BACKGROUNDChild sexual abuse (CSA) has serious consequences that can affect the physical, social and mental health of a child. In the last two decades, concern about CSA has increased around the world including Saudi Arabia.OBJECTIVEEvaluate factors associated with parental perceptions and knowledge of CSA.DESIGNCross-sectional survey.SETTINGSPrimary health care clinic.SUBJECTS AND METHODSSimple random sampling was used to select participants. The main tool for data collection was a self-administered questionnaire.MAIN OUTCOME MEASURESFactors associated with knowledge and perceptions of CSA.SAMPLE SIZE400.RESULTSMost respondents (69%) had good knowledge of the signs of sexual abuse in children. For perception scores, statistically significant variables were age (P=.004), educational level (P=.005), income (P<.001), number of wives (P=.004), number of male children (P=.021), and number of female children (P=.027). For knowledge scores, statistically significant variables were income (P=.008), number of wives (P<.005), number of male children (P=.003) and number of female children (P<.003). Logistic regression showed that the older age group was significantly associated with a good perception score (P<.046).CONCLUSIONSRisk factors for parental lack of knowledge and poor perception associated with CSA are poverty and low education. Protective factors included the older parent age, size of the family and families with more than one wife. Education should be designed for parents and the community to increase the knowledge and perception of CSA.LIMITATIONSSingle-center study and short study period.

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