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Abstract

Background: Child Sexual Abuse (CSA) is becoming a social and public health concern especially because of its short- and long term effects which include transmission of HIV and other sexually transmitted infections (STIs), somatic and visceral injuries, unwanted pregnancy, increasing adolescents’ tendencies to high-risk behavior such as multiple sexual partners, prostitution, delinquency in later life, substance abuse and psychological problems like feeling of vulnerability, fear, shame, guilt, poor self-esteem, poor academic performance and depression.

This study evaluated the prevalence of child sexual abuse (CSA) and socio-demographic risk factors among adolescents in Secondary Schools in Makurdi LGA, Benue State, Nigeria.

Methodology: Using multi-staged sampling technique, 160 adolescents from 3 schools aged 10-19 years were studied in a cross-sectional, school-based survey from November 2021 to January 2022, to determine the prevalence of child sexual abuse among adolescents in Makurdi. Ethical clearance was obtained from Benue State Ministry of Health Research Committee. Confidentiality and anonymity were ensured. Data was collected using a semi-structured questionnaire completed by students. Descriptive statistics was used for data analysis. Test for association between subgroups was carried out using Chi-square test, while the difference between means was determined using the students t-test.

Results: The subjects comprised 73 males (45.6%) and 87 females (54.4%). 35 out of the 160 subjects had experienced CSA giving an overall prevalence of 21.9%. The proportion of females and males that were sexually abused were 17.2% and 27.4% respectively, although the gender difference was not statistically significant (p= 0.130). The highest prevalence of CSA (33.3 %) occurred within the age range of 17-19 years. The age at the time of CSA ranged from 6 – 16 years and above. The prevalence increased among those living with uncles, aunties or grand-parents and was least among those living with both father and mother.

Conclusion: The prevalence of child sexual abuse among adolescents in secondary school in Makurdi LGA is high. Thus, it is recommended that more attention should be given to educating adolescents, parents, teachers and the general public on the prevention of CSA which can reduce its occurrence

Key words

child sexual abuse, adolescents, Makurdi, secondary schools

Introduction

The abuse of children can happen in a variety of settings and locations including in the homes, schools, on the road, fields, care and justice institutions, and public open spaces. It is also evident that child sexual abuse (CSA) occurs in all ages and in all social-economic classes [1]. The World Health Organization (WHO) defines CSA as ‘the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent or that violates the laws or social taboos of society [2]. CSA is evidenced by the activity between a child and an adult or another child, and who by age or development is in a relationship of responsibility, trust or power, the activity being intended to gratify or satisfy the needs of the other person. This may include but is not limited to the inducement or coercion of a child to engage in any unlawful sexual activity; the exploitative use of a child in prostitution or other unlawful sexual practices; the exploitative use of children in pornographic performances and materials [2]. Adolescents are more vulnerable and account for a third of all new cases of human immunodeficiency virus (HIV) infections, high levels of violence, early marriage, low school attendance rate and enrollment than primary school children [3]. During this period, they suddenly become aware of the tremendous changes that are taking place in their sex organs and begin to seek various avenues to get answers to their sexual interest thereby making them vulnerable to CSA [4].

Globally, reports have shown that the prevalence of CSA is 18% for girls and 7.6% for boys [5]. CSA prevalence are higher in Africa (34.4%) followed by Asia and Oceania (23.9%), then Europe (9.2%) [5]. The true burden of CSA in Nigeria is unknown and is estimated to vary between 5% and 38% across different parts of the country [6-8]. In the Eastern part of Nigeria, it was reported that the prevalence of CSA is 10.5% [9].  However, it is higher in Benue State as reported in a study carried out at a law enforcement clinic in Benue State, with the most affected age group being pre-teens (8-12 years) 39.1% and teens (13-18 years) 34.8% and, majority of them been pupils/students, 84.8% of them in primary schools (50.0%) and secondary schools (34.8%).. Majority of them were living in an urban environment (82.6%) with both parents (50%) [10]. The aim of this study was to determine the prevalence and socio-demographic risk factors of CSA among adolescents in Secondary Schools in Makurdi LGA. This will throw light on CSA in secondary schools in Benue State Nigeria, so as to help affected parents and children cope with the management and prevention of this social problem. This study will also help government to develop policy formulations and design interventions to reduce the burden of CSA in Benue State.

