Cross-Sectional Analysis of Contextual Factors Associated With Sexual Violence Against Children and Youth in Low- and Middle-Income Countries

Abstract

Sexual violence (SV) against children and youth is a global problem. Minimal evidence exists on how contextual factors, such as those at the community or societal levels, influence the prevalence of SV in low- and middle-income countries (LMICs). Data from the Violence against Children and Youth Surveys in Cambodia, Colombia, Côte d’Ivoire, El Salvador, Kenya, Mozambique, and Nigeria (n_male = 9,245; n_female = 10,022) were merged with the Out of the Shadows Index (OOSI), a global index of national child protection efforts developed by Economist Impact. Age- and sex-stratified sequential fixed effects random intercepts models assessed associations between cluster-level community-aggregated attitudes and OOSI indicators with forced sexual initiation (FSI), lifetime non-consensual sexual touching (NCST), and lifetime SV. We found that aggregated harmful attitudes about women and men at the community-level were associated with FSI among females (adjusted odds ratio (aOR) = 4.43, p =< .001), and NCST (aOR = 2.86, p < .001), and SV (aOR = 2.70, p < .001) among males. Aggregated community attitudes supportive of intimate partner violence were significantly associated with lifetime SV among females (aOR = 2.09, p < .001) and males (aOR = 3.16, p < .001), and NCST (aOR = 3.10, p < .001) among males. The OOSI legal indicator was associated with lower prevalence of NCST (aOR = 0.94, p =< .001) and SV (aOR = 0.94, p =< .001) among males, and NCST among females aged 13 to 17 years (aOR = 0.96, p = .009). Community attitudes are associated with youth experiences of SV, and protective national legislation is associated with a lower risk of youth experiencing SV in LMICs. National policies and programs that alter these factors have the potential to help prevent SV among children and youth.

Keywords

attitudes child sexual abuse developing countries legislation violence prevention

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