Child and Adolescent Sexual Abuse in Women Seeking Help for Sexual and Reproductive Mental Health Problems: Prevalence, Characteristics, and Disclosure

ABSTRACT

This is a multicentric, descriptive, cross-sectional study of child and adolescent sexual abuse in women over 18 years in 24 primary care sexual and reproductive health centers in Catalonia. A total of 1,013 women were recruited; 345 (37.6%, 95% CI: 34.6–40.9) reported exposure to child sexual abuse: 32.4% disclosed being touched in a sexual way, and 9.6% reported completed sexual intercourse. Abuse occured before the age of 13 in 63.4% of respondents. The perpetrator was a relative or an acquaintance in almost 80% of cases. The risk was higher among women of Central or South American origin (OR: 2.86; 95% CI: 1.33–6.12). Only 31.9% of women disclosed the abuse and 17.3% were blamed. Abuse that involved attempted or completed sexual intercourse was significantly associated with recurrence, physical violence, and revictimization in adulthood.

KEYWORDS:

• adults
• female
• primary health care
• rape
• recurrence
• Reproductive Health Services
• Spain

Acknowledgments

First, we wish to thank the Rubí City Council and the Jury of the Ferran Salsas Prize, the Francesca Bonnemaison Culture Centre for Women, and the Catalan Institute for Women for the financial contribution that has made this study possible. We wish to thank all the women that have participated in the study for their time and the invaluable information on their experiences.

Funding

Funding for this study was provided by Rubí City Council and the Jury of the Ferran Salsas Prize, the Francesca Bonnemaison Culture Centre for Women, and the Catalan Institute for Women.

Additional information

Funding

Funding for this study was provided by Rubí City Council and the Jury of the Ferran Salsas Prize, the Francesca Bonnemaison Culture Centre for Women, and the Catalan Institute for Women.

Notes on contributors

Sílvia López

Sílvia López, LPsy, is consultant psychologist at INAD, Parc de Salut Mar. Barcelona. She is also a clinical psychologist at the PASSIR: Sexual and Reproductive Services, Primary Health Care, Catalan Health Institute, Barcelona. In addition, she is a member of the clinical and health sections at the College of Psychology of Catalonia.

María-Isabel Fernández, LPsy, is a clinical psychologist and consultant psychologist at PASSIR-INAD. She is also an associate professor at the Autònoma University of Barcelona and a member of CAMFIC’s group “Gender Violence.”

Concepció Faro

Concepció Faro, LPsy, is a clinical psychologist and consultant at the Parc de Salut Mar. He also works at the PASSIR of the Primary Health Programs of the Catalan Health Institute.

Lourdes Lopetegui

Lourdes Lopetegui, LPsy, is a senior clinical psychologist at the Mental Health Department Parc Sanitari Sant Joan de Déu (Barcelona). In addition, she is a clinical psychologist at the PASSIR of the Primary Health Care, Catalan Health Institute, Barcelona, and a member of the clinical and health section at the College of Psychology of Catalonia.

Enriqueta Pujol-Ribera

Enriqueta Pujol-Ribera, MD, MSc, is a researcher at the Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) in Barcelona.

Mònica Monteagudo

Mònica Monteagudo, MD, works at the Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) in Barcelona.

Àngels Avecilla-Palau

Àngels Avecilla-Palau, MD, is a gynecologist and head of the Sexual and Reproductive Health Care Unit. He is also the head of the Research Unit at Badalona Serveis Assistencials (BSA), PASSIR, Primary Health Care, Catalan Health Institute. Furthermore, he is a member of the Research Ethics Committee at Germans Trias i Pujol Hospital, Badalona.

Cristina Martínez

Cristina Martínez is a midwife and holds a bachelor of science degree in education science. She is currently the manager of Sexual and Reproductive Services in Primary Health Care at Catalan Health Institute. In addition, she is a teacher at the University of Nursery, University of Barcelona. She is also the president of the Spanish Associations Federation of Midwives.

Jesús Cobo

Jesús Cobo, MD, PhD, is a consultant senior psychiatrist at the Mental Health Department of the Corporació Sanitàia Parc Taulí (Sabadell). He is also an associate professor at the Autònoma University of Barcelona. He is a member of CIBERSAM.

Catalonian Research Group for Sexual and Reproductive Mental Health is a research Workgroup at the PASSIR, Catalan Health Institute. The group included the following researchers: Montserrat Aiger, Imma Albert, Maria-Teresa Auferil, Marta Batlle, Yolanda Bovis, Anna Casino, Sonia Garcia, Maria-Dolores Joya, Pilar Medina, Teresa Pellicer, Cristina Pipó, Teresa Planella, Xavier Pujol, Maria-Jesús Ribes, Muntsa Riera, Margarita Sentís, Teresa Solé, Gemma Torra, Montserrat Villacampa, and Sergi Villanueva.

María-Isabel Fernández

María-Isabel Fernández, LPsy, is a clinical psychologist and consultant psychologist at PASSIR-INAD. She is also an associate professor at the Autònoma University of Barcelona and a member of CAMFIC’s group “Gender Violence.”