Sexual abuse of boys in KwaZulu-Natal, South Africa: a hospital-based study.

Objective - The aim of the study was to determine the prevalence and factors associated with child sexual abuse in a total sample of boys referred for medico-legal assessment in a peri-urban area of KwaZulu-Natal, South Africa. Method - A retrospective analysis was undertaken of clinical and social work records for sexually abused boys presenting for medico-legal assessment at the Mahatma Gandhi Memorial Hospital (Phoenix, KwaZulu-Natal) during the period January 2001 to December 2003. Results - In the period reviewed, 131 boys reported an incident of sexual abuse with temporal trends indicating a significant increase in the incidence of reported abuse over the three year period. Most victims fell in the 4-11 year age category, anal penetration constituted the most common form of abuse (86% of cases), and perpetrators were predominantly persons who were known to the child. Conclusion - Study findings indicate that the sexual abuse of boys constitutes a sizeable and emerging problem in peri-urban communities in South Africa. Evidence suggests that increased rates of victimisation are associated with a breakdown in family support networks in the context of rapid urbanisation.