Rape of girls in South Africa

doi:10.1016/S0140-6736(02)07530-X

The Lancet

Volume 359, Issue 9303, 26 January 2002, Pages 319-320

https://doi.org/10.1016/S0140-6736(02)07530-X Get rights and content

Summary

Child rape violates human rights and causes immediate and long-term health problems for the child. In the 1998 South Africa Demographic and Health Survey, we assessed frequency of rape in a nationally representative study of 11 735 women aged 15–49 years. 153 (1·6%, 95% CI 1·2–1·9%) of these women had been raped (forced or persuaded to have sex against their will) before the age of 15 years. Our results show that younger women were significantly more likely to report rape than older women (p<0·0001). The largest group of perpetrators (33%) were school teachers. Our findings suggest that child rape is becoming more common, and lend support to qualitative research of sexual harassment of female students in schools in Africa.

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Cited by (164)

Non-offending caregivers reflections on the use of a film encompassing child sexual abuse perpetrator's testimonies for potential child protection initiatives in South Africa
2023, Child Abuse and Neglect
Child sexual abuse (CSA) remains a challenge in South Africa, despite various legislative developments to address child abuse. Despite non-offending caregivers (NOC) playing a critical role in child safeguarding, and supporting disclosure and recovery, very little research has focused on understanding what works in assisting them in supporting child victims in South Africa.
The study examines the exposure of NOC who watched a short film based on the testimonies of four CSA perpetrators in therapy, with a view to exploring whether this film could be useful for CSA prevention, disclosure and support initiatives.
A convenience sample of eight NOC attending a community support service in KwaZulu-Natal, South Africa.
After viewing the film, the NOC completed a questionnaire, and were asked to discuss usefulness of film content based on perpetrator testimonials in sensitizing NOC around disclosure of sexual abuse and support of the child. Thematic data analysis combined their perceptions of sexual abuse experienced by their children/grandchildren and the effect that content of the film had on their perceptions.
Five themes emerged; Awareness of CSA and available child protection programs; Views toward CSA disclosure; Emotive responses; Lessons learnt for identification of CSA and child protection; and Recommendations for future programs.
The process of viewing and discussing the film stimulated a shift for NOC to identify risk, facilitate disclosure of CSA, and become more supportive toward child victims. The study highlights the potential of using film to guide NOC targeted child protection and safeguarding initiatives.
Which groups are most affected by sexual violence? A disaggregated analysis by sex, age, and HIV-status of adolescents living in South Africa
2023, Child Abuse and Neglect
Estimates on sexual violence (SV) among adolescents are rarely disaggregated by key indicators.
We examine the independent effects of sex, age, HIV status and mode of HIV acquisition on the exposure to SV using generalised estimating equations models and proportional hazard model.
Data from a 4-year prospective cohort study of 1447 adolescents (ages 10–19, 57% girls, 76% living with HIV) in South Africa.
We describe the lifetime prevalence of three forms of SV: non-contact (unwanted showing of private parts), contact (coerced sexual debut, attempted and completed forced penetrative or oral sex,) and exploitative (sex in exchange for goods/money).
Overall, 23.9% (95%CI = 21.7%–26.1%) reported exposure to SV at some point in their lives: non-contact = 5.7%, contact = 9.0% and exploitative = 15.8%. While girls reported higher rates of exploitative (18.4% vs 12.3%; p < 0.001) and contact SV (12.3% vs 4.6%; p < 0.001), there were no differences in levels of non-contact SV by sex (6.5% vs 4.6%; p = 0.086). Exposure to any SV doubled in late adolescence (10–14 years = 7.0% vs ≥15 years = 31.7%; aIRR = 2.07; 95%CI = 1.82–2.37). Though level of SV were comparable between those living with HIV and those HIV-uninfected (22.9% vs 26.2%; p = 0.182), adolescents who recently acquired HIV were twice as likely to experience SV compared to adolescents who perinatally acquired HIV (42.3% vs 15.7%; aIRR = 2.03; 95%CI = 1.73–2.39). This association persisted when analysis was restricted to incidence SV during follow-up (aIRR = 1.53; 95%CI = 1.23–2.10).
Exposure to SV was high for both sexes, increased with age and more prevalent among adolescents who recently acquired HIV. SV prevention and response services must also be offered to boys and strengthened in HIV care services.
Childhood trauma and genetic variation in the DAT 40-bp VNTR contribute to HIV-associated neurocognitive disorders
2022, IBRO Neuroscience Reports
