Preventing Child Sexual Abuse

Child sexual abuse is a significant but preventable adverse childhood experience and public health problem. Child sexual abuse refers to the involvement of a child (person less than 18 years old) in sexual activity that violates the laws or social taboos of society and that he/she:

• does not fully comprehend
• does not consent to or is unable to give informed consent to, or
• is not developmentally prepared for and cannot give consent to

Child sexual abuse is a significant but preventable public health problem. Many children wait to report or never report child sexual abuse. Although estimates vary across studies, the data shows:

• About 1 in 4 girls and 1 in 13 boys experience child sexual abuse at some point in childhood.

• 91% of child sexual abuse is perpetrated by someone the child or child’s family knows.

• The total lifetime economic burden of child sexual abuse in the United States in 2015 was estimated to be at least $9.3 billion. Although this is likely an underestimate of the true impact of the problem since child sexual abuse is underreported.

Experiencing child sexual abuse is an adverse childhood experience (ACE) that can affect how a person thinks, acts, and feels over a lifetime, resulting in short- and long-term physical and mental/emotional health consequences.
Examples of physical health consequences include:

• unwanted/unplanned pregnancies
• physical injuries
• chronic conditions later in life, such as heart disease, obesity, and cancer

Examples of mental health consequences include:

• depression
• posttraumatic stress disorder (PTSD)

Examples of behavioral consequences include:

• substance abuse including opioid use
• risky sexual behaviors, such as unprotected sex, sex with multiple partners
• increased risk for suicide or suicide attempts

Another outcome commonly associated with child sexual abuse is an increased risk of re-victimization throughout a person’s life. For example, recent studies have found:

• Females exposed to child sexual abuse are at a 2-13 times increased risk of sexual victimization in adulthood
• Individuals who experienced child sexual abuse are at twice the risk for non-sexual intimate partner violence
• The odds of attempting suicide are six times higher for men and nine times higher for women with a history of child sexual abuse than those without a history of child sexual abuse

Adults must take the steps needed to prevent child sexual abuse. Adults are responsible for ensuring that all children have safe, stable, nurturing relationships and environments. Resources for child sexual abuse have mostly focused on treatment for victims and criminal justice-oriented approaches for perpetrators. While these efforts are important after child sexual abuse has occurred, little investment has been made in primary prevention, or preventing child sexual abuse before it occurs.  Limited effective evidence-based strategies for proactively protecting children from child sexual abuse are available. More resources are needed to develop, evaluate, and implement evidence-based child sexual abuse primary prevention strategies to ensure that all children have safe, stable, nurturing relationships and environments.

CDC surveillance systems, violence prevention initiatives, and efforts to support partners in the field have increased our understanding of child sexual abuse, but critical gaps still need to be addressed. We can all lead efforts to prevent child sexual abuse and improve the health, well-being, and quality of life for children, families, and communities. CDC has identified gaps in research and practice that are important to address in our efforts to promote primary prevention of child sexual abuse.

Additional efforts in child sexual abuse prevention are needed to:

• Improve surveillance systems and data collection for monitoring child sexual abuse
• Increase our understanding of risk and protective factors for child sexual abuse perpetration and victimization
• Strengthen existing and develop new evidence-based policies, programs, and practices the primary prevention of child sexual abuse
• Increase dissemination and implementation of evidence-based strategies for child sexual abuse prevention

Youth- and family-serving organizations, public/governmental agencies, faith communities, and others must have the information necessary for effective primary prevention strategies. Child sexual abuse is preventable and CDC provides leadership, using a public health approach, to reduce children’s exposure to sexual abuse and ensure safe, stable, nurturing relationships and environments for all children.

CDC has developed technical packages to help states and communities take advantage of the best available evidence to prevent child abuse and neglect pdf iconas well as sexual violencepdf icon. CDC has also produced a resource, Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidencepdf icon, to help states and communities take advantage of the best available evidence to prevent ACEs. It features six strategies from the CDC Technical Packages to Prevent Violence. Learn more about how you can get started implementing the technical packages in your violence prevention work.