Materials and methods

Ethics

Ethical clearance was obtained from Benue State Ministry of health. Consent was obtained from the school authorities and students. All aspects of the survey were explained on the consent form and clarified to the students. Numbers were assigned to identify each participant’s form. Therefore, none of the information collected was linked to any of the study subjects.

Study design

This was a school based cross-sectional study

Study area

This study was conducted in 3 coeducational secondary schools among adolescents aged between 10 years to 19 years attending secondary schools in Makurdi Local Government Area of Benue State. Makurdi is one of the 23 Local Government Areas in Benue State. It was founded in 1927, and became the Benue state capital in 1976. It is a cosmopolitan LGA with diversity in the culture of the dwellers, different socio-economic classes and family structure. Most dwellers major in farming. There are both public and private secondary schools located in Makurdi, and the estimated population is about 4,219,244 [11].

Study population

The study subjects were adolescent males and females aged 10 -19 years attending junior and senior secondary schools in Makurdi Local Government Benue State.

Selection of study participants

Multi-stage sampling technique was used to select the participants. Makurdi LGA was selected by convenience sampling. Three secondary schools were selected through a random sampling method from the list of private and public secondary schools in the LGA.

The proportionate numbers of subjects were recruited from each of the 3 schools. In schools with more than one arm of a class, an arm was chosen by simple random sampling (balloting) to represent the others, while in schools with only one arm of class, that arm was chosen.

Fifty-four students were selected from each class by simple random sampling (balloting). In all, a total of 160 students participated in the study.

Data collection and analysis

A structured self- administered questionnaire was used to obtain information on the socio-demographic, knowledge of sexual abuse and family structure of respondents. Data were entered and analyzed using the Statistical Package for Social Sciences program (SPSS), version 20. A descriptive statistics was used and results were presented as tables, graphs and charts in simple proportions. Comparison of means was done using the Student’s t-test, while the test for association between two subgroups was carried out using the Chi square test. In all cases, a p-value of 0.05 or less was regarded as statistically significant.

Results

From table 1 above, of the 160 students studied, 73 (45.6%) of them were males and 87 (54.4%) were females.  This difference was not statistically significant (p = 0.04)

Table 1. Age and sex distribution of the respondents

Age	Male No (%)	Female No (%)	Total No (%)
10-13	13 (35.1)	24 (64.9)	37 (100.0)
14-16	40 (41.7)	56 (58.3)	96 (100.0)
17-19	20 (74.1)	7 (25.9)	27 (100.0)
Total	73 (45.6)	87 (54.4)	160 (100.0)

Table 2 shows that of the 160 subjects involved in the study, 35 (21.9%) of them had been sexually abused. Among the 87 females, 15 (17.2%) were abused compared to 20 (27.4%) of the 73 males. The observed gender difference was not statistically significant with p = 0.13.

Table 2. Prevalence of child sexual abuse and gender

Gender	Abused No (%)	Not Abused No (%)	Total No (%)
Male	20 (27.4)	53 (72.6)	73 (100.0)
Female	15 (17.2)	72 (82.8)	87 (100.0)
Total	35 (21.9)	125 (78.1)	160 (100.0)
ꭓ2 = 2.396,   df = 1, p-value = .130

Table 3 shows the prevalence of Child Sexual Abuse according to age range. It shows that 9 (33.3%) of subjects between the ages of 17-19 years reported that they had been sexually abused, this was closely followed by 20.8% among the 14 -16 year age, while the lowest proportion of 16.2% was found among the 10 -13 year age group. The difference within the age groups was not statistically significant (χ²= 2.826, df = 2, p = 0.243).

