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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 41363

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Dr. María del Mar Sánchez-Fuentes

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Guest Editor

Department of Psychology and Sociology, Faculty of Human and Social Sciences (Teruel), University of Zaragoza, 44003 Teruel, Spain
Interests: human sexuality; gender; sexual violence; intimate partner violence; sexual rights

Dr. Ana Isabel Arcos-Romero

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Guest Editor

Department of Psychology, Loyola University, 41704 Seville, Spain
Interests: human sexuality; sexual health; sexual function; sexual response; orgasm; sexual orientation; relationships
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Dear Colleagues,

According to the World Health Organization, violence against children refers to all forms of violence, whether it is carried out by parents, caregivers, family members or strangers and directed at children under 18 years of age. It is estimated that approximately 1 billion children between the ages of 2 and 17 worldwide are victims of physical, sexual, emotional or neglect abuse (Hillis, Mercy, Amobi, & Kress, 2016). Sexual abuse, sexual behaviors and victimization of children and adolescents have negative consequences that affect physical and/or psychological health throughout life. Some of the negative effects of this type of violence are deaths, serious injuries, developmental and neuropsychological disorders, serious behavior problems, higher prevalence of psychological disorders (depression, anxiety, stress, etc.) risky sexual behaviors, pregnancies unwanted, sexually transmitted infections, increased risk of cardiovascular diseases in adulthood and diseases such as diabetes and/or hypertension, and finally it has also been associated with negative consequences at a social level such as dropping out of studies, greater difficulty in finding and keep a job etc. Regarding risk factors, these can be framed at the individual level (eg, sex, age, belonging to a minority group such as LGTB, poverty), interpersonal (family dysfunction, violent family environment, lack of emotional attachment, etc.), social (marginal and / or poor neighborhoods, higher demographic density, child and youth gangs, etc.) and cultural (social and gender norms, public, educational, social, economic policies, countries in conflict, etc.). Research is fundamental both to know the factors, consequences and to create strategies, prevention and treatment programs against child sexual abuse, sexual behavior and victimization of children and adolescents. Papers addressing these topics are invited for this special issue, especially those that combine high academic standards with a focus on providing a better understanding of child sexual abuse, sexual behaviors, and victimization to specify some related challenges facing this field and suggest strategies appropriate to address them.

Dr. María del Mar Sánchez-Fuentes
Dr. Ana Isabel Arcos-Romero
Guest Editors

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Keywords

sexual health
sexual abuse
sexual behavior and victimization
adolescence
youth
negative consequences
health consequences
psychological consequences
preventive programs
future challenges

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Published Papers (10 papers)

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13 pages, 351 KiB

Open AccessArticle

The Association of Recurrent and Multiple Types of Abuse with Adverse Mental Health, Substance Use, and Sexual Health Outcomes among Out-of-School Adolescent Girls and Young Women in Cape Town, South Africa

by Bronwyn Myers, Felicia A. Browne, Tara Carney, Tracy Kline, Courtney Peasant Bonner and Wendee M. Wechsberg

Int. J. Environ. Res. Public Health 2021, 18(21), 11403; https://doi.org/10.3390/ijerph182111403 - 29 Oct 2021

Cited by 9 | Viewed by 4103

Abstract

Although physical and sexual abuse exposure is a well-established risk for poor health, the dimensions of abuse associated with health among socially vulnerable adolescent girls and young women (AGYW) remain underexamined. This article describes associations between combinations of abuse type and timing with mental health, substance use, and sexual risk outcomes among a sample of 499 AGYW (aged 16 to 19) who had left school early and were recruited for a cluster randomized trial in Cape Town, South Africa. Approximately one-third (33.5%; 95% CI: 28.7, 38.6) of participants reported lifetime abuse. Exposure to more than one type of abuse was associated with increased risk of depression (β = 3.92; 95% CI: 2.25, 5.59) and anxiety (β = 3.70; 95% CI: 2.11, 5.28), and greater odds of polydrug use (OR = 2.10; 95% CI: 1.02, 4.34) and substance-impaired sex (OR = 2.17; 95% CI: 1.31, 3.86). Exposure to multiple types of abuse during childhood/early adolescence and again in late adolescence was associated with increased risk of depression (β = 4.65; 95% CI: 3.15, 6.14), anxiety (β = 4.35; 95% CI: 2.70, 6.02), and polydrug use (OR = 2.37; 95% CI: 1.03, 5.73). Findings underscore the need for trauma-informed interventions that reduce mental health, substance use, and sexual risks among AGYW who have experienced multiple forms of abuse and recurrent abuse. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

