Study On Prevalence And Risk Factors Of Child Sexual Abuse Among The Left-behind Children In Rural Areas Of Hubei Province

Objective: To understand the current status of prevalence,causes,harms and social support of left-behind children about sexual abuse in rural areas of Hubei Province.To know the polices about child sexual(CSA)on the social,school,medical,and the judicial departments.To understand the basic situation and influencing factors of left-behind children undefined knowledge and attitude towards CSA in rural areas of Hubei Province.Methods: 1.Epidemiological Investigation: In rural areas of HC and YX,1 primary schools,2 junior high schools and 1 senior high schools were randomly sampled in each area,3 sampling classes has been selected in each of grades on grade 3-12,all left-behind children(2116 middle school students and 1090 primary school students)in sampling classes were selected as the research object by cluster sampling method.The status of left-behind children knowledge,behavior and occurrence of child sexual abuse and related influencing factors were investigated with the questionnaire.2.Typical case analysis: Through visiting all kinds of social public welfare organizations,medical system,judicial organs to obtain typical cases of CSA,and typical cases are analyzed and excavated.3.Interview: The specially trained interviewees conducted in-depth interviews with the staff of education,medical,judicial and other departments to understand their knowledge of CSA and the formulation and implementation of related policies.Result: 1.The prevalence of sexual abuse in left-behind children among the middle school students was 19.0%,and the prevalence of child sexual abuse in female students was 13.3% lower than boys(24.3%).The prevalence of sexual abuse in left-behind children among the primary school students was 19.1%,and the prevalence of child sexual abuse in female students was 14.2% lower than boys(23.0%).The protective factors of the higher prevalence of CSA among the middle school students were girls(OR=0.508),junior school students(OR=0.642),good relationship with caregiver(OR=0.362)and higher attitude scores(OR=0.404),while the risk factor was living inschool(OR=1.324).The protective factors of the higher prevalence of CSA among the primary school students were girls(OR=0.623),higher grade students(OR=0.695),while the risk factors were YX(OR=1.825),lower scores of cognition on CSA(OR=1.520)and lower attitude scores(OR=2.142).2.The results of typical case analysis showed that most of the cases of CSA were committed by acquaintances,the child victims were young and unable to resist the abuse.The cases last for a long time,and it was very difficult to detect it.And the judicial relief and social support for the child victims in this kind of cases were not perfect in our country.3.The interviewees had varying degrees of understanding of CSA.The education sectors had not yet developed teaching materials specifically aimed at the prevention of CSA and had not offered relevant curricula in schools,but indicated that specialized teaching materials would be developed in the future,as well as relevant courses in schools.At present,there is no harm monitoring point and compulsory reporting system for CSA in the medical and health system,but the medical and nursing staff were aware of reporting the cases on their own initiative.The judicial organs had mainly detected cases of CSA through the reports of child victims or their guardians,and had carried out legal popularization activities for the society.Hangzhou and other areas have begun to try out a system for compulsory reporting of cases of CSA.Hubei Province is also preparing to introduce the system.Conclusions: The prevalence of CSA in left-behind primary and secondary school students in rural areas was high.The policies related to CSA in Hubei Province were not perfect.The occurrence of child sexual abuse had not been improved.The judicial relief and social support of child victims could not be effectively guaranteed.It was urgent to improve the policies and strategies about CSA,strengthen the cultivation and education of students' knowledge among CSA.Improve students' undefined safety awareness so as to reduce the prevalence of CSA.