Factors associated with reporting delays and severity of childhood sexual abuse in São Paulo, Brazil

Vertamatti, Maria Auxiliadora Figueredo; Strufaldi, Rodolfo; Evans, Dabney P.; Drezett, Jefferson; Barbosa, Caio Parente; Abreu, Luíz Carlos de

doi:10.1080/13548506.2018.1556397

Cited by 11 publications

(26 citation statements)

References 42 publications

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“…Intimate partner sexual violence stems from hierarchical gender norms that, by their very nature, usually occur in the domestic space. The same is true of sexual violence against children and adolescents, with most cases occurring at home by known and often related 19,20,22,23,34 . Private spaces are also the most frequent places to approach when victims have intellectual disabilities 13 .…”

Section: Discussionmentioning

confidence: 99%

“…Bessa et al (2019) 13 observed that in cases of pregnancy due to incest, the aggressor exerted an influence on the care path of adolescents, making access to health services difficult 13 . Among children, Vertamatti et al (2018) 34 found that a related or known perpetrator postponed disclosure and reporting of sexual abuse to the appropriate authorities 34 .…”

Section: Discussionmentioning

confidence: 99%

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Abortion withdrawal of sexual violence pregnancy: the role of the sex offender

Pimentel

Drezett²,

Macedo

et al. 2020

jhgd

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Introduction: Unwanted pregnancy is a serious consequence for women who experience sexual violence. Although deciding on abortion is frequent in these cases, there is not much information on women who give up abortion in this circumstance. Objective: To analyse the associated factors in abortion withdrawal of sexual violence pregnancy. Methods: A cross-sectional epidemiological study with a convenience sample of adolescents and women with pregnancy due to sexual violence and requesting legal abortion between August 1994 and December 2012, at Hospital Pérola Byington, São Paulo, Brazil. Pregnant women who gave up abortion after receiving the procedure approval were included and, in another group, pregnant women who completed the abortion. The variables were selected from a digitized database and analyzed using SPSS 15.0 software. The outcome was abortion withdrawal. The study variables were age; low education level; gestational age; color/black ethnicity; not being united; declare religion; serious threat from the aggressor; known offender; and residence of the aggressor. Odds ratios with 95% confidence intervals were calculated. The analysis used Wald's chi-square test (?2W) and logistic regression with variable of interest defined as the known aggressor. The research was approved by the Research Ethics Committee of the Federal University of São Paulo, Opinion No. 6767. Results: The study included 941 women, 849 (90.2%) who had an abortion and 92 (9.8%) who gave up after being approved. Age ranged from 10-46 years, mean 23.2 ± 7.9 years, gestational age 4-22 weeks, average 11.9 ± 4.5 weeks. Among those who gave up abortion, 12.0% were <14 years old; 50.0% had gestational age ? 13 weeks; 50.0% had low education; 14.2% were black; 90.2% single; 85.9% declared to have religion; 50.0% were threatened; 12.0% of the cases occurred at the perpetrator's residence and 53.3% of the victims were raped by known perpetrators. In logistic regression, the only significant variable was the known perpetrator, increasing the victim's chance of giving up abortion twice. Conclusion: The known sex offender has influenced the woman or adolescent's decision to give up legal abortion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Abortion withdrawal of sexual violence pregnancy: the role of the sex offender

Pimentel

Drezett²,

Macedo

et al. 2020

jhgd

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“…The same occurs with extragenital damages present between 10% and 80% of cases. 14,15 Women who suffer sexual violence at the hands of strangers in urban centres are usually constrained by serious threat, and the common use of cold weapons or firearms. 16 In those circumstances, the threat of death can inhibit women's resistance, leading to the occurrence of physical damage.…”

Section: Discussionmentioning

confidence: 99%

“…19 Cases of intrafamiliar sexual violence committed by known perpetrators show a greater tendency for under-reporting, limiting attendance at health services. 15 Under those conditions, prophylaxis and diagnosis of STIs are postponed, exposing the different injuries and damages to reproductive health. 16 In Seattle, USA, research with adult women and adolescents who were treated within 72 hours of sexual violence compared cervicovaginal samples collected at baseline and after two weeks.…”

Section: Discussionmentioning

confidence: 99%

Sexually Transmitted Infections Among Adolescent and Adult Women Victims of Sexual Violence in the Metropolitan Region of São Paulo, Brazil

Drezett¹,

Bessa²,

Valenti³

et al. 2020

Hum. Reprod. Arch.

