Prevalence of childhood sexual abuse among Mexican adolescents

Background   To determine the characteristics and prevalence of previous child sexual abuse among a group of Mexican junior high school students.
Methods   A total of 1067 adolescents of both genders were selected to fill out a survey about child sexual abuse.
Results   The prevalence of child sexual abuse was 18.7% ( n  = 200). It was more frequent in girls (58%) than in boys (42%). Sexual abuse involved physical contact in 75% of those cases reporting abuse. The aggressors were neighbours (50.3%), relatives (36.8%) and strangers (13.9%). Abuse was committed through deception in 90% of the cases and involved physical mistreatment in 10% of the cases. Of the victims, 14.4% had spoken about the problem and 3.7% had taken legal action. And 9.6% of those surveyed stated that they required psychological counselling.
Conclusions   In the population studied, the prevalency of child sexual abuse was greater than that reported in Mexico City (4.3–8.4%), although it was similar to that found in the Spanish child population (15–23%). The risk of sexual abuse is greater for girls and the principal aggressors are male neighbours, family friends and relatives; the abuse is committed in the home of the aggressor or the victim and very few cases are reported to the authorities.     

Child sexual abuse and premarital intercourse among high-risk adolescents

This study examined the extent to which child sexual abuse was associated with an increased likelihood of premarital sex among adolescents at high risk of sexual abuse. The sample consisted of 177 teenage girls who, because of evidence of family dysfunction, had become part of a public child welfare system. Half the sample had been placed in a foster home and the remainder were receiving protective services in their own home. About 40% of the teens in both groups had been sexually abused, although teens still living at home were less likely to have reported abuse. Victims of sexual abuse were found to be more likely to have engaged in voluntary sexual intercourse, even after background factors were controlled. Teens in foster home were somewhat less likely to be sexually active than the teens who remained at home.     

Posttraumatic stress disorder in adolescents after sexual abuse is readily treated

Two patients, a boy aged 19 years and a girl aged 16 years, were diagnosed to be suffering from a posttraumatic stress disorder (PTSD) 7 and 2 years after sexual abuse, respectively. There was thus a serious delay in the correct diagnosis and the start of cognitive behavioural therapy, which was successful. A thorough diagnostic procedure with a semi-structured clinical interview ('Clinician administered PTSD scale') is helpful in preventing such a diagnostic delay. The omission of a structured diagnostic interview can lead to serious misjudgement. Cognitive behavioural therapy with repeated imaginary exposure to the traumatic event(s) or cognitive interventions to maladaptive beliefs is the standard treatment for PTSD in adults. Adolescents with PTSD after sexual abuse achieve a good outcome on cognitive behavioural therapy as well.     

The importance of recognizing a history of sexual abuse in female adolescents

We have become increasingly aware of sexual abuse in our society, and yet the majority of teens who were sexually abused as children enter adolescence carrying the secret of their abuse. Such hidden abuse may have devastating effects on the development of personal identity, self-esteem, attitudes, behaviors, and interpersonal relationships that may persist and set a pattern for a troubled adulthood. This article details how children cope with a sexually abusive situation, the long-term effects of unresolved sexual abuse, and diagnostic criteria to differentiate a hidden history of sexual abuse from other trauma and conditions. Focus is on recognizing and assessing “legitimate” symptoms that may be conscious or unconscious cries for help by victims of previous sexual abuse. Correct diagnosis is essential to appropriate intervention to lessen possible further psychologic damage during adolescence.     

Expedited partner therapy for adolescents diagnosed with gonorrhea or chlamydia: a review and commentary

Management of sex partners is a cornerstone of sexually transmitted infection control in the United States. Face-to-face investigation and notification of exposure of sex partners by public health professionals seems to be the most effective method of ensuring appropriate partner management. However, resources rarely permit such intensive partner management for gonorrhea and chlamydial infection. Alternatives to public health-assisted notification and referral include expedited partner therapy, in which partners are treated before evaluation, most typically through patient-delivered therapy. Results from trials have shown generally favorable biomedical and behavioral outcomes. This article discusses the evidence for expedited partner therapy and its associated liability, confidentiality, financial, and administrative issues relating to adolescent patients and their health care providers.     

