Sexual abuse against minors in the communes of Abomey-Calavi and So-Ava in Southern Benin

INTRODUCTION

Childhood is a crucial stage in an individual’s development. It represents an important phase where the child seeks parental love, family protection, the joy of first discoveries, a playful environment, and learning to live harmoniously in society.¹ Sexual violence against children is a major public health issue that is increasingly on the rise. It is associated with a wide range of harmful consequences and represents a barrier to the development of low- and middle-income countries.^2–4 Several studies have revealed that nearly one-third of young people in low- and middle-income countries (LMICs) have experienced at least one episode of sexual violence during their childhood.^2,5 Approaches to defining sexual violence against children are diverse. The United States Center for Disease Control (CDC) defines sexual violence as “the involvement of a child (a person under the age of 18) in a sexual activity that violates the laws or social taboos of society”.⁶ This includes behaviors such as fondling, penetration, and exposing a child to other sexual activities.⁷ According to the United Nations International Children’s Emergency Fund (UNICEF), sexual abuse refers to any abuse or attempted abuse of a position of vulnerability, differential power, or trust for sexual purposes, perpetrated by humanitarian workers against children and the families they serve.⁸ Sexual violence against children is widespread throughout the world. Over the past decades, numerous studies conducted in different countries have examined the prevalence of sexual violence against children and have identified a generally high rate. That is 1 in 5 women and 1 in 13 men worldwide reported having experienced sexual violence.⁹ In France, children are the main victims of sexual violence, with girls being much more affected than boys: 81% of sexual violence cases begin before the age of 18, 51% before the age of 11, and 21% before the age of 6.¹⁰ This phenomenon affects both girls and boys from urban and rural areas.¹¹ The COVID-19 pandemic and various response strategies have amplified the impact of the prevalence of violence against children and its consequences. Thus, the closure of some schools, travel restrictions, isolation, and decreased income, among other factors, have increased the level of stress and anxiety among individuals worldwide.⁹

The histories of sexual violence among children are associated not only with short-term consequences but also with long-term emotional effects, including anxiety, fear, and suicidal thoughts.^2,9,12 In China, studies have concluded that sexual violence against children is significantly linked to mental health issues.¹³ A study showed that in China rural areas, adults with backgrounds of childhood sexual violence displayed significantly higher rates of depression and suicide attempts.⁹ Several other national studies in the Netherlands and China revealed that adults who experienced sexual violence during childhood were at a higher risk of depression.⁹ An association was also reported, showing that sexual violence experienced in childhood significantly increases the risk of alcohol consumption as well as alcohol-related disorders among both male and female victims.^9,14,15 Other consequences, such as sexual delinquency and borderline personality disorder, have been identified as linked to childhood sexual violence.¹⁶

Although this phenomenon has been less studied in Africa, the few available studies showed that it represents a major public health issue among children, adolescents, and young adults. The prevalence of sexual violence against children ranged from 9.9% to 37.8% in studies conducted in some African countries, including South Africa, Tanzania, and Kenya.^17,18 The results of these studies reveal that girls are at a higher risk of experiencing sexual violence than boys.¹⁹

In West Africa, few studies have assessed the prevalence of sexual violence and explored the associated consequences among adolescents and young men. Given the critical lack of data on sexual violence in Benin, information on the prevalence, risk factors, and consequences of sexual violence among adolescent girls, young women, as well as adolescent and young men, is clearly necessary to help shed light on the development of prevention and intervention programs aimed at eradicating this major public health issue. The purpose of this study is to examine the scope and the factors that promote different types of sexual violence among children within a population in southern Benin, while exploring the categories of social and demographic factors in an African context and in a low-income country such as Benin.

METHODS

Type of study

This was a retrospective cross-sectional study with an analytical aim, focusing on victims of sexual violence received at the social promotion centers in the communes of Abomey-Calavi and So-Ava in southern Benin from 2018 to 2022.

Study population

The study has considered 125 children aged 0 to 18 victims of sexual violence in the communes of So-Ava and Abomey-Calavi in southern Benin from 2018 to 2021. The parents or guardians of all participants gave their written informed consent after the study protocol was explained, and their questions were answered.

Selection criteria

Inclusion criteria included being under 18 years of age, having been supported by a Social Promotion Center in Abomey-Calavi or So-Ava, and still residing in the area covered by the survey. All children meeting these criteria during the period of 2018 to 2022 were considered based on the inclusion criteria.

Sampling method and size

The sampling method was non-probabilistic and exhaustive for selecting children who were victims of sexual violence. For the selection of victims to survey, the aim was to choose any eligible child, without any gender or nationality discrimination, identified in the GBV registers of the CPS of So-Ava and Abomey-Calavi from 2018 to 2022. The sample size was equal to the exhaustive number of cases of children who were victims of violence identified by the CPS of So-Ava and Abomey-Calavi

Data collection techniques and tools

All participants answered a questionnaire to assess demographic data and socioeconomic variables. Questions regarding the characteristics of these victims' parents were also asked. The questions were asked to the participants by trained members of the research team, using a semi-structured interview guide.

