Sexual abuse in Chinese children in Hong Kong: a review of 134 cases

A review of child sexual abuse cases presenting to a paediatric emergency department

INTRODUCTION

Child sexual abuse (CSA) adversely affects a child's growth and well-being. This study aimed to describe the profile of children presenting to a tertiary paediatric emergency department(ED) with CSA.

METHODS

Children 0-16 years old presenting to KK Women's and Children's Hospital ED from June 2016 to August 2020 with sexual abuse were retrospectively reviewed. We performed a secondary analysis on girls and stratified them by age <13 and ≥13 years old.

RESULTS

There were 790 patients who made 833 visits for CSA. Victims were predominantly girls (747, 94.8%) and perpetrators were predominantly men (763, 96.6%). The abuse first occurred before the age of 13 years in 315 victims (39.9%). For 468 (59.2%), more than one incident occurred before presentation. Compared to girls ≥13 years old, girls <13 years old were more frequently abused by a family member (47.7% versus 8.0%, P<0.001) and abused in their own home (55.7% vs 21.0%, P<0.001). Among all children, parental divorce and the absence of one or both biological parents in the household were prevalent, with 287/783 (36.7%) having divorced parents, and only 374/784 (47.8%) residing with both biological parents.

CONCLUSION

The findings highlight common characteristics of CSA cases, and can aid the future identification and protection of vulnerable children. The fact that most children presented after more than one incident suggests the need to more closely monitor and protect potentially at-risk children.

Perception and Attitude about Child Sexual Abuse among Vietnamese School-Age Children

Child sexual abuse has become a significant public health concern in Vietnam in recent years, and the likelihood of being abused could be prevented by increasing the awareness of sexual abuse and self-protection skills among children. However, little is known about the perception and attitude of schoolchildren toward this issue in Vietnam. This study aimed to evaluate the knowledge and attitude of school-age children toward child sexual abuse and the risk factors affecting their knowledge and attitude. A cross-sectional study was conducted among 800 Vietnamese students from grades four to nine. Most of the respondents had insufficient knowledge of sexual abuse in children; teachers and strangers would not be perpetrators (57.9% and 74%); and schools and home were safe places (55.8% and 58.8%). Almost all participants disagreed with touching and non-touching actions, even from acquaintances (94.5% to 99.5%). Being female, older age, not living with family or relatives, and living in an urban setting were found to be positively associated with the right perception and attitude toward child sexual abuse. A sexuality education program should be officially applied at schools for children with the support of their parents to narrow the knowledge gap between different geographical locations and genders.

Association between childhood sexual abuse and adult sexual victimization in a representative sample in Hong Kong Chinese

OBJECTIVE

The current study investigated the prevalence and impact of childhood sexual abuse (CSA) on adult sexual victimization (ASV) in Hong Kong, China. This study also examines correlates of demographic characteristics, depression, suicidal ideation, and self-esteem with ASV.

METHODS

A total of 5,049 Chinese adult respondents were interviewed face-to-face about their experiences of CSA, childhood witness of parental violence, ASV (by non-partner), and intimate partner violence (IPV). Self-reports also measured depression, suicidal ideation, self-esteem, and demographic details.

RESULTS

Of all respondents, 0.9% reported some form of CSA, with a higher percentage being women. CSA was found to pose a significant risk for preceding year IPV (sexual) after controlling for demographic factors. Gender, age, indebtedness, alcohol and drug abuse, depression, and low self-esteem significantly increased the odds of IPV (sexual), whereas suicidal ideation and being newly arrived from China increased the risk of ASV (by non-partner). Childhood witness of parental psychological aggression and physical violence were also associated with a higher risk of IPV (sexual).

CONCLUSIONS

Childhood sexual abuse may have an independent association with future sexual victimization in adulthood, but many covariates can also affect the impact of CSA and increase the risk of revictimization.

PRACTICAL IMPLICATIONS

Intervention with ASV should include an assessment of CSA history and thus a screening for multiple victimization from IPV among victims. Prevention of revictimization for IPV victims with CSA histories may focus on making social and individual changes.

Sexual violence against women and children in Chinese societies

This article provides a comprehensive overview of the reported patterns of sexual violence against women and children in China. It reviews the prevalence of and risk factors for various types of sexual violence and discusses community knowledge and perceptions of these violent acts. It also critically examines three major problems of sexual violence research in China. First, the diversity of findings and study methods reported by surveys and criminal reports reflects the problems in obtaining accurate figures on the scope of the problem. Second, precautions must be taken in reading studies on Chinese culture-specific risk factors for domestic violence. Third, the study of culture-specific factors should not focus solely on cultural factors in a vacuum but rather, should examine traditional culture in the context of modern societies and consensus international standards of human rights. Recommendations for future research are also discussed.

Characteristics of child sexual abuse cases referred for psychological services in Hong Kong:a comparison between multiple incident versus single incident cases

This study examined 58 sexually abused children referred for clinical psychological services in 1999 in Hong Kong and compared the characteristics and disclosure patterns between those with multiple incidents of abuse and those with single incident. The former group was more likely to have been abused by a family member, took a longer time to disclose, and was more often abused in contexts where the abusers had control and power. Over 40% of subjects also reported presence of other persons during abuse. Myths and misconceptions among professionals are highlighted. Implications on future service development and training needs in child protection are discussed.

Childhood experience of sexual abuse among Hong Kong Chinese college students

OBJECTIVES

This study aimed to explore the prevalence rate and profiles of abusers and victims of child sexual abuse in a Chinese society.

