Sexual Abuse in Malawi: Patterns of Disclosure

Abstract

Potential human immunodeficiency virus transmission makes prompt disclosure of child sexual abuse in Africa critical. The pattern of disclosure of 133 children presenting to the largest hospital in Malawi were analyzed. Eighty percent presented early enough for effective use of HIV postexposure prophylaxis. Seventy-five percent of children made a disclosure of child sexual abuse; 29% spontaneously and 47% after prompting. Disclosures were most commonly made to a parent, and age did not affect the pattern of disclosure. The number of children reporting child sexual abuse is increasing, possibly because of increasing awareness, availability of services, and fear of HIV. Although prompt disclosure rates were relatively high, facilitating easier disclosure of child sexual abuse by a free telephone help-line and better training of teachers may be helpful.

KEYWORDS:

• sub-Saharan Africa
• HIV
• self-disclosure
• delay
• presentation

Additional information

Notes on contributors

Carole Mason

Carole Mason, MBChB, MRCPCH, is a speciality trainee in paediatrics at the Northern Deanery, Newcastle Upon Tyne, United Kingdom. In 2010 she spent six months living and working in Malawi.

Neil Kennedy

Neil Kennedy, MRCPCH, MMedSci, DTM&H, is head of the Department of Pediatrics and Child Health in the University of Malawi in Zomba, Malawi. He has worked in Malawi for more than 10 years and with the Ministry of Health has established the Malawi’s first multidisciplinary team to work with survivors of child sexual abuse.