Sexual abuse of children and adolescents: characteristics of sexual victimization in family relations

This study analyzes the characteristics of sexual abuse committed within the family against age groups classified according to the Brazilian Statute for Children and Adolescents (the prevailing legislation on matters pertaining to minors) and treated at the Reference Center for Children and Adolescents and the Guardianship Councils in Ribeir?o Preto, S?o Paulo State, Brazil, from 1995 to 2000. Some 234 abuses were identified, committed by 217 aggressors, against 210 families and a total of 226 victims. A total of 131 children (48.7%) and 95 adolescents (41.2%), predominantly females, were victimized. Children ranging from 10 to 12 years were the most frequently abused (19.5%), as well as adolescents from 12 to 14 years old (17.3%). The majority of the victims live in families with 3 (19.9%) or 4 children (177%), and the firstborn are the most frequently abused (33.6%). The majority of aggressors who acted alone victimized only one individual (86.7%). Fathers (34.2%) and stepfathers (30.3%) were the most frequent aggressors, with the former victimizing more children (19.7%) and the latter adolescents (17.1%).     

Syphilis testing in association with gonorrhea/chlamydia testing during a syphilis outbreak

We used an electronic medical records system retrospectively to evaluate how frequently, in a public hospital and its clinics, combined gonorrhea/chlamydia tests were accompanied by a syphilis test before and during a syphilis outbreak. Among 70,330 gonorrhea/chlamydia tests (1996-2000), the proportion with a syphilis test increased from 13% (preoutbreak) to 50% (intervention period) for men and from 6% to 13% for nonpregnant women. The increased syphilis testing coincided with a multifaceted public health intervention.     

Anogenital warts in children: sexual abuse or unintentional contamination?

Anogenital warts (AGW) were recently recognized in children, and their significance as an index of childhood sexual abuse is controversial. We report our transdisciplinary approach (including a pediatric surgeon, psychologist, social worker, ethics expert, and occasionally law enforcement agents) and its results in a group of 17 children with AGW treated at the public pediatric referral hospital in Rio de Janeiro, Brazil, during a 3-year period (1996-1999). All children were treated by electrocauterization of the warts, tested for other STDs, and submitted to perineal examination under anesthesia. Families received psycho-social counseling as necessary and cases were referred to child protection and law enforcement agents when indicated according to Brazilian legislation. We identified a high incidence of sexual abuse (8 children, 5/7 > 5 years old), with 3 patients inconclusive as to sexual abuse and 7 cases of perinatal transmission (5/8 < 4 years old). We conclude that AGW are indeed a strong sign of suspicion for sexual abuse in children, especially but not exclusively > 5 years of age. However, strong support and a transdisciplinary approach to the children and their families is necessary to identify it.     

History of childhood sexual abuse and HIV risk behaviors in homosexual and bisexual men

OBJECTIVES: We examined the prevalence and frequency of childhood sexual abuse and their association with sexual risk among a sample of gay and bisexual men. Methods. Cross-sectional data were collected by survey from randomly selected gay and bisexual men who attended the 1997 and 1998 Minneapolis/St. Paul Gay, Lesbian, Bisexual, and Transgender Pride Festivals. Data included demographics, sexual activity, history of childhood sexual abuse, HIV status, history of sexually transmitted infection, use of sex-related drugs (such as crack, cocaine, Ecstasy, amyl nitrate, crystal methamphetamine, and Special K), and history of exchanging sex for payment. Results. childhood sexual abuse was reported by 15.5% of the survey respondents (n = 134). Those who reported experiencing abuse regularly were more likely to (1) be HIV positive, (2) have exchanged sex for payment, and (3) be a current user of sex-related drugs. Neither unsafe sex nor sexually transmitted infections were associated with childhood sexual abuse. CONCLUSIONS: These findings show that more than 1 in 7 gay and bisexual men in a non-clinical, festival-based setting were victims of childhood sexual abuse and that childhood sexual abuse was associated with alarmingly high rates of men who were HIV infected and antecedent risk behaviors.     

漯河市淋病与梅毒流行特征分析

目的分析漯河市淋病与梅毒的流行特征,探讨相关危险因素,为预防控制措施的制定提供依据。方法对漯河市历年来的淋病与梅毒疫情资料进行描述性分析。结果漯河市自1991年有淋病疫情报告以来,截至2012年底累计报告淋病2391例,淋病发病率一直呈上升趋势,1998年达到最高峰为13．01／10万,之后发病率一直呈下降趋势,2012年降至最低,为0．55／10万,2005年之前梅毒发病率一直低于淋病,2005年疫情有所上升,自2008年以来呈快速上升势头,由1991年的0．08／10万上升到2012年发病率达35．30／10万,1991--2012年累计报告梅毒3566例,2004--2012年隐性梅毒（1699例）占总病例数（3293例）的51．59％。结论漯河市近年来梅毒发病率上升速度较快,隐性梅毒占比重较大,必须加强梅毒防治知识的宣传教育;加强对临床医生传染病诊断标准的培训,规范性病的报告,提高疫情报告准确率。     

Psychiatric distress in incarcerated women with recent cocaine and alcohol abuse.