METHOD

A convenience sample of 2,147 Hong Kong Chinese college students completed questionnaires which included items on definitions of child sexual abuse, recall of sexual abuse experience before age 17, information about the sexual abuse incidents, and personal demographics.

RESULTS

The overall prevalence rate for various forms of child sexual abuse was 6%, with the rates being higher for females than for males. The average age of the victims at the time of the sexual abuse was 11 years old, with a majority of them experiencing sexual abuse during their teenage years. The average age of the abusers as estimated by the victims was 24 years old, and only 28% of the abusers were strangers to the victims. Males were about three times more likely than females to be sexually abused by their friends, whereas females were about twice more likely than males to be sexually abused by strangers. Only 39% of the victims reported their sexual victimization to others, and 56% of the reported incidents were not followed up.

CONCLUSIONS

As compared to Western studies, the present study showed lower rates for more intimate or severe forms of child sexual abuse. The Chinese victims were more reluctant to disclose their sexual victimization than their Western counterparts. Limitations and practical implications of the study are also discussed.

The nature and frequency of reported cases of teacher perpetrated child sexual abuse in rural primary schools in Zimbabwe

OBJECTIVE

The main purpose of this study was to investigate the nature and magnitude of reported cases of teacher perpetrated child sexual abuse of rural primary school pupils in Zimbabwe. The study also determined the distribution of reported cases of child sexual abuse according to the characteristics of victims and perpetrators.

METHOD

This is a retrospective case series study of reported cases of child sexual abuse drawn from six randomly selected educational jurisdictions. The study covered an 8-year period (1990-1997) and used a study sample of 110 nonclinical case files of teacher perpetrators. Descriptive statistics were used to analyze the findings.

RESULTS

Gender-wise, 108 (98%) of the victims were girls, while all perpetrators were male teachers. Penetrative sex was the most prevalent (70%) type of sexual abuse. Meanwhile, the modal age for sexual abuse in the study sample was 12 years, which represents 46% of reported cases, while the most vulnerable age group comprised pubertal (11-13 years) children, who accounted for 69% of all sexual abuse cases. On the one hand, beginning teachers (0-5 years), who comprised 63% of the study sample, were most at risk of sexually abusing school children. Finally, 78% of 32 cases handled by the courts resulted in convictions, while 83% of all teacher perpetrators were dismissed from the teaching service.

CONCLUSION

The results of the study clearly indicate that the problem of teacher perpetrated child sexual abuse is not uncommon among rural primary schools in Zimbabwe. The study has also shown that the perpetrators of child sexual abuse in rural primary schools are generally male teachers; a majority of them are young and inexperienced. Finally, this study showed that penetrative sex was the most prevalent form of abuse (70%), perpetrated on predominantly female victims (98%), and that all perpetrator teachers were males, and may clearly reflect Zimbabwe's highly patriarchal society.

Conceptualization, reporting and underreporting of child abuse in Hong Kong

OBJECTIVE

To understand the conceptualization of child abuse and attitudes on reporting behaviors of Hong Kong adults.

METHODS

Cross-sectional telephone survey of 1,001 randomly selected subjects.

MAIN RESULTS

There is a discrepancy between perceived prevalence and the ability to name different child abuse types without prompting: 79.9% named physical abuse, while 41.2% felt it was common: 21.0% named child neglect, while 76.9% felt it was common; 13.4% named psychological abuse, while 47.4% felt it was common; 6.8% named sexual abuse, while 23.5% felt it was common. Most respondents classified severe physical abuse situations as abusive (e.g., "severely injuring a child"). Other scenarios such as "mildly injuring a child" and neglect and psychological abuse scenarios (e.g., "leaving a young child alone at home" and "shouting at a child often") were often not classified as abusive. As regards case-reporting behavior, only about 40% would report abuse cases to authorities. Those who would not report abuse were less likely to classify abuse situations as abusive and more likely to think that seeking help is difficult, troublesome and unhelpful.

CONCLUSIONS

The official reported prevalence figures for child abuse in Hong Kong should be interpreted with care, because underreporting is likely to be serious. Hong Kong people's conceptualization and awareness of what comprises child abuse is found to differ from official definitions. They are reluctant to report abuse cases, due to their perceived low efficacy of case reporting. Both the difference in conceptualization and the reluctance to report might partly be attributable to Chinese culture.

Child abuse in Hong Kong revisited after 15 years: characteristics of victims and abusers

The purpose of this paper was to examine the characteristics of the victims and abusers of child abuse cases on the Child Protection Registry in Hong Kong as of March 1995 and to compare findings with a similar community report of child abuse in Hong Kong conducted approximately 15 years earlier. As of March 31, 1995, there were 457 active cases of child abuse or suspected child abuse (44% male and 56% female) on the computerized Child Protection Registry. Fifty percent of the victims were grade school age children between 7-12, and 62.4% suffered physical abuse. The abusers or suspected abusers were 52% male and 48% female with nearly half (49%) in their thirties. The majority of abusers were married/cohabiting (75%) with only a grade school education (60%). As compared to 1979, there was an increase of sexual child abuse cases, female victims of child abuse, and an increase in male abusers or suspected abusers.

Negative self-perception and components of stress in Canadian, British, and Hong Kong adolescents

Responses to a 68-item Adolescent Stress Scale of 14- to 16-yr.-olds in Canada (n = 369), Britain (n = 217), and Hong Kong (n = 349) were compared. Four common subscales identified by principal component analysis emerged in the three samples. Scores on subscales (Relationship Problems, Abuse at Home, Scholastic and Career Problems, and Loneliness and Social Isolation) were significantly correlated for both sexes with negative self-esteem scores in the three national groups. Differences in stress between cultures were explicable in terms of known cultural differences.