Study variables

Individual characteristics of the surveyed victims of sexual violence includes age, gender, level of education, active sexuality or not, place of residence, place of occurrence of violence, year or period of occurrence.

Family characteristics includes siblings, parents' occupation, age of siblings, existence of other sexual violence victims in the family or not, family’s perception of sexual violence, and the family’s socio-economic status.

Health characteristics includes HIV status, regular hospital stays, offering of healthcare support or not.

Victim’s sociability includes understanding with other adolescents, preferred social network, leisure, resource persons.

Victim's relationship with his or her family including understanding with parents, good atmosphere among siblings, moderate healthcare expenses.

Stable academic performance, motivation, regular attendance to classes, existence of a life project.

Victim’s health state includes absence of feelings such as anxiety, fear, stress, suicidal thoughts, disability or not, chronic illness or not, general health state.

Economic consequences of sexual violence against minors viz. expenses related to post-violence exams, expenses related to legal proceedings, and other expenses due to sexual violence.

Statistical analysis

The data were coded, entered, and analyzed using IBM SPSS software version 21. Data processing and analysis included content analysis (for qualitative data) and statistical analysis for quantitative data. Standard statistical measures were used depending on the type of variables. These included the calculation of means with their standard deviations, percentages, and tests for comparison of proportions (Pearson's Chi² test), with 0.05 as the significance threshold. Bivariate analysis consisted of comparisons of means between the recrudescence of sexual violence as a public health issue and the categorical independent variables.

RESULTS

Our study focused on 125 children, all victims of sexual violence, including 11 boys or young boys (8.8%) and 114 girls or young girls (91.2%). Most victims were from the commune of So-Ava (65.6% compared to 34.4% residing in Abomey-Calavi).

Socio-demographic characteristics of victims

Age and professional activity of victims of sexual violence

The average age of participants was 13.18±3.16 years. The 125 participants included in the analysis were mostly aged between 15 and 18 years (47.20%). At the time of the study, 93.60% of participants were students, and about 7% were merchants or artisans.

Male children who were victims of sexual violence were mostly aged 5-10 years (54.55%), while female victims were primarily aged 15-18 years (47.37%). There is a significant association between the age and gender of the children surveyed who were victims of sexual violence.

Occupation of parents of victims of sexual violence

The distribution of the fathers of the 125 surveyed child victims of sexual violence by occupation highlights significant socio-economic factors. Farmers represented the largest group, accounting for 29.6% (n=37) of fathers. Merchants followed closely, making up 27.2% (n=34) of the total. Fathers without any occupation constituted 21.6% (n=27), while artisans represented 12% (n=15). Civil servants formed the smallest group, comprising 9.6% (n=12). These findings illustrate the diverse socio-professional backgrounds of the fathers of affected children, which may influence the vulnerabilities and risk factors associated with sexual violence.

The distribution of the mothers of the 125 surveyed child victims of sexual violence by occupation reveals a predominance of informal employment. Merchants constituted the largest group, representing 28.8% (n=36) of mothers. Farmers and housewives each accounted for 24.8% (n=31), highlighting a significant proportion of mothers engaged in agriculture or domestic responsibilities. Artisans comprised 20% (n=25) of the total, while civil servants represented the smallest group, making up only 1.6% (n=2). These findings suggest that the socio-economic status of mothers, particularly in informal sectors, may play a role in shaping household vulnerabilities to sexual violence.

Sexual activity among victims of sexual violence

Table 1 describes sexual activity among the surveyed victims of sexual violence. Most of the children surveyed (58.4%) had sexual activity. This was frequent among 12.8% of the children.

Types of sexual violence

The distribution of the 125 surveyed child victims by the type of sexual violence experienced indicates that the majority suffered rape with harassment, accounting for 83.2% (n=104) of cases. In contrast, 16.8% (n=21) of the victims experienced rape without harassment. These findings highlight the prevalence of harassment as a compounding factor in most cases of sexual violence against children. The predominant form of sexual violence was rape with harassment (among 83.20% of the children surveyed).

Factors associated with different types of sexual violence

The socio-demographic and economic characteristics of the 125 participants are presented in Table 2, based on the types of sexual violence suffered by the surveyed children.

*p value=0.004.

p value >0.05

*p value=0.004; **p value=0.000

*p value=0.004; **p value=0.000

p value=0.000

In cases of sexual violence, the risk of being a victim of rape without harassment seemed to increase with the age of the children and the female gender. The same trend was observed for children whose parents had no occupation. The children surveyed had at least one parent without occupation in 42.40% of cases. However, these associations are not significant at the 5% threshold.

Similarly, schooled children, who had no leisure activities, living with remarried parents or a single parent, as well as elders, seemed to have an increased risk of being victims of rape with harassment if subjected to sexual violence. Children with no leisure activities and those living with remarried or single parents represented 53.60% and 66.40% of the study population, respectively. However, these associations are not significant at the 5% threshold.

Children who did not receive basic education from their biological parents were 1.2 times more likely to be victims of harassment and rape in cases of sexual abuse (p value=0.000).

Consequences of sexual violence on victims

Tables 3, 4, 5, 6 and 7 present the different types of sexual violence and their consequences on the surveyed victims.

