Sexual abuse characteristics in Santo André, São Paulo, Brazil: from victims to aggressors, from diagnosis to treatment

Abstract

Introduction: Sexual violence against children and adolescents in Brazil is an underreported public health problem. Knowing the profile of the victims and the factors related to each case is a strategy for the development of more effective public policies.Objective: To describe the profile of children and adolescent victims of libidinous act, characteristics of aggression and aggressors, consequences for victims, and legal actions related to sexual abuse.Methods: This is a descriptive study. Sociodemographic characteristics of the victims, characteristics of the aggressors and aggression, and clinical, psychological, and legal aspects of 61 sexually abused patients admitted to the specialized outpatient clinic of the Network of Health for Violence and Sexual Abuse located in Santo André, São Paulo State, Brazil, were analyzed.Results: Victims had a mean age of 10.4 years, female (60.7%, n= 37), white (70.5%, n= 43), and admitted to the care network after of 72 hours of having been a victim of abuse (68.3%, n = 40). Most of the aggressions were by a libidinous act (65.6%, n = 40) and by an individual known by the victim (72.1%, n= 44). As a result of libidinous act, the children had a change in family composition (42.6%, n = 26), cognitive disturbances (34.4%, n= 21), emotional disturbances (83.6%, n= 51), and behavioral disorders (54.1%, n= 33). Two-thirds of the cases resulted in a police investigation, only 20% of the offenders were convicted. Conclusion:Girls suffer sexual abuse where the perpetrator is known and close to the family; they delay seeking health services and can present mental disorders related to those abuses, but the perpetrators remain unpunished in most cases. Sexual violence against children and adolescents is a global public health problem, especially in low and middle income countries, where cases remain largely hidden. Less than 10% of cases reach the health system and the police due to the so-called "silence pact" Keywords1 . This pact of silence is where victims of sexual assault and those responsible are aware of the violence, but for various reasons, they prefer to not to report it. This challenge becomes greater in relation to sexual and domestic violence, where it is more present and associated with feelings of fear and prejudice.In children and adolescents, sexual violence has short-and long-term consequences for health. The victims may present physical sequelae (unwanted pregnancies, sexually transmitted diseases, and other injuries in general), psychological (cognitive, emotional, and behavioral dysfunction) 2,3 and social (school dropout, family dysfunction, child prostitution) 4 with a higher incidence of revictimization during adolescence and/or in adulthood 5 . In recent decades, recognition of this problem and its hidden nature has resulted in intersectoral mobilization focused on early diagnosis, treatment, and prevention strategies [6][7][8][9][10][11] . The data collected through RESAVAS are essential to determine the magnitude and nature of violence, the profile...

Characterization of Adolescent Pregnancy and Legal Abortion in Situations Involving Incest or Sexual Violence by an Unknown Aggressor

“…To prevent identification of sexual violence and its consequent accountability, the abuser usually does not use physical violence, which significantly reduces the risk of producing physical evidence or victim resistance, a situation described by other authors [24]. Even in cases of incest in which vaginal or anal penetration occurs, physical injuries are found at low frequencies [25,26,27].…”

Abuso sexual infantil e consequências na vida adulta: uma revisão sistemática

“…Pelo fato do agressor ser uma pessoa próxima à vítima e ter forte grau de parentesco com a mesma, muitas das ocorrências são mascarados e omitidas (Chehab et al 2017). O sigilo é uma circunstância que prejudica a vida das crianças e adolescentes vítimas de abuso sexual (Florentino, 2015).…”

“…Porém, inicialmente o abusador conquista a confiança da criança com afagos suaves, para que a relação se sustente e torne-se mais profunda física e emocionalmente (Vertamatti, 2017). O parente abusador muitas vezes "se apossa" de sua vítima, transcorrendo como um cuidador zeloso e preocupado tentando estar sempre perto, levando a vítima a entender a situação como uma demonstração natural de afeto (Chehab et al 2017). Ou seja, o sigilo é obtido mediante de ilusionismo da realidade e das emoções da criança (Vertamatti, 2017).…”

“…Research, Society and Development, v. 9, n. 11, e93391110484, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i11.10484 8 Nesse contexto, é imprescindível redobrar a cuidado quanto aos impactos à longo prazo para o desenvolvimento físico e emocional de crianças expostas à violência (Lira et al 2017). Pois, a maioria das vítimas manifestam transtornos emocionais, psicológicos e comportamentais causados pela violência sexual (Chehab et al 2017).…”

“…O abuso sexual contra crianças e adolescentes é um dilema global, onde os casos se mantem, em grande parte, de maneira sigilosa. Menos de 10% dos casos chegam ao sistema de saúde e à polícia por causa do chamado "pacto de silêncio", que consiste no comportamento de omissão, por diversos motivos, por parte das vítimas e seus responsáveis, estando estes conscientes da existência do abuso (Chehab, Paiva, Figueiredo, Daboin, Reato, Adami, 2017).…”