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Prioritizing child sexual abuse prevention

Smiling elementary school children wearing backpacks

1 in 4 girls and 1 in 10 boys have experienced child sexual abuse at some point before they turned 18. Child sexual abuse (CSA) is a serious and widespread problem; however, it can be prevented. The Department of Health and Human Services and the Centers for Disease Control and Prevention sent a report on preventing child sexual abuse to Congress, which highlights how preventing childhood sexual abuse is a public health priority. It also explains CDC’s current efforts to prevent child sexual abuse, and it addresses the gaps that still exist in preventing child sexual abuse. 

Preventing childhood sexual abuse is a public health priority. We know that:     

  • The prevalence of CSA is underestimated - About 676,000 children experienced CSA in 2016, but the actual number may be higher due to underreporting. Many children are abused by someone they know and trust, and they typically delay or never disclose to family, friends, or authorities. 
  • There are substantial health and economic consequences of CSA - This includes short-term health problems such as headaches, unwanted/unplanned pregnancies, physical injuries, and chronic health conditions such as heart disease, obesity, and cancer. Mental health consequences include depression, post-traumatic stress disorder (PTSD), learning and memory difficulties, suicide attempts, substance abuse, and risky sexual behaviors, among others. The total lifetime economic cost of CSA is estimated to be $9.3 billion, but the total is likely higher due to limitations in available data. 
  • CSA victimization and perpetration are associated with risk and protective factors - The report discusses risk and protective factors for victimization and perpetration at the individual, relationship, community, and societal level. 
  • CSA can be prevented - Most children are sexually abused by someone they know and trust. The report notes that evidence suggests there are strategies to prevent perpetration of CSA. Research on peer and juvenile-perpetrated CSA has indicated some strategies have resulted in reductions in perpetration. Programs that teach children about healthy relationships, safe dating, and healthy sexuality; programs that teach healthy social norms; and programs that try to create a safe and protective environment by improving the safety of schools have shown positive effects.    
  • More research is needed in the following areas: 
    • Better data collection is needed on victimization. Official data is limited by reporting, and many children delay or never disclose their abuse. Data is also at times inconsistent and contradictory because there is no standard measurement and definition of CSA. For more information on the CSA surveys currently conducted or sponsored by CDC, see pages 20-21 of the report. 
    • More data is needed on the factors leading to CSA perpetration to better inform primary prevention. Most data on perpetration of CSA is based on information collected from victims or is from poor-quality research or is based on small sample sizes. More research is needed to examine the different types of CSA perpetrators, on risk and protective factors for perpetration, and on how these risk factors overlap with perpetrating other forms of violence.
    • More research is needed to identify and evaluate approaches on all levels (individual, relationship, community, and societal) for preventing adult and juvenile perpetration. 
    • Additional research is needed to understand how to best communicate about CSA and adapt evidence-based prevention programs to different communities. 

Child sexual abuse is a major public health problem, but it can be prevented. These CDC resources are valuable tools for people working to prevent and respond to sexual abuse and assault. Check them out to learn more about the scale and impact of this critical public health issue and how we can continue to bridge gaps in preventing child sexual abuse.