中国儿童性虐待的流行病学研究现状:测量工具、流行现状及危险因素分析

Literature review of epidemiological studies on child sexual abuse in China: measuring instruments,prevalence and risk factors

目的初步掌握中国0-17岁儿童性虐待的流行病学研究现状。方法通过对近20年（1992-2012年）的国内外文献进行检索,获取较全面的、有代表性的中国儿童性虐待流行病学研究资料,对儿童性虐待研究的测量工具、发生率现状及危险因素等进行系统分析。结果 1测量工具：现有研究比较多的是调查16岁前发生的性虐待,多采用成年人回顾的方式进行调查。常用的测量方法是采用不记名自填式问卷对接触性和非接触性性行为的发生情况进行回顾性调查,也有研究者使用标准化的儿童虐待量表。2发生率现状：男性遭受性虐待的发生率为10.2%-23.0%,女性遭受性虐待的发生率为14.2%-25.5%;在性虐待发生的性别差异方面,尽管不同研究结果存在不一致性,但总体上女性遭受性虐待的发生率高于男性。3危险因素：城市地区儿童遭受性虐待的比例高于农村地区,生活在重组家庭中的儿童性虐待的报告率高于核心家庭,父、母亲经常在家庭中使用暴力、有不良嗜好、体弱多病、家庭关系紧张等是儿童性虐待发生的危险因素。结论有关儿童性虐待问题的测量方法不一致,现有研究多为成人回顾性调查,有必要在测量工具标准化、全国流行现状等方面开展深入研究。

Objective To recognize the epidemiology research progress on sexual abuse among 0-17 year-old children in China. Methods Domestic and internationalliteratures about child sexual abuse from 1992 to 2012 were searched to collect comprehensive valuable and representative data in China. Measuring instruments, current provenance and risk factors according to child sexual abuse were analyzed. Results 1. Measuring instruments： Most researches focused on sexual abuse before 16 years old using anadult retrospective survey method. Un-standardizedanonymousself-administered questionnaires were common used to collect information on contact or non-contact sexual behaviors. A few studies used standardized child abuse scales to measure sexual abuse. 2. Sexual abuse prevalence： The incidences of sexual abuse among boys are around 10.2% to 23.0% , which are around 14.2% to 25.5% among girls. In terms of gender difference, although it varies among studies, female tended to suffer more cases than male. 3. Risk factors： Children living in urban areas tended to suffer more in sexual abuse than rural areas. Children livinz in the reorganized families suffermore insexual abusethan the core families. Parents often use violence in the family, with bad habits, sickly orstrained familyrelationshipswere risk factors for child sexual abuse. Conclusion The measuring methods on child sexual abuse are inconsistent. Most of the existing researches were from adult retrospective survey. Research on survey instrumentsand the national level epidemiology are needed.