Exploração sexual de crianças e adolescentes em situação de rua no Sul do Brasil / Sexual exploitation of homeless children and adolescents living on the streets in Southern Brazil

Resumo O objetivo do estudo foi investigar a prevalência de exploração sexual entre crianças e adolescentes em situação de rua e as características associadas a este desfecho. Neste estudo transversal, conduzido nos municípios de Rio Grande e Porto Alegre-RS, os dados foram coletados por meio de entrevistas com os participantes, as quais foram conduzidas por entrevistadores treinados. O método de amostragem foi o Respondent-Driven Sampling (RDS) e as análises estatísticas foram conduzidas por meio da regressão de Poisson com ajuste robusto da variância. A amostra foi composta por 186 crianças e adolescentes com idades entre 10 e 17 anos, das quais 8% relataram ter tido experiência de exploração sexual. Ter idade entre 16 e 17 anos, ter sofrido relação sexual forçada e não ter vínculo escolar foram características independentemente associadas a este desfecho. Foi observada que a falta de vínculo escolar aumentou em 16 vezes a probabilidade de sofrer exploração sexual, sendo o principal fator de risco identificado neste estudo. Sugere-se que a inclusão e permanência das crianças e adolescentes em situação de rua no contexto escolar possa reduzir significativamente o risco de exploração sexual entre esta população.

Abstract The scope of this study was to investigate the prevalence of sexual exploitation of homeless children and adolescents living on the streets, as well as characteristics associated with this outcome. In this cross-sectional investigation, carried out in the municipalities of Rio Grande and Porto Alegre-RS, data were collected through interviews, which were conducted by trained interviewers. The Respondent-Driven Sampling (RDS) strategy was adopted and statistical analyses were conducted using Poisson regression with robust adjustment of variance. The sample included 186 children and adolescents between 10 and 17 years of age, of which 8% reported having been subjected to sexual exploitation. Being 16 to 17 years old, having had forced sexual intercourse and not having bonds with school were characteristics independently associated with this outcome. It was observed that the lack of contact with school increased the probability 16-fold of having suffered sexual exploitation, being considered the main risk factor in this study. The proposition is that the inclusion and permanence of homeless children and adolescents living on the streets into schools might significantly reduce the risk of sexual exploitation of this population group.

Repercussões do abuso sexual vivenciado na infância e adolescência: revisão integrativa / Impacts of sexual abuse in childhood and adolescence: an integrative review

Resumo O objetivo deste artigo é identificar as repercussões do abuso sexual experienciado na infância e na adolescência. Trata-se de uma revisão integrativa de literatura realizada no mês de setembro de 2018, a partir da base de dados da Biblioteca Virtual em Saúde. Para busca, associou-se os seguintes descritores: Abuso Sexual de Crianças e Adolescentes and (Adultos Sobreviventes de Abuso Sexual or Desenvolvimento Infantil), considerando como critérios de inclusão: artigos originais; disponíveis completos; publicados no período de 2013 a setembro de 2018; nos idiomas português, inglês e espanhol. Após a leitura dos títulos e dos resumos, selecionou-se 16 artigos, os quais foram lidos na íntegra e organizados através de uma tabela. Os estudos evidenciaram que pessoas que experienciam abuso sexual na infância e na adolescência apresentam repercussões de ordem psicológica, física, sexual e social, as quais perduram por toda vida. O estudo oferece subsídios para alertar profissionais de saúde quanto à necessidade de investigarem sinais e sintomas sugestivos de abuso sexual, visto que experienciar tal agravo traz inúmeras repercussões para vida das vítimas.

Abstract This article identifies the impacts of sexual abuse in childhood and adolescence. We conducted an integrative literature review in September 2018 using the Virtual Health Library. A search was conducted using the following descriptors: Sexual Abuse of Children and Adolescents and Sexual Abuse or Child Development. The inclusion criteria were open access full-text original articles published between 2013 and September 2018 in Portuguese, English or Spanish. Sixteen eligible articles were selected after reading the titles and abstracts. The full texts of these articles were read and organized into a table. The studies show that sexual abuse in childhood and adolescence has lifelong psychological, physical, sexual and social impacts. The findings of this study can help alert health care professionals to the importance of investigating the signs and symptoms of sexual abuse given the multiple impacts of abuse on victims' lives.