Citation Excerpt :
In 2019, HIV was estimated to affect 19% of South African adults with a prevalence of 25% in South African women, compared to 12.9% in South African men of the same age (UNAIDS, 2019). The high rate of intimate partner violence, rape and childhood trauma contribute to the high prevalence of HIV amongst South African women (Andersson, Cockcroft and Shea, 2008; Jewkes et al., 2002, 2001; Kalichman and Simbayi, 2004). HIV infection puts individuals at particularly high risk for developing HAND.
HIV/AIDS is a major public health burden in South Africa, currently affecting an estimated 13.5% of the population. Despite improved access to antiretroviral therapies, HIV-associated neurocognitive disorders (HAND), characterised by a spectrum of neurocognitive impairment, emotional disturbances and motor abnormalities, continue to persist. Gene-environment interactions contribute to HAND pathophysiology and previous research has identified childhood trauma as an environmental risk factor. Dopaminergic signalling in the prefrontal cortex plays a key role in cognitive function. Thus, variants in genes encoding the dopamine transporter (DAT) and catechol-O-methyltransferase (COMT), which are responsible for dopamine transport and metabolism, could represent genetic risk factors for HAND. This study investigated whether the DAT variable number of tandem repeats (VNTR) and COMT Val158Met (rs4680) polymorphisms are associated with longitudinal change in cognitive function in the context of childhood trauma and HIV. Participants (n = 49 HIV-negative and n = 64 HIV-positive women) completed the Childhood Trauma Questionnaire – Short Form (CTQ-SF) and provided blood for genetic analyses. Global cognitive scores were generated from baseline and one-year follow-up assessments. Following polymerase chain reaction, genotypes were determined using gel electrophoresis and confirmed by Sanger sequencing. Baseline global cognitive scores, genotype, HIV status and CTQ-SF scores were regressed on one-year global cognitive scores in regression models. Analysis of variance was used to examine the effect of including predictor variable interactions on model fit. HIV seropositivity was associated with poorer cognitive performance at one-year follow-up (p = 2.46 ×10⁻⁴). The combination of HIV and DAT 10-repeat homozygosity (DAT 10/10) was associated with reduced global cognitive scores in longitudinal models (p = 0.010). Including the interaction between DAT 10/10, childhood trauma, and HIV explained significantly more of the variance in longitudinal cognitive scores (p = 0.008). There were no significant associations with the COMT genotype. Our research indicates that childhood trauma and genetic variation in DAT contribute toward the aetiology of HAND. Future studies in larger cohorts are warranted to verify these results.
The demographics of patients presenting for sexual assault to US emergency departments
2020, Journal of Forensic and Legal Medicine
Citation Excerpt :
It is not surprising that most of the perpetrators in schools are known to the victim. A study in South Africa showed that the largest group of child rape perpetrators was teachers, committing 33% of child rapes.40 Teachers are obviously known to their victims.
Few studies address the demographics/epidemiology of patients presenting to emergency departments (ED) for evaluation of sexual assault across an entire nation. It was the purpose of this study to analyze the demographics of sexual assault using a national data base.
This was a retrospective study of prospectively collected data from National Electronic Injury Surveillance System - All Injury Program for years 2005–2013. Patients presenting for sexual assault were analyzed. Descriptive and logistic regression statistical analyses were performed with SUDAAN 11.0.01™ software. A p < 0.05 was considered statistically significant.
Sexual assault accounted for an estimated 657,719 ED visits (0.24% of all injuries, and 3.4% of injuries due to violence). When an assault victim presented to the ED, a sexual assault was most likely when the patient was 0–14 years old (OR = 19.48 [12.02, 31.57]), White (OR = 2.12 [1.30, 3.47]), the perpetrator being a stranger (OR = 10.51 [8.21, 13.46]), and occurring at home (OR = 10.05 [6.61, 15.27]). The average annual incidence of ED visits for sexual assault per 10,000 US population was 2.39; 0.47 for males and 4.92 for females. The average was 19.6 years; 90.3% were female. Assaults occurred in the home in 45.6%, and were more common in the summer. The perpetrator was unknown in 37.5%, a friend/acquaintance in 24.8%, other relative in 9.4%, multiple perpetrators in 9.3%, spouse/partner in 6.8%, with the remaining 12.7% from other groups. Racial composition was White in 60.9%, Black in 25.9%, Amerindian in 12.5%, and Asian in 0.5%. The perpetrator was a close relative nearly twice as frequently for male victims compared to female victims. Hospital admission overall was 2.7%: 7.1% when the assault occurred on the street, 1.8% when at school or sporting locations, 4.9% for males and 1.5% for females. Nearly all (98.2%) extremity injuries occurred in females.
