Child sexual abuse among women in Brazil: Prevalence and associated factors in urban and rural settings.

BACKGROUND

Child sexual abuse (CSA) remains a public health concern, but Brazilian population-based evidence on childhood abuse, familial violence, and victimization markers across life stages is limited.

OBJECTIVE

This study examined CSA prevalence and associated familial and adult violence-related markers in two Brazilian settings.

PARTICIPANTS AND

SETTING

Data came from the Brazilian arm of the WHO Multi-country Study on Women's Health and Domestic Violence: 2645 women aged 15-49 years from São Paulo (n = 1172) and Zona da Mata de Pernambuco (n = 1473), surveyed in 2000-2001.

METHODS

Unconditional logistic regression, using a forward stepwise approach and complex-sampling correction, identified factors associated with CSA. Model 1 examined familial childhood-context markers; Model 2 examined markers reported at different life stages, including adult violence-related markers.

RESULTS

CSA prevalence was 7.7% in São Paulo and 4.7% in Pernambuco; 94.5% of perpetrators were male. In Model 1, maternal IPV was associated with CSA (OR = 2.34; 95% CI [1.58, 3.48]). In Model 2, CSA was associated with adult victimization markers, including physical IPV in São Paulo (OR = 3.40; 95% CI [1.17, 9.91]) and sexual IPV in Pernambuco (OR = 3.90; 95% CI [1.35, 11.31]); early sexual initiation was examined as a related life-course marker.

CONCLUSIONS

CSA was associated with familial and adult violence markers across life stages. These results support coordinated, trauma-informed, intersectoral approaches linking child protection, domestic violence responses, sexual and reproductive health, mental health, and clinical support services.