Abuso sexual en niñas y adolescentes: experiencias de 10 años / Sexual abuse of girls and teenagers: Ten-year experience

RESUMEN

Definimos como abuso sexual a aquel acto en el que se involucran niños y adolescentes de ambos sexos, inmaduros y dependientes, en actividades sexuales que no son verdaderamente comprendidas y frente a las cuales son incapaces de consentir responsablemente. OBJETIVO: estudiar el comportamiento, por edades, niñas (0-10 años) y adolescentes (11-19 años), del diagnóstico y características epidemiológicas en víctimas de Abuso Sexual en 10 años de trabajo en una consulta de Ginecología Infanto Juvenil del Policlínico Luis Pasteur. MÉTODOS: se realizó un estudio descriptivo, longitudinal y retrospectivo, se revisó el 100 por ciento de las historias clínicas de 6 440 niñas y adolescentes atendidas en consulta entre el 1º de enero de 1997 al 31 de diciembre de 2006, la muestra quedó integrada por 32 casos con diagnóstico de abuso sexual. Las variables estudiadas fueron motivo de consulta, hallazgos al examen físico, presencia o no de ITS, tipo de abuso, características del perpetrador y denuncia o no del hecho. RESULTADOS: encontramos mayor incidencia de abusos en niñas con 1,15 por ciento, siendo 0,5 por ciento la incidencia global, la mayor incidencia bruta estuvo en adolescentes con 24 casos. Predominó el abuso sexual crónico que representó el 100 por ciento en niñas y 50 por ciento en adolescentes. La causa más frecuente de consulta fueron síntomas relacionados con infección genital, se halló alta correlación entre abuso sexual y presencia de ITS, solo en 6 casos se refirió antecedente de abuso como motivo de consulta. Predominó el familiar/conocido como perpetrador, se reportó baja incidencia de denuncias. CONCLUSIONES: el abuso sexual es poco conocido y pesquisado en nuestro medio, resulta importante promover su diagnóstico y pesquisa, pues es causa de severa afectación a la salud mental y reproductiva de niñas y adolescentes.

ABSTRACT

We defined the sexual abuse as every act in which immature and dependent children and teenagers of both sexes are involved in sexual activities that are not truly understood by them and for which they are unable to give their consent in a responsible way. OBJECTIVE: to study the behavior of diagnosis and epidemiological characteristics of sexual abuse victims by age in girls (0-10 years) and teenagers (11-19 years) in a ten-year period at the Infant and Young Gynecological Service of "Luis Pasteur" polyclinics. METHODS: we carried out a retrospective, longitudinal and descriptive study in which we reviewed all the medical histories of 6 440 girls and teenagers seen at this service from January 1st, 1997 to December 31st, 2006 and the final sample comprised 32 patients diagnosed as sexual abuse cases. The studied variables were reasons to go to the gynecologist, findings at physical exam, existence or absence of sexually-transmitted infections, type of abuse, characteristics of the perpetrator, and report to the police. RESULTS: we found the highest abuse incidence in girls (1,15 percent), being 0,5 percent the global incidence. The highest gross incidence was observed in teenagers with 24 cases. Chronic sexual abuse prevailed in 100 percent of studied girls and 50 percent of teenagers. The most common cause to go to the gynecologist was feeling genital infection symptoms; sexual abuse and sexually-transmitted infections were very much correlated; sexual abuse was only found in 6 cases as reason to go to the gynecologist's. Either a relative or an acquaintance was the sexual abuse perpetrator in most of cases but the amount of reports to the police was low. CONCLUSIONS: sexual abuse is poorly known and screened in our context, so it is important to encourage its diagnosis and screening since it brings about serious effects for the mental and reproductive health of girls and adolescents in general.