Legal and secondary biopsychosocial outcomes of child sexual abuse: Experience from a hospital-based multidisciplinary child protection unit in an urban lower-middle income country setting
Background: Child sexual abuse (CSA) is prevalent in the Philippines. The Philippine General Hospital–Child Protection Unit (PGH-CPU) provides multidisciplinary management. Local literature on legal and secondary biopsychosocial outcomes of CSA is limited. Objective: Determine legal and biopsychosoc...
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| Language: | English |
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Elsevier
2024-04-01
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| Series: | Child Protection and Practice |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950193824000068 |
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| author | Riza C. Lorenzana Mariella Sugue-Castillo Atty Carmela Andal-Castro Bernadette J. Madrid |
| author_facet | Riza C. Lorenzana Mariella Sugue-Castillo Atty Carmela Andal-Castro Bernadette J. Madrid |
| author_sort | Riza C. Lorenzana |
| collection | DOAJ |
| description | Background: Child sexual abuse (CSA) is prevalent in the Philippines. The Philippine General Hospital–Child Protection Unit (PGH-CPU) provides multidisciplinary management. Local literature on legal and secondary biopsychosocial outcomes of CSA is limited. Objective: Determine legal and biopsychosocial outcomes among CSA survivors and determine factors associated with reaching court and perpetrator conviction. Participants: CSA survivors evaluated at the PGH-CPU in 2009–2013. Methods: A mixed transdisciplinary design to obtain data from medical records, court documents, and interviews of study participants and key informants. Results: Factors associated with CSA cases reaching court were having multiple perpetrators (OR 5.26, 95% CI 1.45–19.05, p = 0.011) and an age difference of more than 10 years between child and perpetrator (OR 2.51, 95% CI 1.26–5.01, p = 0.009). A 10-year age difference between child and perpetrator was a significant determinant for conviction (OR 3.69, 95% CI 1.04–13.14, p = 0.044). Interviews showed that the child's testimony is the most significant factor for successful prosecution. CSA survivors have increased risks for negative biopsychosocial outcomes. Children who followed-up at PGH-CPU showed a significantly lower rate of suicide attempts (0% vs. 7.7% in children without follow-up, p = 0.023) and had lower odds of having multiple sexual partners (OR 0.12, 95% CI 0.03–0.49, p = 0.003) and being employed (OR 0.23, 95% CI 0.07–069, p = 0.009). Conclusions: There is a need to strengthen capacities of professionals to optimize legal processes and outcomes. CSA survivors have varied long-term outcomes requiring continued holistic aftercare interventions. |
| format | Article |
| id | doaj-art-8e76d5746a5543eaa315b91eda2fff1b |
| institution | OA Journals |
| issn | 2950-1938 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Child Protection and Practice |
| spelling | doaj-art-8e76d5746a5543eaa315b91eda2fff1b2025-08-20T02:02:57ZengElsevierChild Protection and Practice2950-19382024-04-01110000610.1016/j.chipro.2024.100006Legal and secondary biopsychosocial outcomes of child sexual abuse: Experience from a hospital-based multidisciplinary child protection unit in an urban lower-middle income country settingRiza C. Lorenzana0Mariella Sugue-Castillo1Atty Carmela Andal-Castro2Bernadette J. Madrid3Child Protection Unit, University of the Philippines Manila–Philippine General Hospital, Taft Avenue, Manila, Philippines; Corresponding author.Consuelo Zobel Alger Foundation, Paseo de Roxas, Makati, PhilippinesConsuelo Zobel Alger Foundation, Paseo de Roxas, Makati, PhilippinesChild Protection Unit, University of the Philippines Manila–Philippine General Hospital, Taft Avenue, Manila, PhilippinesBackground: Child sexual abuse (CSA) is prevalent in the Philippines. The Philippine General Hospital–Child Protection Unit (PGH-CPU) provides multidisciplinary management. Local literature on legal and secondary biopsychosocial outcomes of CSA is limited. Objective: Determine legal and biopsychosocial outcomes among CSA survivors and determine factors associated with reaching court and perpetrator conviction. Participants: CSA survivors evaluated at the PGH-CPU in 2009–2013. Methods: A mixed transdisciplinary design to obtain data from medical records, court documents, and interviews of study participants and key informants. Results: Factors associated with CSA cases reaching court were having multiple perpetrators (OR 5.26, 95% CI 1.45–19.05, p = 0.011) and an age difference of more than 10 years between child and perpetrator (OR 2.51, 95% CI 1.26–5.01, p = 0.009). A 10-year age difference between child and perpetrator was a significant determinant for conviction (OR 3.69, 95% CI 1.04–13.14, p = 0.044). Interviews showed that the child's testimony is the most significant factor for successful prosecution. CSA survivors have increased risks for negative biopsychosocial outcomes. Children who followed-up at PGH-CPU showed a significantly lower rate of suicide attempts (0% vs. 7.7% in children without follow-up, p = 0.023) and had lower odds of having multiple sexual partners (OR 0.12, 95% CI 0.03–0.49, p = 0.003) and being employed (OR 0.23, 95% CI 0.07–069, p = 0.009). Conclusions: There is a need to strengthen capacities of professionals to optimize legal processes and outcomes. CSA survivors have varied long-term outcomes requiring continued holistic aftercare interventions.http://www.sciencedirect.com/science/article/pii/S2950193824000068Child sexual abuseLegal and biopsychosocial outcomesMultidisciplinary team and servicesChild protectionPhilippinesLower-middle income country |
| spellingShingle | Riza C. Lorenzana Mariella Sugue-Castillo Atty Carmela Andal-Castro Bernadette J. Madrid Legal and secondary biopsychosocial outcomes of child sexual abuse: Experience from a hospital-based multidisciplinary child protection unit in an urban lower-middle income country setting Child Protection and Practice Child sexual abuse Legal and biopsychosocial outcomes Multidisciplinary team and services Child protection Philippines Lower-middle income country |
| title | Legal and secondary biopsychosocial outcomes of child sexual abuse: Experience from a hospital-based multidisciplinary child protection unit in an urban lower-middle income country setting |
| title_full | Legal and secondary biopsychosocial outcomes of child sexual abuse: Experience from a hospital-based multidisciplinary child protection unit in an urban lower-middle income country setting |
| title_fullStr | Legal and secondary biopsychosocial outcomes of child sexual abuse: Experience from a hospital-based multidisciplinary child protection unit in an urban lower-middle income country setting |
| title_full_unstemmed | Legal and secondary biopsychosocial outcomes of child sexual abuse: Experience from a hospital-based multidisciplinary child protection unit in an urban lower-middle income country setting |
| title_short | Legal and secondary biopsychosocial outcomes of child sexual abuse: Experience from a hospital-based multidisciplinary child protection unit in an urban lower-middle income country setting |
| title_sort | legal and secondary biopsychosocial outcomes of child sexual abuse experience from a hospital based multidisciplinary child protection unit in an urban lower middle income country setting |
| topic | Child sexual abuse Legal and biopsychosocial outcomes Multidisciplinary team and services Child protection Philippines Lower-middle income country |
| url | http://www.sciencedirect.com/science/article/pii/S2950193824000068 |
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