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Clinical characteristics of children presenting with a suspicion or allegation of historic sexual abuse
  1. Sarah Al-Jilaihawi1,
  2. Kevin Borg1,2,
  3. Katharine Jamieson1,
  4. Sabine Maguire3,
  5. Deborah Hodes1
  1. 1 Department of Paediatrics, University College London Hospital, London, UK
  2. 2 Department of Paediatrics and Adolescent Health, Mater Dei Hospital, Msida, Malta
  3. 3 Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK
  1. Correspondence to Dr Sarah Al-Jilaihawi, Department of Paediatrics, Northwick Park Hospital, Watford Rd, Harrow HA1 3UJ, UK;{at}


Introduction Police-recorded sexual offences against children and young people (CYP) increased 85% in the UK between 2010/2011 and 2014/2015. Many children delay disclosure, but little data are available regarding characteristics of CYP presenting with historic child sexual abuse (CSA).

Aim To identify the clinical and CSA-related characteristics of CYP presenting with a suspicion or allegation of historic CSA.

Method Data were collected on all CYP<17 years presenting with suspected or alleged historic CSA (ie, >3 days since last sexual assault in prepubertal children, >7 days pubertal girls) between October 2009 and November 2014. Data collected: source and indication for referral, alleged perpetrator, physical findings. Findings supportive of CSA were peer reviewed for consensus agreement. Analysis: χ2 test, Fisher’s exact test and logistic regression.

Results Among 249 CYP, presentation with physical/behavioural symptoms was associated with age <13 years (p<0.01), and alleged penetration with ages 13–17 years (p<0.01). Where known, time since alleged CSA ranged from 1 week to 13 months. Anogenital findings supportive of CSA were present in 7% of examined children (16/233), significantly associated with alleged penetration (p<0.01) and more likely with increasing age (OR 1.46, 95% CI 1.23 to 1.72). Additionally, where tested, sexually transmitted infections (STI) were detected in 2.6% CYP (3/116). Alleged perpetrators were intrafamilial in 66% (126/190). No associations were identified between perpetrator type and gender (p=1.0), age (p=0.7) or indication for referral (p=0.35).

Conclusions Despite significant time delay since the alleged CSA, this study highlights the persistence of anogenital findings supportive of CSA in 7% and STIs in 2.6% of CYP.

  • Child Abuse
  • General Paediatrics
  • Comm Child Health
  • Social Work

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  • Contributors DH conceptualised and designed the study, based on the clinic for which she is the clinical lead, and critically revised the final manuscript. SA acquired and analysed the data and drafted the initial manuscript. KB participated in acquiring data and statistical analysis. KJ participated in acquiring data and writing of the manuscript. SAM critically revised the manuscript. All authors participated in the revision of the initial and subsequent versions of the manuscript and approved the final manuscript as submitted.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Requests for access to data should be addressed to the corresponding author.

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