Sexual abuse characteristics in Santo André, São Paulo, Brazil: from victims to aggressors, from diagnosis to treatment

Introduction: Sexual violence against children and adolescents in Brazil is an underreported public health problem. Knowing the profile of the victims and the factors related to each case is a strategy for the development of more effective public policies.Objective: To describe the profile of children and adolescent victims of sexual abuse, characteristics of aggression and aggressors, consequences for victims, and legal actions related to sexual abuse.Methods: Sociodemographic characteristics of the victims were analyzed, as well as characteristics of the aggressors and aggression, and clinical, psychological, and legal aspects of 61 sexually abused patients admitted to the specialized outpatient clinic of the Network of Health for Violence and Sexual Abuse located in Santo André, São Paulo State, Brazil.Results: Victims had a mean age of 10.4 years, female (60.7%, n= 37), white (70.5%, n= 43), and admitted to the care network after of 72 hours of having been a victim of abuse (68.3%, n = 40). Most of the aggressions were by a sexual act (65.6%, n = 40) and by an individual known by the victim (72.1%, n= 44). As a result of sexual abuse, the children had a change in family composition (42.6%, n = 26), cognitive disturbances (34.4%, n= 21), emotional disturbances (83.6%, n= 51), and behavioral disorders (54.1%, n= 33). Two-thirds of the cases resulted in a police investigation, only 20% of the offenders were convicted.Conclusion: Girls suffer sexual abuse where the perpetrator is known and close to the family; they delay seeking health services and can present mental disorders related to those abuses, but the perpetrators remain unpunished in most cases