Prevalence of sexual violence against children and age at first exposure: a global analysis by location, age, and sex (1990-2023).

backgroundMeasuring sexual violence against children (SVAC) is vital to prevention and advocacy efforts, yet existing prevalence studies present estimates for few countries. Here we estimate the prevalence of SVAC for 204 countries by age and sex, from 1990 to 2023, and also report the age at which young survivors of lifetime sexual violence first experienced sexual violence.

methodsWe reviewed publicly available repositories for data on the prevalence of SVAC. To harmonise heterogeneity in the identified input data, we adjusted for alternative case definitions of SVAC and differential disclosure by survey mode. We then used a spatiotemporal Gaussian process regression to estimate a full time series of exposure to SVAC for each age-sex-country combination. We accounted for uncertainty in the underlying data and modelling processes. We also analysed the age at which adolescent and young adult survivors of lifetime sexual violence first experienced this type of violence by sex, data source, and world region.

findingsWe estimate that the global age-standardised prevalence of SVAC was 18·9% (95% uncertainty interval [UI] 16·0-25·2) for females and 14·8% (9·5-23·5) for males in 2023. At the super-region level, these estimates ranged from 12·2% (9·0-17·2) in southeast Asia, east Asia, and Oceania to 26·8% (21·9-32·7) in south Asia for females and from 12·3% (5·2-24·6) in central Europe, eastern Europe, and central Asia to 18·6% (9·7-32·3) in sub-Saharan Africa for males. At the country level, age-standardised estimates ranged from 6·9% (4·8-9·6) in Montenegro to 42·6% (34·4-52·1) in Solomon Islands among females and from 4·2% (1·7-9·2) in Mongolia to 28·3% (13·2-49·8) in Côte d'Ivoire among males. Globally, these estimates remained relatively stable since 1990, with slight variations at the country and regional levels. We also find that the first experience of sexual violence among adolescents and young people occurred before the age of 18 years for 67·3% of female and 71·9% of male survivors.

interpretationThe prevalence of SVAC is extremely high for both females and males across the globe. Given data sparsity and ongoing measurement challenges, findings probably underestimate the true pervasiveness of SVAC. An overwhelmingly high proportion of survivors first experienced sexual violence during childhood, revealing a narrow yet sensitive window that should be targeted in future prevention efforts. It is a moral imperative to protect children from violence and mitigate its compounding impacts on health across the lifecourse.

fundingThe Gates Foundation.