DESCRIPTION

Sexual abuse is the involvement of children in sexual activities that they are not developmentally prepared to understand, to which they cannot give informed consent, and/or that violate societal norms.

• Forms include contact and noncontact acts ranging from oral, genital, or anal contact; fondling; child pornography; prostitution; exhibitionism; voyeurism; and communicating in a sexual manner by phone, electronic mail, or social media (e.g., sexting).
• About 90% of sexual abuse victims know their abuser, whereas 10% are abused by a stranger.
• Most children who are sexually abused will have no discernible physical injury.

EPIDEMIOLOGY

• ~150,000 substantiated cases/year; most likely underestimates the incidence as these include only those cases reported
• Prevalence rates between 10% and 30%; the National Violence Survey reported 27% of adult women and 16% of adult men reported sexual abuse during childhood.

RISK FACTORS

• Peak age of vulnerability: 7 to 13 years of age
• Girls are victimized more than boys, although abuse of boys is underreported.
• Single-parent households, domestic violence, parental substance abuse, and mental illness are risk factors.
• Children who experience other types of abuse are also more likely to be victimized sexually.
• Race and socioeconomic status do not appear to be risk factors for child sexual abuse.
• Risk factors for revictimization: younger aged children; more severe maltreatment; families with mental health and substance abuse problems and violence histories
• >90% of children who are commercially sexually exploited have been sexually abused in the past.