A UNICEF-funded study from Swaziland has shown that sexual violence against female children is linked to lifetime STD contraction, pregnancy complications or miscarriage, unwanted pregnancy, and depression. The findings are reported in an Article published Online First and in an upcoming edition of The Lancet, written by Dr Avid Reza and Dr Matthew Breidling Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA, and Dr Jama Gulaid, UNICEF, Mbabane, Swaziland, and colleagues.
Sexual violence against girls—defined as female children younger than 18 years of age—is a substantial global health and human-rights problem, and a growing concern in sub-Saharan Africa. However, few studies have been done about sexual violence in this age group. In this study, data from a nationally representative sample of girls and women aged 13-24 from selected households in Swaziland was obtained. The questionnaire looked at the types of sexual violence that occurred before the respondent was age 18 years, circumstances of the incident, and health-related conditions. A total of 1244 women and girls responded (96% of those surveyed).
The researchers found that 33% of respondents reported an incident of sexual violence before they reached 18 years of age. The most common perpetrators of the first incident were men or boys from the respondent's neighbourhood (32%) and boyfriends or husbands (26%). The first incident most often took place in the respondent's own home (26%). Sexual violence was associated with a three-and-a-half fold increase in both reported lifetime experience of sexually transmitted diseases, and risk of pregnancy complications or miscarriages. Sexual violence increased by three times the risk of unwanted pregnancy, and more than doubled the risk of self-reported depression.
The authors say: "This study documents that sexual violence against girls younger than 18 years of age affected one in three women aged 13 years in Swaziland and has serious health consequences. About 5% of girls had forced intercourse and 9% had coerced intercourse before 18 years of age. About three-quarters of the perpetrators of sexual violence against girls were men or boys from the respondent's neighbourhood, boyfriends or husbands, or male relatives."
They conclude: "Thus, perpetrators of sexual violence are either partners or well known to the girl, which is common across many cultures. This pattern could indicate the vulnerability of girls to victimisation and the importance of cultural factors that influence relationships between men, women, and children. Future strategies should focus on prevention of perpetration by men of sexual violence against girls, and since sexual and intimate partner violence might have common roots, local and national initiatives could be reviewed, adapted, and potentially scaled up for this purpose."
In an accompanying Comment, Dr Laura Murray and Dr Gilbert Burnham, Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA, conclude: "To date, health programmes have largely avoided the needs of children who have been sexually abused, as such programmes seek a wider focus in reproductive health and gender-based violence in adults. A shift in focus to include children is even more urgent in areas with high seroprevalence of HIV. This persistent global tragedy for children is too large to continue ignoring."
Erica Mizelle, Centers for Disease Control and Prevention (CDC) Media Office, Atlanta, GA, USA T) +1 770-488-4902 E) mei2@cdc.gov
Dr Jama Gulaid, UNICEF Swaziland T) +268-602-8248 E) jgulaid@unicef.org
Dr Gilbert Burnham, Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA T) +1 410-955-3928 E) gburnham@jhsph.edu
For full Article and Comment, see: http://press.thelancet.com/sexualviolence.pdf
Journal
The Lancet