Sexual assaults account for 4.4% of ED visits for violence. There was a decrease in the number of sexual assaults occurring on the street and at school/sporting locations over time while the number of assaults by strangers increased. For males, 54.1% occurred in those <10 years of age. The differences between patients by demographic and event characteristics is important information for health care providers.
Learning for development: Learners’ perceptions of the impact of the Kha Ri Gude Literacy Campaign
2020, World Development
This article describes how the Kha Ri Gude Literacy Campaign in South Africa utilized an enriched literacy curriculum in enliterating 4.7 million adult learners who, as a result of the legacy of apartheid in South Africa, had little or no education. The article uses a mixed-methods approach—mixing quantitative and qualitative data—to determine what adult learners considered to be important benefits of initial literacy. Moreover, it explores the extent to which these benefits correlated with the developmental intent which aimed, by using MDG/SDG inspired themes, to impact on the social, economic and developmental opportunities that might be afforded by literacy acquisition. The article analyzes the responses obtained from a sample of 485,941 literacy learners to a 24-item instrument which sought to establish learner perceptions of the benefits (or lack thereof) of their participation in the literacy campaign. The high rate of positive responses showed that the majority of the learners perceived the campaign to have benefited them with regard to their feelings of self-confidence, their ability to participate in community matters, increased understandings of health issues, increased involvement in income generation, technological abilities, as well as in increasing their appetite for lifelong learning. The quantitative findings were triangulated with the findings of the learner interviews conducted with learners who had completed the program in the previous two to five years. In addition to focusing on the responses of learners who perceived the campaign to have had positive impacts, further quantitative analyses were conducted on the responses of those learners who gave negative feedback. It is believed that both the positive impact and the non-impactful findings reported in this article will allow for a closer tailoring of literacy programs in order to maximize their developmental potential.
A factor analytic study of the Childhood Trauma Questionnaire-Short Form in an all-female South African sample with and without HIV infection
2019, Child Abuse and Neglect
The Childhood Trauma Questionnaire-Short Form (CTQ-SF) is widely used around the world but no norms have been established for South African users of the CTQ. The CTQ has been employed in South Africa but not yet validated. The present study aims to address this gap. There is great need in both clinical and research settings for an assessment tool that adequately measures childhood trauma, a sensitive and challenging construct to measure.
This study explores the psychometric properties of the CTQ-SF in an all-female cohort living with and without HIV infection in South Africa, the first study of its kind in this population.
The CTQ-SF was administered to 314 women (170 HIV uninfected; 144 HIV infected) in Cape Town, South Africa.
Internal consistency of the CTQ-SF was determined by Cronbach alpha coefficients. Using Lisrel, a confirmatory factor analysis (CFA) was performed, followed by an exploratory factor analysis (EFA) to explore an alternative factor structure model in this cohort.
For the group as a whole, the model fit was acceptable but not good. However, for the sub-sample of women living with HIV, the CFA revealed poor model fit. The EFA revealed a three-factor model, with mostly stable factor loadings for four of the five subscales. However, the Physical Neglect (PN) subscale cross loaded on two of the three factors.
Our findings revealed an alternative factor structure from the original model in this study cohort. The PN subscale does not have stable factor loadings and is not homogenous. The original instrument may therefore benefit from revision for use in this population. Measures such as the CTQ can be informative for preventative strategies in HIV-infected or at-risk youth and for clinical interventions aimed at mitigating the negative psychological sequelae of childhood maltreatment.

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Research LettersRape of girls in South Africa

Summary

Soc Sci Med

Clinical characteristics of women with a history of childhood abuse: unhealed wounds

JAMA

Research Letters
Rape of girls in South Africa