How does Childhood Sexual Abuse affect HIV prevention?


Childhood Sexual Abuse (CSA) is a painful experience on many levels that can have a profound and devastating effect on later physiological, psychosocial and emotional development.

Childhood Sexual Abuse experiences can vary with respect to duration (multiple experiences with the same perpetrator), degree of force/coercion or degree of physical intrusion (from fondling to digital penetration to attempted or completed oral, anal or vaginal sex). The identity of the perpetrator–ranging from a stranger to a trusted figure or family member–may also impact the long-term consequences for individuals. To distinguish Child Sexual Abuse from exploratory sexual experimentation, the contact should be unwanted/coerced or there should be a clear power difference between the victim and perpetrator, often defined as the perpetrator being at least 5 years older than the victim.

People who experience childhood sexual abuse may feel powerless over their sexuality and sexual communication and decision-making as adults because they were not given the opportunity to make their own decisions about their sexuality as children or adolescents. As a result, they may engage in more high-risk sexual behaviour, be unable to refuse sexually aggressive partners and have less sexual satisfaction in relationships.

What seems to be common, is that people who come forward to report their abuse, only do so after the perpetrator has died or a number of other abuse survivors have come forward to present their case.  In high profile cases, this means victims of Jimmy Saville, Gary Glitter, Max Clifford, Rolf Harris, Chris Denning et al.  For more information on these investigations, search for Operation YewTree online.

The reality is much worse than what the papers are informing.  Child Sexual Abuse is more likely to occur in families under duress. Children are at risk of sexual abuse in families that experience stress, poverty, violence and substance abuse and whose parents and relatives have histories of child abuse.

Childhood Sexual Abuse can affect HIV risk because childhood and early adolescence are critical times in a person’s sexual, social and personal development, sexual abuse can distort survivors’ physical, mental and sexual images of themselves. These distortions, combined with coping mechanisms adopted to offset the trauma of abuse can lead abuse survivors into high-risk sexual and drug-using behaviours that increase the likelihood of HIV infection.

Childhood Sexual Abuse survivors may have difficulties forming attachments and long term relationships and may dissociate from their feelings, resulting in having multiple sexual partners, “one night stands” and short-term sexual relationships.  The effects of child sexual abuse may be different for adult men and women. Female survivors of abuse may have lower condom self-efficacy with partners, use condoms less frequently, exhibit more sexual passivity and attract or be attracted to overly controlling partners.  Male survivors of abuse may experience higher levels of eroticism, exhibit aggressive, hostile behaviour and victimize others.

Adults with child abuse histories may use dissociation and other coping efforts to avoid negative thoughts, emotions and memories associated with the abuse. One of the most common dissociation methods is alcohol and drug abuse. A study of men and women with a history of substance abuse found that 34% had experienced child sexual abuse.

More on historic Childhood Sexual Abuse

For years, there have been undercurrents on Twitter and other websites about a network of individuals who sexually abuse children.  It’s not a small network of people, it’s large and the organisation was called the Paedophile Information Exchange (PIE) between 1974 to 1984.  To research more for yourself, search #CSAInquiry or #PIE on Twitter or Google.

The Paedophile Information Exchange network was set up as a special interest group who’s stated aim was to “to alleviate suffering of many adults and children” by campaigning to abolish the age of consent thus legalising sex between adults and children. (Read More).  At the time, the Paedophile Information Exchange group was legal and sought to promote the rights of paedophiles by arguing that children had the right to indulge in their sexual feelings with adults, and argued the age of consent should be lowered to four years old, or abolished altogether.

Until recently, this story has been limited to activists and deemed ‘conspiracy’ because of the high volume of alleged abuse which has been reported by high profile celebrity’s and currently, alleged against politicians.

In October, 2012 ITV aired a documentary “Exposure: The Other Side of Jimmy Savile” (Available online here) which broke the story of Savile’s sexual abuse of young girls into the main stream media.  The programme contained several allegations by women who said that, as teenagers, they had been sexually abused by Savile, who had gained access to them through the television programmes he had presented.  Following the broadcast, many other people came forward to make allegations about Savile’s conduct towards young people, including sexual abuse that had taken place on BBC premises and in hospitals to which Savile had access.

It didn’t stop there, since the ITV documentary, journalists, magazines and newspapers have consistently reported stories of child sex abuse, gradually gaining traction until it exploded in most newspapers last weekend.

Read those stories:

What’s next, and how can we cope?

Although dealing with child sexual abuse may seem like a daunting task for many HIV prevention programs, there are a variety of usable approaches to address abuse in adults.  Programs can: include questions on abuse during routine client screening, reassess clients over time, provide basic education on the effects of Childhood Sexual Abuse and offer referrals for substance abuse and mental health services.

People who are likely to interact with Childhood Sexual Abuse survivors such as medical and other health professionals, religious and peer counsellors, including alcohol, substance abuse and rape counsellors, and probation officers need to be educated on the effects of child sexual abuse and on sexual and drug risk behaviours. They also need training on how to recognize symptoms of child sexual abuse and how to address these issues or provide appropriate referrals for treatment.

We hope you find this knowledge, educational and informative. To be perfectly honest, we hope it makes you angry, angry enough to research Childhood Sexual Abuse for yourself and ensure that you stay up to date with the developments which are unfolding now before our very eyes and ears, on the news, in the newspapers and on the radio.

Many survivors of child abuse believe they have been let down by the system of child protection in the UK.  Thousands had nowhere to turn. Nobody listened and nobody helped.

In fact, one person tried.  His name was Geoffrey Dickens who was the Conservative MP for Huddersfield West.  Dickens gave Leon Brittan, (then home secretary) a dossier of allegations about an alleged paedophile ring among MPs (Read more about that here)

On Tuesday last week, Simon Danczuk, Labour MP for Rochdale, called on Lord Brittan to say what he knew about the allegations made by Dickens, who died in 1995. On Wednesday, Lord Brittan said he had asked Home Office officials to report back to him at the time if “action needed to be taken”, but did not recall having been contacted further. The Home Office said on Wednesday that it had conducted a review of the matter last year and found that the concerns raised by Dickens had been passed on to the appropriate authorities.

It is one of 114 Home Office files relating to allegations of child sex abuse that it has admitted have either been destroyed, lost or gone missing.  The disappearance of the files was not disclosed in the 2013 Home Office review. Mark Sedwill, the permanent secretary of the department, has promised to appoint an independent legal figure this week to determine whether the conclusions of last year’s review “remain sound”.

The missing Home Office files and the failure of previous police and local authority inquiries has meant that MPs from all the political parties have supported calls for an overarching national inquiry, A Child Sex Abuse Inquiry (or #CSAInquiry for short).

A petition is available online ( asking Theresa May to establish a national inquiry into allegations of organised child abuse.  Please visit it, we owe it to the survivors. They expect nothing less.



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