10 pages, 367 KiB

Open AccessArticle

Sexual Abuse vs. Sexual Freedom? A Legal Approach to the Age of Sexual Consent in Adolescents in Spanish-Speaking Countries

by Sandra M. Parra-Barrera, María del Mar Sánchez-Fuentes, Carlos Fuertes-Iglesias and Miguel Ángel Boldova

Int. J. Environ. Res. Public Health 2021, 18(19), 10460; https://doi.org/10.3390/ijerph181910460 - 5 Oct 2021

Cited by 2 | Viewed by 2874

Abstract

Child and adolescent sexual abuse (CSA) is an international public health problem. Despite the importance of CSA, there is no consensus definition, and the lack of consensus is related to difficulties in conducting prevalence studies as well as research in other areas. To establish a consensual definition, legal aspects such as the age of sexual consent and the difference in age or power between victim and aggressor as well as aspects related to sexual freedom and sexual indemnity must be considered. Therefore, the main goal of this research was to analyze the age of sexual consent in the legal systems of Spanish-speaking countries and to examine whether the Romeo and Juliet clause is established. To achieve the proposed aims, we employed the legal interpretation method, and we analyzed the current Criminal Codes of the 21 Spanish-speaking countries. From the results, it is found that the age of sexual consent varies between countries, establishing valid sexual consent between 13 and 18 years. In addition, only six countries have the Romeo and Juliet clause that protects sexual freedom in adolescents. Finally, we discussed the lack of consensus on the age of sexual consent and the limitations presented by the Romeo and Juliet clause. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

12 pages, 805 KiB

Open AccessArticle

Analysis of Sexual Inhibition and Satisfaction from a Gender Perspective among University Students

by Samuel P. León, Cristina Abengózar Sánchez, José María Augusto-Landa and Inmaculada García-Martínez

Int. J. Environ. Res. Public Health 2021, 18(15), 7994; https://doi.org/10.3390/ijerph18157994 - 28 Jul 2021

Cited by 2 | Viewed by 2469

Abstract

University is characterized by a critical stage where students experience their sexuality, across a range of relationships. From these experiences, university students consolidate their personality and their sexual role. Factors such as age, sex, or traumatic experiences of violence or sexual abuse can affect their sexual role. The present study aims to analyze how the variables age, sex and having suffered abuse or violence may predict sexual satisfaction and inhibition. In addition, we analyze the mediating effect that sexual role plays on these relationships. For this purpose, Bem Sex Role Inventory (BSRI-12), Sociosexual Orientation Inventory (SOI-R), Inhibited Sexual Desire Test (ISD) and New Sexual Satisfaction Scale (NESS) were administered to 403 university students. The findings report that sex (β = −0.313), age (β = −0.116) and being a survivor of sexual assault (β = 0.413) are predictive of male role, but not from the female role. Also, people with more male features tend to have lower levels of commitment and inhibition than those who have more female ones. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

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11 pages, 354 KiB

Open AccessArticle

Child Sexual Abuse in Mexican Women: Type of Experience, Age, Perpetrator, and Disclosure

by Pilar Rueda, Marta Ferragut, M. Victoria Cerezo and Margarita Ortiz-Tallo

Int. J. Environ. Res. Public Health 2021, 18(13), 6931; https://doi.org/10.3390/ijerph18136931 - 28 Jun 2021

Cited by 5 | Viewed by 4837

Abstract

Child sexual abuse (CSA) is a type of maltreatment that occurs in practically all countries and social statuses. Due to the taboo and shame that surrounds it, CSA is a problem universally silenced despite the important consequences (both physical and psychological) that it has for the victim and their family. This work aimed to study the correlates of CSA in Mexican women. Our sample comprised 1058 women ranged from 18 to 73 years (M = 40.19; SD = 10.24). They completed an anonymous online survey including questions about all the different types of abuse, questions about who perpetrated it, at what age it happened, and whether the victim disclosed the abuse. Our results showed that, depending on the type of abuse, from 13.9% to 65.8% of the participants had suffered at least one episode of CSA throughout their childhood. The first episode typically occurred between 6 and 12 years old, with the perpetrator being a male. The youngest women reported higher rates of being shown pornography by a family member, whereas the oldest ones reported higher rates of exhibitionism by a stranger. Only 31.3% of the sample disclosed the abuse, usually to their mother or a peer. Differences among the correlates of the different types of abuse, the age of the victims, and the relationship with the perpetrator are discussed as well as the victims’ feelings of being believed when they disclosed the abuse. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

10 pages, 366 KiB

Open AccessArticle

Alcohol Use and Sexual Violence among Nursing Students in Catalonia, Spain: A Multicentre Cross-Sectional Study

by Concepció Fuentes-Pumarola, Zaira Reyes-Amargant, Alba Berenguer-Simon, David Ballester-Ferrando, Maria Dolors Burjalés-Martí, Assumpta Rigol-Cuadra, Elena Maestre-González, Carolina Rascón-Hernán, Paola Galbany-Estragués and Dolors Rodríguez-Martín

