Global Prevalence of Sexual Violence Against Children: A Systematic Review and Meta-Analysis.

IMPORTANCE

Sexual violence against children is a global concern, yet worldwide figures of its prevalence are scant.

OBJECTIVE

To estimate the global prevalence of sexual violence against children using national-level population-based studies.

DATA SOURCES

We searched the PubMed, Embase, CINAHL, Web of Science, PsycINFO, ERIC, and APA PsycArticles databases from their respective inceptions to March 2022. Searches were updated through April 2024.

STUDY SELECTION

Reports were included if (1) they were national-level population-based studies, (2) they reported lifetime or past-year prevalence data on any form of sexual violence against children (mean age ≤19 years), and (3) the data were based on children's self-reports of sexual violence perpetrated by anyone.

DATA EXTRACTION AND SYNTHESIS

Data extraction included study and participant characteristics, prevalence rates, and types of sexual violence. Outcomes were pooled using a random-effects model. Exploratory subgroup analyses were performed with categorical moderators.

MAIN OUTCOMES AND MEASURES

Primary outcomes included lifetime and past-year prevalence of forced sexual intercourse, contact sexual violence, and sexual harassment.

RESULTS

We identified 165 studies that included 958 182 children from 80 countries, with the majority of data focusing on girls (58.2%). The sample sizes of the studies ranged from 330 to 132 948; the mean age ranged from 10.5 to 19.4 years. Lifetime sexual harassment was the most prevalent outcome, with a pooled rate of 11.4% (95% CI, 8.5%-15.1%), followed by any contact sexual violence, with a rate of 8.7% (95% CI, 4.7%-15.5%). Furthermore, 6.1% (95% CI, 5.1%-7.3%) of children reported experiencing completed forced sexual intercourse in their lifetime, and 1.3% (95% CI, 1.0%-1.7%) reported experiencing it in the preceding year. Rates of lifetime completed forced sexual intercourse were higher among girls (6.8% [95% CI, 6.1%-7.6%]) compared with boys (3.3% [95% CI, 2.5%-4.3%]), similar to past-year violence (2.3% [95% CI 1.9%-2.7%] for girls and 0.6% [95% CI 0.4%-0.9%] for boys). We found considerable variation across regions and countries in the reported prevalence of sexual violence. Older age of children, lower national income levels, and the use of school-based surveys were associated with higher rates of sexual violence reporting in some exploratory analyses.

CONCLUSIONS AND RELEVANCE

The findings of this systematic review and meta-analysis highlight the burden of sexual violence against children worldwide based on current available evidence. There is a pressing need to enhance data collection efforts globally, especially in underresearched regions and for boys.

STUDY REGISTRATION

PROSPERO CRD42022327090.