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Background: Sexual violence is a serious violation of human rights that mainly affects women. Among the impacts on health, sexually transmitted infections (STIs) are important due to their high prevalence and possible reproductive harm. Objective: To check and compare the incidence of STIs in adolescent and adult women victims of sexual violence. Method: Retrospective cohort study with 135 adolescents (10-19 years) and 154 adult women (≥20 years) attending the Pérola Byington Hospital, São Paulo, Brazil, with vaginal and/or anal unprotected exposure during the sexual crime, with ingression between 72 hours and 10 days of the violence, who did not receive prophylaxis for STIs, hepatitis B or HIV. Cases with earlier STIs, pregnant women and violence from an intimate partner were excluded. The outcome was the occurrence of STIs in the two groups. Data were introduced in the program Epi Info6, version 6.04b, with statistical analysis by chi-square test. Results: The diagnosis of STIs occurred for 32.6% of adolescents and 31.1% of adult women. The median age was 21.0±5.8 years. Adolescents were more vulnerable to the related and known aggressors. Ninety-two patients with STIs (31.8%) were found along with 120 infections among the 289 women, distributed between HPV (16.9%), trichomoniasis (6.6%), chlamydia (3.8%), herpes (2.4%), hepatitis B (2.4%), syphilis (2.1%), gonorrhea (1.7%) pelvic inflammatory disease (1.7%), hepatitis C (1.4%), HIV (1.4%) and HTLV I and II (1.0%). Conclusion: The incidence and distribution of STIs show no differences in the two groups, suggesting similar risk for adolescent and adult women when submitted to the same forms of exposure during sexual crime.

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“…Current understandings of incest must overcome the reductionism implicit in legal definitions; these often limit the phenomenon to biological or kinship degrees [3]. To a certain extent, incest is an expression of gender-related violence, since it is based on power asymmetry; between the aggressor and the victim.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Adolescent Pregnancy and Legal Abortion in Situations Involving Incest or Sexual Violence by an Unknown Aggressor

et al. 2019

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Background and Objectives: In pregnancies resulting from incest, the adolescent maintains close family and emotional relations with the aggressor, different from what occurs when pregnancy results from sexual violence by strangers. Evidence indicates that this type of relationship with the aggressor may interfere in the dynamics of such violence and the adolescent’s access to health services. Materials and Methods: The objective of this research was to describe and correlate aspects associated with pregnancy when resulting from rape of adolescents in situations of incest; rape when perpetrated by an unknown aggressor and an abortion as allowed by law was sought. Method: A cross-sectional, epidemiological study of adolescents treated at the Pérola Byington Hospital, São Paulo, Brazil, bringing an allegation of pregnancy, resulting from sexual violence and a request for abortion as allowed by law. A total of 311 adolescents, being 134 in the “pregnancy from incest group”, and 174 in the group “pregnancies resulting from rape by a stranger” were considered under the study variables; relationships were investigated using the chi-squared test and Poisson regression with robust variance. Results: The study included 137 cases (44.1%) of pregnancy resulting from incest, and 174 cases (55.9%) of pregnancy from rape by a stranger. In cases of incest, a declaration of religion (92.0%) was significantly more frequent, and the adolescents were approached in spaces considered safe or private (92.7%); the aggressor taking advantage of the adolescent’s legal condition of vulnerability as a function of age (83.3%). Cases of incest presented a lower median adolescent age and greater gestational development, with gestations being ≥ 13 weeks prevailing. Conclusion: Cases of pregnancy by incest presented indicators suggesting both proximity and relationship with the aggressor, and pregnancy at a very early age, which postponed the adolescent’s procurement of health service, and interfered negatively with abortion assistance as allowed by law.

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Factors associated with reporting delays and severity of childhood sexual abuse in São Paulo, Brazil

Cited by 11 publications

References 42 publications

Abortion withdrawal of sexual violence pregnancy: the role of the sex offender

Abortion withdrawal of sexual violence pregnancy: the role of the sex offender

Sexually Transmitted Infections Among Adolescent and Adult Women Victims of Sexual Violence in the Metropolitan Region of São Paulo, Brazil

Characterization of Adolescent Pregnancy and Legal Abortion in Situations Involving Incest or Sexual Violence by an Unknown Aggressor

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