Int. J. Environ. Res. Public Health 2021, 18(11), 6036; https://doi.org/10.3390/ijerph18116036 - 4 Jun 2021

Cited by 8 | Viewed by 3565

Abstract

(1) Background: Sexual violence (SV) has become common in universities for reasons related to unwanted social/peer pressures regarding alcohol/drug use and sexual activities. Objectives: To identify perceptions of SV and alcohol use and estimate prevalence among nursing students in Catalonia, Spain. (2) Methods: Observational descriptive cross-sectional study of a convenience sample of nursing students attending public universities. (3) Results: We recruited 686 students (86.11% women), who reported as follows: 68.7% had consumed alcohol, 65.6% had been drunk at least once in the previous year, 62.65% had experienced blackouts and 25.55% had felt pressured to consume alcohol. Drunkenness and blackouts were related (p < 0.000). Of the 15.6% of respondents who had experienced SV, 47.7% experienced SV while under the influence of alcohol and were insufficiently alert to stop what was happening, while 3.06% reported rape. SV was more likely to be experienced by women (OR: 2.770; CI 95%: 1.229–6.242; p = 0.014), individuals reporting a drunk episode in the previous year (OR: 2.839; 95% CI: 1.551–5.197; p = 0.001) and individuals pressured to consume alcohol (OR: 2.091; 95% CI: 1.332–3.281; p = 0.001). (4) Conclusions: Nursing instructors need to raise student awareness of both the effects of alcohol use and SV, so as to equip these future health professionals with the knowledge and skills necessary to deal with SV among young people. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

14 pages, 550 KiB

Open AccessArticle

Challenging the Stereotypes: Unexpected Features of Sexual Exploitation among Homeless and Street-Involved Boys in Western Canada

by Elizabeth M. Saewyc, Sneha Shankar, Lindsay A. Pearce and Annie Smith

Int. J. Environ. Res. Public Health 2021, 18(11), 5898; https://doi.org/10.3390/ijerph18115898 - 31 May 2021

Cited by 6 | Viewed by 4035

Abstract

Research about the sexual exploitation of homeless and street-involved boys is limited and often combined with that of girls. As aggregation can distort unique issues among genders which are exploited, this study provides information about the context of exploitation for homeless boys. Boys participated in the anonymous, multi-city British Columbia (BC), Canada Homeless and Street-Involved Youth Health paper surveys of 2006 and 2014. Measures included questions about trading sex for money, shelter, or other consideration; age first exploited; for whom; where they were living when first traded sex; gender of exploiters; and demographics. Analyses, separately for younger/older boys, explored the prevalence, timing of exploitation vs. homelessness, and ANOVAs to evaluate the patterns of the age of first exploitation by the genders of exploiters. Just over one in four boys reported exploitation (n = 132), with a median age of 14–15 in most groups. Most were runaway or homeless before their first exploitation, but 25.5% (2006) and 41% (2014) were living with family. Most boys were exploited by women (78%–85%), with 62%–65% were exclusively exploited by women. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

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13 pages, 310 KiB

Open AccessArticle

Barriers to Accessing Treatment Services: Child Victims of Youths with Problematic Sexual Behavior

by Alexandra Slemaker, Peter Mundey, Erin K. Taylor, Lana O. Beasley and Jane F. Silovsky

Int. J. Environ. Res. Public Health 2021, 18(10), 5302; https://doi.org/10.3390/ijerph18105302 - 17 May 2021

Cited by 5 | Viewed by 3973

Abstract

Child sexual abuse (CSA) remains a significant public health problem. Although the deleterious effects on the child victims could be mitigated through evidence-based interventions, victims often fail to be identified and receive clinical assessment and therapy services, particularly when they have been victimized by another youth. Given that at least a third of CSA cases are committed by another youth, understanding the process of identifying and addressing the needs of CSA victims of youth is the focus of the present study. Factors impacting services for child victims of youths with problematic sexual behavior (PSB) were examined through qualitative interviews (N = 226) with mental health agency administrators, direct service providers, and community stakeholders from eight geographically diverse communities across the United States. Responses focused on macro and micro level barriers to the identification and service provision for child victims of PSB of youths. Implications for clinicians and policymakers are discussed, along with strategies to enhance access and provision of services to meet the needs of the child victims. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

9 pages, 322 KiB

Open AccessArticle

Profiling Children Sexual Abuse in a Sample of University Students: A Study on Characteristic of Victims, Abusers, and Abuse Episodes

by Angel Castro, José David Moreno, Berta Maté, Javier Ibáñez-Vidal and Juan Ramón Barrada

