Teenage pregnancy and child sexual exploitation in the Caribbean: A qualitative study

Background Globally, child sexual exploitation and abuse are widespread but because they are largely hidden, the harm caused is often underestimated. This paper draws on research conducted in six Caribbean countries to examine child sexual exploitation and abuse as contributory factors in the high rate of teenage pregnancy in the region and socio-cultural factors that underpin the problem, with its consequences and costs. The authors propose a framework for analysis and programming that would address these inter-connected issues and generate a more holistic approach to public health policy for both teenage pregnancy and child sexual exploitation. Methods The study used a mixed-methods research design to investigate perceptions and attitudes to CSA, and its consequences in six countries purposively selected to reflect regional diversity. A multi-staged cluster sampling strategy was used to recruit 1,340 adults for a community survey, in-depth interviews and focus groups. Survey data were analyzed using SPSS version 16 and qualitative data were analyzed using the thematic template method. Results CSA was reported as a serious problem in the Caribbean region which profoundly damages the physical, sexual, reproductive, emotional, mental and social well-being of individuals and has knock-on consequences for families and whole societies. Health outcomes include physical injury, teen pregnancy, abortion, sexually transmitted infections (including HIV) and a range of psychological disorders. Conclusions The magnitude of poor health outcomes due to teenage pregnancy arising out of sexual abuse is comparable to other health risks but when the economic costs of the wider implications of child sexual victimization are factored in, the increase in the overall social cost/burden for countries may impede developmental progress and undermine reproductive and other rights for women and girls