Estudo epidemiológico de abuso sexual e fatores associados entre crianças e adolescentes assistidos no Hospital Universitário Júlio Müller, Cuiabá-MT

• Autor(a) principal: Azevedo, Alda Elizabeth Boehler Iglesias
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFMT
• Texto Completo: http://ri.ufmt.br/handle/1/744
• topic: Abuso sexual; Violência sexual; Criança; Adolescente; Epidemiologia; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA; Sexual abuse; Sexual violence; Children; Adolescents; Epidemiology

Violence against children and adolescents is a serious public health issue. Inserted into a historical and social context and with deep cultural roots, the sexual abuse of children and adolescents is a severe form of violence characterized by a complex dynamic, which involves biological, psychological, social and legal aspects, requiring the coordinated intervention of different institutions and must be properly addressed by the healthcare team. Objective: To analyze sexual abuse among the population of children and adolescents attended at University Hospital Júlio Müller. Methods: A cross-sectional descriptive study, with informations obtained from the medical records of children and adolescents referred due to sexual abuse from 2003 to 2011. Data were stored in Microsoft Excel 2010® and analyzed with Statistical Package for Social Sciences (SPSS®) version 20.0. The results were presented in absolute and relative frequencies, figures and tables. It was made the unpaired t test for analysis of differences between the mean age by sex. To verify the association of some independent variables with the assisted population categorized according to final classification and age group (dependent variables) were done Pearson chi-square test, with significance level of 5%. Results: Of the 615 records analyzed, 90.60% were female. The average age of the female population was 11.98 years and 8.30 years in male, 51.71% were of mixed race/color, 62.93% had incomplete primary education and 42.11% owned their own house. Among 203 victims with per capita family income known, 62.56% had incomes below Brazilian line poverty reference. In the municipalities, 67.32% of the victims were from Cuiabá and 49.27% of the sexual abuse occurred in this city, predominantly in the north and south regions. The victims were mostly referred by the Forensic Medicine Institute of the State (52.20%) and the mother was the main escort at the first consultation (53.66%). The first evaluation of the victims was mostly done by the social service (97.24%) and medical team (84.39%). After the first care, laboratorial exams were requested in 78.70%, and the Health Ministry Protocol for the prevention of sexually transmitted diseases was applied in 32.03%. Of the victims assisted, 54.31% were confirmed in the first attendance, after follow, have been confirmed 59.51% of cases, with a loss follow up of 87.32%. Analysis of the 366 confirmed cases of this study categorized according to age group, we found a significant association (p <0.05) for children under 12 years and the occurrence sexual abuse: male gender; daytime period; residence of the victim; repetitions episodes of sexual abuse; violence of vulnerable person, and known abuser. For the age group greater equal to 12 years, there was an association of the occurrence of sexual abuse with: female gender, nocturnal period, unique episode; use of physical strength; unknown abuser. It was found that sexual abuse occurred equally in children and adolescents categorized according to age group for rape, when the abuser was the father/stepfather, with intra- or extra-familial relationship and race/color white or black. Conclusions: The proportions of sexual abuse showed that, even though the phenomenon is female and the highest frequencies were found in adolescent girls, boys are also abused, especially in childhood