Table 3. Prevalence of child sexual abuse and age

Age	Abused No (%)	Not Abused No (%)	Total No (%)
10-13	6 (16.2)	31 (83.8)	37 (100.0)
14-16	20 (20.8)	76 (79.2)	96 (100.0)
17-19	9 (33.3)	18 (66.7)	27 (100.0)
Total	35 (21.9)	125 (78.1)	160 (100.0)
ꭓ2 = 2.826,   df = 2, p-value = .243

Figure 1 showing the age at the time of sexual abuse. The ages at time of abuse ranged from 6 – 16 years and above, with the least prevalence among girls 6 years and below (44.4%), and the highest among boys 16 years and above (75%).

Figure 1. Age at the time of Child Sexual Abuse

Table 4 shows that of the 93 subjects who lived with both parents, 13 (14.0%) reported that they were sexually abused compared to 9/30 (30.0%) of those who lived with a single parent, and 13/37 (35.1%) of those who lived with none of their biological parent as shown above. The difference in the prevalence of sexual abuse among the three groups was statistically significant. (χ² =8.359, df =2, p = 0.015)

Table 4. Child sexual abuse and who the respondents live with

Live with	Abused No (%)	Not Abused No (%)	Total No (%)
Both Parents	13 (14.0)	80 (86.0)	93 (100.0)
Single Parent	9 (30.0)	21 (70.0)	30 (100.0)
Others	13 (35.1)	24 (64.9)	37 (100.0)
Total	35 (21.9)	125 (78.1)	160 (100.0)
ꭓ2 = 8.359,   df = 2, p-value = .015

Discussion

The prevalence of sexual abuse among adolescents in Makurdi L.G.A of 21.9% found in this study was the same with reports from Lagos where a fifth (21.9%) of the respondents had experienced sexual abuse in the past year among secondary school students [12]. Likewise in the Northern province of South Africa among secondary school adolescents, 28.9% were victims of oral/anal/vaginal intercourse [13]. However, the prevalence in this study is lower than the report in a study among secondary school students in three of the six states of North Eastern Nigeria, where 36% of respondents had experienced CSA [14]. The finding in this study also contrasts with a lower prevalence of 1.8% - 9.1% of CSA among males in China [15]. The variations in the definitions used for sexual abuse, the study area and the age of the study population may be contributory to this lower prevalence.

There are various differing findings concerning the relationship between gender and childhood sexual abuse. Reports have consistently shown that the prevalence was higher in females than in males [16,17]. However, the present study differs with a higher prevalence of sexual abuse in males (27.4%) compared to females (17.2%). This is not surprising, as more focus has been on the girl child since most studies showed more abuse among females. Furthermore, sexual abuse of the boy child may not be uncommon but perhaps under- recognized and therefore under reported.

Few studies have examined the age at onset of CSA. For instance, in India, victims experienced first CSA between the ages of 10 - 13 years [18]; while in Lao, 22% experienced sexual violence prior to age 13; 25% between the ages 14 - 15; and 53% between the ages 16 – 17 [19]. However, in this study the age of abuse was mostly in the late-adolescent age groups in 33.3% of the victims. More females experienced first CSA at 6years and below (55.6%), while more males experienced their first CSA at 16 years and above (75.0%). This finding is at variance with two other studies that reported the age of onset of abuse to be before the adolescent age group.

The presence of both parents as a barrier against the perpetration of CSA is undeniable from the research findings of this study. It was established that the likelihood of experiencing sexual abuse were higher among respondents who did not live with both biological parents. In this regard, the finding from this study is consistent with numerous earlier studies which reported that not living with both biological parents places a child at a higher risk of CSA [20,21].

Conclusion

In conclusion, therefore, this study established a high prevalence of child sexual abuse among adolescents in Makurdi LGA, which was associated with living with other relatives other than their biological parents. The adolescent males reported more CSA. It is recommended that a stable home with the full involvement of both parents and adequate monitoring of children (both the girl and boy child), as well an increased public enlightenment on the risk factors and prevention of CSA, can prevent its occurrence.

Conflict of interest

There was no conflict of interest and no funding.

Acknowledgement

We are grateful to Mr Victor and Mr Francis for their assistance in the data collection and analysis for this study.

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