Abstract
IMPORTANCE: Sexual violence against children is a global concern, yet worldwide figures of its prevalence are scant. OBJECTIVE: To estimate the global prevalence of sexual violence against children using national-level population-based studies. DATA SOURCES: We searched the PubMed, Embase, CINAHL, Web of Science, PsycINFO, ERIC, and APA PsycArticles databases from their respective inceptions to March 2022. Searches were updated through April 2024. STUDY SELECTION: Reports were included if (1) they were national-level population-based studies, (2) they reported lifetime or past-year prevalence data on any form of sexual violence against children (mean age ≤19 years), and (3) the data were based on children's self-reports of sexual violence perpetrated by anyone. DATA EXTRACTION AND SYNTHESIS: Data extraction included study and participant characteristics, prevalence rates, and types of sexual violence. Outcomes were pooled using a random-effects model. Exploratory subgroup analyses were performed with categorical moderators. MAIN OUTCOMES AND MEASURES: Primary outcomes included lifetime and past-year prevalence of forced sexual intercourse, contact sexual violence, and sexual harassment. RESULTS: We identified 165 studies that included 958 182 children from 80 countries, with the majority of data focusing on girls (58.2%). The sample sizes of the studies ranged from 330 to 132 948; the mean age ranged from 10.5 to 19.4 years. Lifetime sexual harassment was the most prevalent outcome, with a pooled rate of 11.4% (95% CI, 8.5%-15.1%), followed by any contact sexual violence, with a rate of 8.7% (95% CI, 4.7%-15.5%). Furthermore, 6.1% (95% CI, 5.1%-7.3%) of children reported experiencing completed forced sexual intercourse in their lifetime, and 1.3% (95% CI, 1.0%-1.7%) reported experiencing it in the preceding year. Rates of lifetime completed forced sexual intercourse were higher among girls (6.8% [95% CI, 6.1%-7.6%]) compared with boys (3.3% [95% CI, 2.5%-4.3%]), similar to past-year violence (2.3% [95% CI 1.9%-2.7%] for girls and 0.6% [95% CI 0.4%-0.9%] for boys). We found considerable variation across regions and countries in the reported prevalence of sexual violence. Older age of children, lower national income levels, and the use of school-based surveys were associated with higher rates of sexual violence reporting in some exploratory analyses. CONCLUSIONS AND RELEVANCE: The findings of this systematic review and meta-analysis highlight the burden of sexual violence against children worldwide based on current available evidence. There is a pressing need to enhance data collection efforts globally, especially in underresearched regions and for boys. STUDY REGISTRATION: PROSPERO CRD42022327090.