PURPOSE: Women frequently abuse cocaine and alcohol before incarceration. Research indicates that women in criminal justice settings also suffer high rates of psychiatric distress. This study aimed to determine how preincarceration abuse of alcohol and cocaine affected current psychiatric distress among female jail detainees held for 10-14 days. METHODS: A probability sample of women in a large urban jail (n = 469) were assessed for use of alcohol and cocaine during the 6 months before incarceration and for their current psychiatric distress. They were grouped based on their level of alcohol consumption and cocaine use: high cocaine/high alcohol; high cocaine/low alcohol; low cocaine/high alcohol; and low cocaine/low alcohol. Profile analysis was used to examine the relation of psychiatric distress, as measured by the Brief Symptom Inventory, to levels of recent alcohol and cocaine use. RESULTS: Psychiatric distress is highest (and similar) among women in the high cocaine groups, regardless of alcohol use, and psychiatric distress is lowest among those who used both substances infrequently. Characteristics of psychiatric distress differed based on level of alcohol use, but only when cocaine use was low. High alcohol and cocaine use alone and together also predict the likelihood of psychiatric distress reaching a diagnosable level of severity. CONCLUSIONS: High cocaine, alcohol, or combined use is related to higher levels of psychiatric distress among incarcerated women in this jail. Women should be screened at the time of incarceration, and women who have alcohol and other drug problems should receive treatment that includes mental health services.     

Psychophysiological sexual arousal in women with a history of child sexual abuse

On the basis of literature that suggests that child sexual abuse (CSA) survivors with post traumatic stress disorder (PTSD) have higher baseline sympathetic nervous system (SNS) activity than healthy controls and research that suggests that the SNS plays a critical role in female physiological sexual arousal, we examined the impact of SNS activation through intense exercise on sexual arousal in women with CSA and PTSD. We measured physiological and subjective sexual arousal in women with CSA (n = 8), women with CSA and PTSD (n = 10), and healthy controls (n = 10) during exposure to nonerotic and erotic videos. After exercise, women with CSA and women with CSA and PTSD showed no significant differences in the physiological sexual response compared with no exercise, which was different from the increased physiological sexual response after exercise observed in control women.     

Child sexual abuse as a risk factor for sexual risk behaviours among socially disadvantaged adolescents in Ibadan,Nigeria

This study documents the prevalence and association between child sexual abuse (CSA) and risky sexual behaviours among in-school adolescents in Ibadan, Nigeria. A cross-sectional study with 1,079 boys and 1,211 girls was conducted in 22 socially disadvantaged public secondary schools in a suburb of Ibadan, Nigeria. A 70-item sexual risk behaviour questionnaire was used to collect information on lifetime and current sexual experiences. Fifty-five per cent of students reported to have ever experienced at least one form of CSA. Thirty-six per cent reported a history of intra-family CSA, whereas 46% had experienced inter-family CSA. Five hundred and sixty-four (24.6%) of these adolescents were sexually active at the time of the study. There was a strong relationship between having ever experienced CSA and sexual risk behaviours: adolescent boys and girls with CSA were three-fold as likely not to use condom at last vaginal intercourse; thrice as likely to engage in casual sex with a partner known for a day; twice as likely to drink alcohol heavily before sex; thrice for tobacco smoking and three- fold for STD. Logistic regression shows that the relationship between CSA and non-use of condom at last vaginal intercourse remained after controlling for age, family type, parents staying together and hawking after school. We found that experiences of CSA may precipitate risky sexual behaviours in this population. A structural and educational approach towards educating both adolescents and parents of the possible effect of CSA to sexual risk behaviours is presented in this article.     

北京市2004-2012年梅毒和淋病流行特征分析

目的分析2004-2012年北京市梅毒和淋病的流行特征,为预防控制性传播疾病提供数据参考。方法收集北京市2004-2012年通过中国疾病预防控制信息系统上报的梅毒和淋病病例进行描述流行病学分析。结果 2004-2012年北京市共报告梅毒33 363例,年报告发病率范围为12.26/10万～25.13/10万;淋病23 983例,年报告发病率范围为5.52/10万～35.53/10万,呈逐年下降趋势(χ2趋势=48.53,P<0.01)。除隐性梅毒外,其他各期梅毒和淋病男性病例均多于女性。梅毒和淋病报告病例主要集中在20～49岁性活跃年龄组,分别占全部报告病例的64.59%和88.43%。梅毒报告病例以隐性梅毒为主,占所有报告病例的53.76%。梅毒和淋病报告病例较多的区县均为丰台区、海淀区和朝阳区,以家政、家务及待业人员为主。结论梅毒已成为北京市发病率最高的性病,应重点针对流动人口集中区域加强梅毒防治知识的宣传教育,以有效控制性传播疾病的流行。