Int. J. Environ. Res. Public Health 2021, 18(9), 4610; https://doi.org/10.3390/ijerph18094610 - 27 Apr 2021

Cited by 2 | Viewed by 2587

Abstract

Because of its prevalence and its potential negative consequences, child sexual abuse (CSA) is a public health problem in every country in the world. Knowledge of the characteristics of abuse episodes (victim, abuser, relationship between them, type of sexual contact, duration, threat and/or use of force) is essential to specify the contents of intervention programs for the detection and reduction of the negative consequences of CSA. Starting with an initial sample of 1605 university students of both sexes (70.9% women, 29.1% men), aged between 18 and 26 years (M = 21.1, SD = 2.2), 90 participants who had suffered an episode of CSA up to age 16 were selected (84.4% women, 15.6% men; M_age = 21.1, SD = 2.2). It was found that: (1) there was a higher prevalence of CSA among women and that the victims’ average age when they suffered abuse was around 11 years; (2) the abusers were mostly male, close to the victims, and with an average of slightly less than 30 years; and (3) there was a significant proportion (25.6%) of CSA cases with penetration and in which force was used or threatened. These results are relevant, as they show that there is still a noteworthy prevalence of CSA cases on university campuses that needs to be addressed. Knowing the characteristics of these episodes is critical to implementing more effective interventions. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

13 pages, 693 KiB

Open AccessArticle

Myths about Sexual Aggression, Sexual Assertiveness and Sexual Violence in Adolescent Romantic Relationships

by Andrés A. Fernández-Fuertes, Noelia Fernández-Rouco, Susana Lázaro-Visa and Eva Gómez-Pérez

Int. J. Environ. Res. Public Health 2020, 17(23), 8744; https://doi.org/10.3390/ijerph17238744 - 25 Nov 2020

Cited by 19 | Viewed by 4662

Abstract

Sexual violence is a worldwide health and social issue. However, little is known about the sexual violence that occurs in the context of romantic relationships. This study analyzes the existence of sexual violence in adolescents’ romantic relationships, the possible associations between such violence (both committed and suffered) and myths about sexual aggression and sexual assertiveness, and the possible gender-related distinctions. A sample of 329 students aged between 15 and 19 (M = 16.3; SD = 0.79) was surveyed; all participants were in a romantic relationship when the data were collected. The results reveal that both genders report the existence of sexual violence in their romantic relationships; however, in heterosexual relationships, males were more often the perpetrators of sexual violence. Additionally, myths about sexual aggression and sexual assertiveness were found to be significantly associated with both perpetration and victimization. Accordingly, these predictors should be focal points in prevention programs for adolescent sexual violence. The findings of this study show the de-prioritization of sexuality education in the Spanish educational system, as well as the need to strengthen the competence of adolescents in this area. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

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13 pages, 311 KiB

Open AccessCase Report

Sexual Violence and Trauma in Childhood: A Case Report Based on Strategic Counseling

by Valeria Saladino, Stefano Eleuteri, Elisa Zamparelli, Monica Petrilli and Valeria Verrastro

Int. J. Environ. Res. Public Health 2021, 18(10), 5259; https://doi.org/10.3390/ijerph18105259 - 14 May 2021

Cited by 5 | Viewed by 6327

Abstract

Children and adolescents are too often victims of sexual abuse and harassment. According to the World Health Organization (WHO), approximately 150 million girls and 73 million children <18 have been victims of violence and sexual exploitation during their childhood. Data show that females are more likely to be a victim of abuse and violence than males (20% vs. 5–10%). Such abuses lead to long-term psychophysical and relational consequences and victims are often afraid of asking for support from both parents and professionals. This case report shows the story of a 17-year-old adolescent, Sara, involved by her mother in a strategic counseling process, to solve BDSM-type sexual addiction (slavery and discipline, domination and submission, sadism and masochism), self-aggressive behavior, and alcohol abuse issues. The strategic counseling process is structured in 15 sessions and was based on problem-solving techniques and corrective behavioral strategies. During the sessions, it emerged that Sara had been a victim of sexual violence at the age of 6 and that she had never talked about the rape with anyone. At the age of 12, she began to experience social anxiety and shame, feelings that led her to use alcohol and seek violent sexual partners and bondage relationships. During the counseling sessions, Sara elaborated on her trauma, becoming more aware of her resources and her desires, and she learned to manage the sense of guilt and shame associated with the violence suffered, through alternative strategies. At the end of the process, Sara normalized her relationship with sex and alcohol, regaining her identity. Full article

(This article belongs to the Special Issue Sexual Abuse, Sexual Behavior and Victimization in Adolescence and Youth)

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