Meinck Franziska, Cluver Lucie Dale, Boyes Mark Edward
1 University of Oxford, Oxford, UK.
2 University of Cape Town, Cape Town, South Africa.
J Interpers Violence. 2017 Sep;32(18):2804-2836. doi: 10.1177/0886260515596331. Epub 2015 Jul 29.
Sexual abuse has severe negative impacts on children's lives, but little is known about risk factors for sexual abuse victimization in sub-Saharan Africa. This study examined prospective predictors of contact sexual abuse in a random community-based sample of children aged 10 to 17 years ( N = 3,515, 56.6% female) in South Africa. Self-report questionnaires using validated scales were completed at baseline and at 1-year follow-up (96.8% retention rate). Cross-sectional and longitudinal associations between hypothesized factors and sexual abuse were examined. For girls, previous sexual abuse (odds ratio [OR] = 3.44, 95% confidence interval [CI] = [2.03, 5.60]), baseline school dropout (OR = 2.76, 95% CI = [1.00, 6.19]), and physical assault in the community (OR = 2.17, 95% CI = [1.29, 3.48]) predicted sexual abuse at follow-up. Peer social support (OR = 0.84, 95% CI = [0.74, 0.98]) acted as a protective factor. Previous contact sexual abuse was the strongest predictor of subsequent sexual abuse victimization. In addition, peer support moderated the relationship between baseline assault and subsequent sexual abuse. For boys, no longitudinal predictors for sexual abuse victimization were identified. These results indicate that the most vulnerable girls-those not in school and with a history of victimization-are at higher risk for sexual abuse victimization. High levels of peer support reduced the risk of sexual abuse victimization and acted as a moderator for those who had experienced physical assault within the community. Interventions to reduce school drop-out rates and revictimization may help prevent contact sexual abuse of girls in South Africa.
性虐待对儿童的生活有着严重的负面影响，但对于撒哈拉以南非洲地区性虐待受害的风险因素却知之甚少。本研究在南非一个基于社区的随机抽样样本中，对10至17岁儿童（N = 3515，56.6%为女性）接触性虐待的前瞻性预测因素进行了考察。使用经过验证的量表的自填问卷在基线时和1年随访时完成（保留率为96.8%）。研究了假设因素与性虐待之间的横断面和纵向关联。对于女孩而言，既往性虐待（优势比[OR]=3.44，95%置信区间[CI]=[2.03，5.60]）、基线时辍学（OR = 2.76，95% CI = [1.00，6.19]）以及社区中的身体攻击（OR = 2.17，95% CI = [1.29，3.48]）可预测随访时的性虐待。同伴社会支持（OR = 0.84，95% CI = [0.74，0.98]）起到了保护因素的作用。既往接触性虐待是后续性虐待受害的最强预测因素。此外，同伴支持调节了基线攻击与后续性虐待之间的关系。对于男孩，未发现性虐待受害的纵向预测因素。这些结果表明，最易受伤害的女孩——即未上学且有受害史的女孩——遭受性虐待受害的风险更高。高水平的同伴支持降低了性虐待受害的风险，并对那些在社区中经历过身体攻击的人起到了调节作用。降低辍学率和再次受害的干预措施可能有助于预防南非女孩的接触性虐待。
