Cagney Jack, Spencer Cory, Flor Luisa, Herbert Molly, Khalil Mariam, O'Connell Erin, Mullany Erin, Bustreo Flavia, Singh Chandan Joht, Metheny Nicholas, Knaul Felicia, Gakidou Emmanuela
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Lancet. 2025 May 24;405(10492):1817-1836. doi: 10.1016/S0140-6736(25)00311-3. Epub 2025 May 8.
Measuring sexual violence against children (SVAC) is vital to prevention and advocacy efforts, yet existing prevalence studies present estimates for few countries. Here we estimate the prevalence of SVAC for 204 countries by age and sex, from 1990 to 2023, and also report the age at which young survivors of lifetime sexual violence first experienced sexual violence.
We reviewed publicly available repositories for data on the prevalence of SVAC. To harmonise heterogeneity in the identified input data, we adjusted for alternative case definitions of SVAC and differential disclosure by survey mode. We then used a spatiotemporal Gaussian process regression to estimate a full time series of exposure to SVAC for each age-sex-country combination. We accounted for uncertainty in the underlying data and modelling processes. We also analysed the age at which adolescent and young adult survivors of lifetime sexual violence first experienced this type of violence by sex, data source, and world region.
We estimate that the global age-standardised prevalence of SVAC was 18·9% (95% uncertainty interval [UI] 16·0-25·2) for females and 14·8% (9·5-23·5) for males in 2023. At the super-region level, these estimates ranged from 12·2% (9·0-17·2) in southeast Asia, east Asia, and Oceania to 26·8% (21·9-32·7) in south Asia for females and from 12·3% (5·2-24·6) in central Europe, eastern Europe, and central Asia to 18·6% (9·7-32·3) in sub-Saharan Africa for males. At the country level, age-standardised estimates ranged from 6·9% (4·8-9·6) in Montenegro to 42·6% (34·4-52·1) in Solomon Islands among females and from 4·2% (1·7-9·2) in Mongolia to 28·3% (13·2-49·8) in Côte d'Ivoire among males. Globally, these estimates remained relatively stable since 1990, with slight variations at the country and regional levels. We also find that the first experience of sexual violence among adolescents and young people occurred before the age of 18 years for 67·3% of female and 71·9% of male survivors.
The prevalence of SVAC is extremely high for both females and males across the globe. Given data sparsity and ongoing measurement challenges, findings probably underestimate the true pervasiveness of SVAC. An overwhelmingly high proportion of survivors first experienced sexual violence during childhood, revealing a narrow yet sensitive window that should be targeted in future prevention efforts. It is a moral imperative to protect children from violence and mitigate its compounding impacts on health across the lifecourse.
The Gates Foundation.
衡量针对儿童的性暴力（SVAC）对于预防和宣传工作至关重要，但现有的患病率研究仅针对少数国家给出了估计数据。在此，我们估算了1990年至2023年期间204个国家按年龄和性别的SVAC患病率，并报告了曾遭受过终身性暴力的年轻幸存者首次经历性暴力的年龄。
我们查阅了公开可用的数据库，以获取有关SVAC患病率的数据。为协调所识别的输入数据中的异质性，我们针对SVAC的替代病例定义以及调查方式导致的不同披露情况进行了调整。然后，我们使用时空高斯过程回归来估算每个年龄-性别-国家组合的SVAC暴露全时间序列。我们考虑了基础数据和建模过程中的不确定性。我们还按性别、数据来源和世界区域分析了曾遭受过终身性暴力的青少年和青年幸存者首次经历此类暴力的年龄。
我们估计，2023年全球年龄标准化的SVAC患病率女性为18.9%（95%不确定区间[UI] 16.0 - 25.2），男性为14.8%（9.5 - 23.5）。在超区域层面，这些估计值女性从东南亚、东亚和大洋洲的12.2%（9.0 - 17.2）到南亚的26.8%（21.9 - 32.7）不等，男性从中欧、东欧和中亚的12.3%（5.2 - 24.6）到撒哈拉以南非洲的18.6%（9.7 - 32.3）不等。在国家层面，年龄标准化估计值女性从黑山的6.9%（4.8 - 9.6）到所罗门群岛的42.6%（34.4 - 52.1）不等，男性从蒙古的4.2%（1.7 - 9.2）到科特迪瓦的28.3%（13.2 - 49.8）不等。全球范围内，自1990年以来这些估计值相对稳定，在国家和区域层面有轻微变化。我们还发现，67.3%的女性和71.9%的男性幸存者在18岁之前首次经历性暴力。
全球范围内，SVAC在女性和男性中的患病率都极高。鉴于数据稀缺和持续存在的测量挑战，研究结果可能低估了SVAC的实际普遍程度。绝大多数幸存者首次经历性暴力是在童年时期，这揭示了一个狭窄但敏感的窗口期，应在未来的预防工作中加以关注。保护儿童免受暴力并减轻其对整个生命历程健康的复合影响是一项道德责任。
盖茨基金会
