Sexual abuse of children is common, but discussion of it is generally taboo, and facts are therefore difficult to come by. However, indirect evidence strongly suggests that child pornography, child molestation, incest and prostitution are all widespread. For example, evidence of sexual abuse may be extracted from patient records at treatment centres for sex-related diseases, crisis centres, or maternity hospitals. A l988 study in Zaria, Nigeria, found 16 per cent of female patients seeking treatment for sexually transmitted diseases (STDs) were children under age 5, and another 6 per cent were between ages 6 and 15.

A study based on the records of the Maternity Hospital of Lima, Peru, revealed that 90 per cent of young mothers aged 12 to 16 had become pregnant because they had been raped. The vast majority had been victimized by their father, stepfather, or a close relative. In Costa Rica, an organization working with adolescent mothers reported that 95 per cent of its pregnant clients under 15 were victims of incest.

Sadly, children themselves provide some insight into the prevalence of sexual abuse. In l991, a Nicaraguan health non-governmental organization (NGO) held a national conference for children participating in the CHILD to CHILD programme, which aimed to train youngsters to be better child-care providers for their siblings. These children declared that physical and sexual abuse were the health concerns they were most worried about.

U.S. studies confirm that child sexual abuse victims suffer from psychological effects that carry over into adulthood. This psychological trauma is often manifested in physical problems such as pelvic pain, headaches, asthma, and gynaecological problems. These girls also endure long-term damage to their self-esteem, serious depression, and are often unable as adults to negotiate safe sex, or enjoy intimacy and relationships.

A significant link has also been established between childhood sexual abuse and teenage pregnancy. According to U.S. research findings, compared to teens who became pregnant but had not been abused, sexually abused girls initiated intercourse a year earlier and were likelier to use drugs and alcohol. The average age of first intercourse for abused girls was 13.8, as contrasted with the national average of 16.2. And only 28 per cent of these abused teens used birth control at first intercourse.