**7. Conclusion**

122 Sexual Abuse – Breaking the Silence

Don't know 122 19.4 Playful/gentle coaxing 149 23.7 Bribes 91 14.5 Commands/instructions 8 1.3 Verbal threats 21 3.3 Physical threats 98 15.6 Physical force 125 19.9 offering alcohol 4 .6 Other 10 1.6

None 329 52.4 Genital Pain 177 28.2 Abdominal Pain 48 7.6 Discharge 9 1.4 Bleeding 5 .8 Genital itching 5 .8 Bruising 1 .2 Behavior change 8 1.3 Other 46 7.3

Table 6. Methods used to engage the child and presenting signs and symptoms

Child sexual abuse in the sub-saharan region is a risk factor to the acquisition of HIV infection ( Dunkle 2006, UNICEF 2001, WHO 2006). Risk factors to child sexual abuse are evaluated in this chapter to help guide health workers, psychosocial counsellors, organisations and other professionals tasked in the protection of children to help manage sexually abused children. Planning strategies to mitigate against child sexual abuse requires

The female child was by far more likely to be abused. Other studies in the sub-Saharan region have reported similar findings (Birdthistle et al2009, Mathew et al 2011). Zambia has one of the highest HIV prevalence rates 14% (Zambia NAC 2009) and females aged between 15-19 are more likely to be HIV infected 16% as compared to their male counterparts 10%

**How Did The Abuser Engage The Child?**

**What is the presenting** 

**complaint?** 

understanding risk factors associated with CSA.

**6. Discussion** 

Frequency Percent

Child sexual abuse is prevalent in Lusaka.The female child is by far the most vulnerable and there needs to urgent policy and support for prevention of CSA for this vulnerable group. Communities need to be sensitised on the dangers of CSA as numbers reporting to the OSC are the tip of the iceberg. The 23% of children abused aged 0-5 years pose a great challenge as this is a helpless vulnerable group when abuse is occurring within the home.Understanding family dynamic should be part of the prevention strategy of CSA. There needs to be more resources and better tools for collection of data to better unravel risk factors associated with sexual abuse.
