in a tertiary hospital in Sokoto, Northern Nigeria were amongst children less than 12 years. Other researchers have reported similar findings with children aged between 6 – 18 years more likely to suffer one or more forms of sexual assault [34,35].
The report in this study and other reports by different researchers [12,15,36] has become worrisome as most of these abuses occur very early in the lives of these young ones and especially as majority (60%) of these perpetrators were persons familiar with the subjects and probably put under their care for supervision and protection. It is quite disturbing that most children were assaulted by well known persons trusted by both the children and their parents.
All parents, therefore, need to be mindful of this risk when leaving their children alone with anyone, however, well known or trusted the individual might seem. Perpetrators that have been identified were in those homes were sophisticated monitoring devices were put in place at home, however, how many parents can afford such devices at home. Thus, most of these abuses may continue to go unnoticed if parents don’t put in strong measures to monitor care givers.
The findings on more male perpetrators of sexual abuse as reported in this study supports the reports of by other researchers globally [12,14,15,32]. Ozbaran., et al. [33] Daru., et al. [23] and Manyike., et al. [12] that sexual violence is more likely to be perpetrated by peers, boyfriends, acquaintances, neighbours, or relatives, whilst Ogunfowokan., et al. [34] reported that male adolescents lone or gang raped their female sexual partners who were mostly adolescent girls.
The prevalence of sexual abuse of 38.9% found in this study is high and is increasing with a changing pattern. Males are increasingly been assaulted, but female victims are still in the majority. Adolescents remain a highly vulnerable group for sexual abuse with unsuspecting perpetrators. Therefore, strong legislations should be put in place to protect these vulnerable ones.
The authors declare no competing interests.
Copyright: © 2020 Joyce Okagua and Balafama A Alex- Hart. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Open Access by
Acta Scientific is licensed under a Creative Commons Attribution 4.0 International License
Based on a work at https://actascientific.com
ff
ff
© 2024 Acta Scientific, All rights reserved.