Most of the children surveyed (90.48% and 81.73% of children who were victims of rape without harassment and those who were victims of rape with harassment, respectively) felt fear of rejection independently of the type of sexual violence they experienced. Children who had experienced rape only, felt a sense of being different in 52.38% of cases, compared to 44.23% for those who were victims of both harassment and rape.

(*) p value = 0.001

Most children who were victims of rape only did not have a network of friends (61.9%), compared to 28.85% of those who were victims of rape with harassment.

Additionally, among the children surveyed, all those who were victims of rape only had sexual activity, compared to 50% of those who were victims of rape with harassment.

There is a significant association between the type of sexual violence and both the existence of a network of friends and the frequency of sexual activity.

The time elapsed between the occurrence of sexual violence and the reporting of the incident by the children was 1-3 months for the majority (76.8%). Children who were victims of rape only attended treatment appointments less regularly (38.1% compared to 2.88% for children who were victims of rape with harassment) and had a longer treatment duration (95.24% compared to 4.81% for children who were victims of rape with harassment). There is a significant association between the type of sexual violence and both the regularity of attendance at treatment appointments and the treatment duration after the violence.

Frequent absences from school or work were most common among child victims of rape only (33.33% compared to 7.69% among those who were victims of rape with harassment).

DISCUSSION

In total, 125 children who were victims of either rape only or with harassment were surveyed during the study. Most of the surveyed children were female (91.2%). This corroborates the findings of who showed that girls are the main victims of sexual violence.²⁰ This situation highlights the vulnerability of young girls and adolescents in developing countries, characterized by sociocultural constraints such as women's lack of decision-making power within society. The average age of the children was 13.18±3.16 years. These results are identical to those of a study conducted in Senegal in 2014 on the determinants of rape among minors. The average age of victims was 12.3±3 years.²¹ Unlike the present study (where 93.6% of the victims are students), 66% of the victims surveyed in this study in Senegal were students. The others were homemakers or unemployed. These differences in results can be explained by the sociocultural differences between the two countries, despite both being part of sub-Saharan Africa region. Additionally, Benin's national policy in recent years to promote schooling for children, especially young girls, has certainly influenced this finding.

The most common age group was 15 to 18 years. Data from 21 African countries, analysed by UNICEF reached a similar conclusion, indicating that children were mostly victims of sexual violence for the first time between the ages of 15 and 19.²² This finding is also corroborated by a study in the Democratic Republic of Congo, which revealed that the most affected age group (62.93%) was 14 to 17 years.²³ Several other studies on sexual violence against minors have reached the same conclusions. These findings therefore underscore the vulnerability of the 14 to 18 age group, which must prompt a response adapted to the realities and determinants of such violence among this stratum. With the emergence of secondary sexual characteristics, some adolescents engage in activities such as watching pornographic films and early sexual experimentation, sometimes leading to sexual violence. Violent pornography, in particular, tend to reinforce aggressive acts and negative behaviors toward children.²⁴

Regarding the educational level, unschooled children were a minority, representing 7.52% of the surveyed children. This finding differs from those observed in several other studies conducted in Senegal and Ivory coast.^21,25

Likely limitations of this study include

Selection bias: The study relies on data from social promotion centers, potentially excluding unreported victims, which could underestimate the true scale of the problem.

Limited representativeness: The sample focuses on two communes in southern Benin, which somewhat limits the generalizability of results to other regions or countries with different socio-cultural contexts.

Factors not explored: The study focuses on socio-demographic and economic factors, but other determinants, such as cultural norms, the role of judicial and health institutions, or the impact of public policies, are not sufficiently analyzed.

Methodological limitations: The use of non-probabilistic, exhaustive sampling may introduce bias, and the absence of a comparison group makes it difficult to establish solid causal relationships.

Limited temporal analysis: The study covers a period from 2018 to 2022 but does not allow us to assess the evolution of trends over time or the impact of any interventions put in place to combat sexual violence.

CONCLUSION

This study allowed to identify the determinants of different types of sexual violence against minors in the communes of Abomey-Calavi and So-Ava. Given the prevalence of this type of sexual violence and its repercussions on the victims' lives, it is essential for authorities to continue enforcing laws against sexual violence to punish offenders and carry out the public health actions generated. It should also be noted that the lack of reliable data on sexual violence against children and the associated factors hinders the development, implementation, and evaluation of proposed interventions to combat such violence. Therefore, replicating such a study nationwide would significantly contribute to the availability of information related to the prevalence of sexual violence and its associated factors in Benin. Furthermore, an action plan that centers parental education within the theory of change, based on an effective communication strategy, should be developed at the national level, targeting the entire population, especially parents/guardians, social workers, children, adolescents, youth, and community child protection mechanisms. The issue of enforcing laws against sexual violence should not be overlooked.

ACKNOWLEDGEMENTS

We would like to thank all those who contributed, directly or indirectly, to this study, particularly the research assistants (interviewers) who were patient enough during interviews with each of the children, allowing us to ensure the quality of the data collected.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the National Health Research Ethics Committee CNERS (N°30 du CNERS/Dos-30/Ses- 17/11/22)

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