The problem of child sexual abuse in india laws, legal lacuna and the Bill - PCSOB-2011.

Child abuse is the physical or psychological maltreatment of a child, can be differentiated into four major categories, physical abuse, emotional abuse, neglect and worst of all; the sexual abuse. Child Sexual Abuse (CSA) is a kind of physical or mental violation of a child with sexual intent, usually by a person who is in a position of trust or power vis-à-vis the child. India is the second largest child population in the world, 42% of India’s total population is below eighteen years. In a shocking revelation, a Government commissioned survey has found that more than 53% of Indian children are subjected to sexual abuse / assault. Majority of these cases were perpetrated by someone known to the child or in a position of trust and responsibility, Not surprisingly, most children did not report the abuse to anyone. There is not a single law aimed at safeguarding children and protecting them against sexual abuse & assault, which is a serious lacuna against this background and is needed urgently. This paper will focus on child sexual abuse, the laws, legal loopholes, and The Protection of Children against Sexual Offences Bill, 2011.

Condiloma gigante anogenital em menina de 12 anos vítima de abuso sexual: relato de caso / Giant anogenital condyloma in 12- year-old-girl victim of sexually abused: a casa report

Adolescente, 12 anos, com verrugas vulvares há sete meses; dor e odor fétido após uso de podofilina há três dias. Abuso sexual repetitivo. Tratamento para sífilis há 4 meses com dose única de penicilina benzatina. Ao exame: extenso condiloma vulvar, períneo e perianal, com áreas de necrose, secreção purulenta e odor fétido. Pele com manchas hipocrômicas, crostas em membros e tronco. Hipóteses diagnósticas: condiloma gigante infectado anogenital e sífilis secundária associada à piodermite. Realizado tratamento clínico e sindrômico para sífilis secundária, com cobertura para infecção secundária e cervicite. Foi empregado imiquimode para tratamento de lesão verrucosa, com excelente resultado clínico.

Adolescent, 12 years old, with warts in vulva for seven months, pain and fetid odor after use of podofilina three days ago. Repetitive sexual abuse.Treatment for syphilis four months ago with a single dose of benzatin penicilin. On examination: extensive condyloma in vulva, perineum and perianal, with areas of necrosis, purulent discharge and fetid odor. Hypochromic stain on the skin, crusts on members and trunk. Diagnostic hypotheses: giant condyloma infected anogenital and secondary syphilis associated with piodermitis. Clinical and syndromic treatment were done for secondary syphilis, with coverage to secondary infection and cervicitis. Imiquimod was used for treatment of condyloma, with excellent clinical outcome.

Sexual Abuse of Children

Child abuse and neglect refers to any act or failure to act that violates the rights of children and affects their overall optimal health, survival or development. Also sexual abuse in children is defined as engaging a child in sexual acts that the child does not understand, to which the child cannot give informed consent, or which violate the taboos of our society. Sexual abuse may involve direct acts perpetrated against children as well as other non-touching abuses, which include exhibitionism, voyeurism, or the use of children for pornographic purposes. Although precise incidence and prevalence rate data are lacking, sexual abuse of children is common in our country and throughout the world. Child sexual abuse is a universal problem that has frequently passed unrecognized and its victims (both children and perpetrators) untreated. Child sexual abuse results in significant social damage. The physical and psychological consequences of child sexual abuse may result in trauma and has implications throughout the lifespan. Experiencing sexual abuse as a child also has the consequence of contributing to an increased risk of violent victimization, perpetration, self-directed violence and suicide later in life. Despite the importance of the issues, information about sexual abuse in children and amongst adults has not been commonly shared by health professionals. The purpose of this review article is to assist the physician in their investigation of child sexual abuse by exploring the important topics.