Child sexual abuse in India: A systematic review.

Vikas Choudhry,Radhika Dayal,Ameeta S Kalokhe,Divya Pillai,Klaus Beier,Vikram Patel,Alexander C Tsai

doi:10.1371/journal.pone.0205086

Abstract

ObjectiveChild Sexual Abuse (CSA) is a pressing human right issue and public health concern. We conducted a systematic review of quantitative and qualitative studies published in the past decade on CSA in India to examine the distribution of the prevalence estimates for both genders, to improve understanding of the determinants and consequences of CSA and identify gaps in the current state of research.MethodsFor this systematic review, we searched electronic literature databases (PubMed, POPLINE, and PsycINFO) for articles published in English on Child Sexual Abuse in India between January 1, 2006 and January 1, 2016 using 55 search terms. Data were extracted from published articles only.FindingsFifty-one studies met inclusion criteria for the review. The review indicates that prevalence rates of CSA is high among both boys and girls in India. Due to heterogeneity of study designs and lack of standardised assessments, reported prevalence estimates varied greatly among both genders in different studies. There is a need to conduct representative studies using a validated instrument to obtain valid epidemiological estimates. Commercial sex workers, men who have sex with men, and women with psychiatric disorders were at higher risks for sexual abuse during childhood. In addition, the synthesis of qualitative data across studies included in the review suggests that exposure and perpetration of CSA is a multifaceted phenomenon grounded in the interplay between individual, family, community, and societal factors. The review indicates poor physical, behavioural, social, and mental health outcomes of CSA in India. We conclude with a research agenda calling for quantitative and qualitative studies to explore the determinants and perpetration of child sexual abuse in India from an ecological lens. This research agenda may be necessary to inform the development of a culturally tailored primary prevention and treatment strategy for CSA victims in India.

Highlights

The World Health Organization (WHO) defines Child Sexual Abuse (CSA) as “the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society. . .”[1]
The initial search of CSA articles published in electronic literature databases (PubMed, POPLINE, and PsycINFO) identified 4,186 potentially eligible studies based on the inclusion criteria
The patriarchal societal norms and power differentials in such societies based on class, gender, and sexual preferences emerged as common descriptive themes that increased the risks of CSA across the qualitative studies on Commercial Sex Workers (CSWs) and men who have sex with men (MSM) [31, 34, 35]

Summary

Introduction

The World Health Organization (WHO) defines Child Sexual Abuse (CSA) as “the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society. . .”[1]. The World Health Organization (WHO) defines Child Sexual Abuse (CSA) as “the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society. Other systematic reviews which included studies conducted worldwide across hundreds of different age-cohort samples have observed alarming rates of CSA, with averages of 18–20% for females and of 8–10% for males, with the lowest rates for both girls (11.3%) and boys (4.1%) found in Asia, and highest rates found for girls in Australia (21.5%) and for boys in Africa (19.3%) [5, 6]. Other common sequelae for adult survivors of CSA may include relational challenges (e.g., increased risk for domestic violence), violent behaviors, and increased risk of perpetration of CSA as adults [2, 13]

Results

Discussion

Conclusion