International Journal of Reproductive Research

Abstract

Background: Sexual violence (SV) against adolescent girls is public health problem and is often under-reported. Present study was conducted to gather information regarding SV against unwed adolescent girls in tribal, rural communities. Methodology: Community-based cross-sectional analytic study included 2500 randomly selected unwed adolescent girls aged ≥10-<20 years, residing in 140 remote villages and who consented to participate. Face-to-face interviews of participants regarding SV suffered at home and workplaces were conducted for 15-30 minutes using semi-structured questionnaire. Results: Of 2500 women interviewed, majority (51.56%) belonged to ≥18-<20 years of age, educated up to higher secondary (43.4%), laborer by occupation (36.5%), and belonged to lower economic class (77.4%). Of all participants, 1342 (53.7%) suffered SV, 1158(46.3%) at both home and workplace, and 184(7.4%) only at the workplace. Of all women, 72.4% who suffered SV at home and workplaces informed about SV to someone, with family members being most common (84.8%). Only 13.4% of girls who suffered SV at home and workplaces informed police. Similarly, of all adolescent girls who suffered SV at home and workplaces, 65.9% sought health care. Conclusion: In present study, 53.7% unwed adolescent girls suffered SV at home and workplaces. Most girls informed family members after suffering SV at home and workplaces with very few reporting to police about SV. It is therefore necessary to generate awareness, formulate laws and policies for protection of adolescent girls against violence as they constitute a vulnerable population and they suffer silently due to social stigma.

Background

Violence against adolescent girls has been one of the most important issues and a major public health concern too. It is a violation of human rights and has physical and mental effects on the victim [1]. Sexual violence (SV) against young girls is a widespread and complex issue that encompasses a range of coercive sexual acts. This includes attempted or completed rape, sexual coercion and harassment, as well as any unwanted sexual contact achieved through force or threats [2]. According to the recent UNICEF data, at least 120 million girls under 20—around 1 in 10—have been coerced into sexual acts, though the true number is likely to be much higher. Approximately 90% of adolescent girls who report experiencing forced sex indicate that their first perpetrator was someone familiar, often a boyfriend or spouse [3]. SV poses significant risks to the mental and physical health of girls, increasing their likelihood of experiencing poor mental health outcomes, injuries, reproductive health issues, and the transmission of HIV and other sexually transmitted infections [4]. Furthermore, emerging research indicates that experiences of SV during youth can elevate allostatic load, a measure of chronic stress and trauma. This heightened allostatic load is associated with a greater risk of various health problems later in life, underscoring the long-term consequences of such violence [4-5]. Community-based studies focusing on unwed adolescents, particularly in rural areas, are limited. This lack of research hinders the understanding of their unique challenges and needs.

Objectives

The present community-based cross-sectional study was conducted to gather information regarding SV suffered by unwed adolescent girls residing in remote villages in a forestry, and hilly region of India.

Material and methods

Study Design: Cross-sectional Observational study.

Study setting and duration: The study was conducted in a total of 140 tribal villages in remote rural, forestry, and hilly region over a period of one year. These villages were around the village with the health facility, the study centre.

Inclusion criteria: Randomly a minimum of 15 girls aged ≥10-<20 years were selected from each village and willing to undergo a personal interview were enrolled as study participants considering some villages were small and some large.

Exclusion criteria: -Girls ≥20 years or <10 years of age, married, not willing to be a part of the study were excluded.

Sample size: - Calculated sample size was 2500 with 95% confidence and 2% absolute precision. The sample size was calculated using a free online statistical calculator

(statulator) [6].

Data collection

After the Institutional ethical committee’s approval and informed consent from the participants, socio-demographic features of all the participants including age, education, occupation, and economic status were collected by research assistant (trained nurse midwife) and were recorded on a pre-designed data collection tool, semi-structured questionnaire with open and close-ended questions. In-depth face-to-face interviews of the study subjects regarding SV suffered by girls at home, workplaces and other places were conducted. Each interview was conducted for a duration of around 15-30 minutes, maintaining confidentiality and privacy in an area convenient to participants and the trained research assistant.

Participants were not given the tool to fill out themselves.

Statistical analysis

The data was statistically analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. The numerical data was presented as numbers and percentages and categorical variables as frequencies or rates wherever needed.

Results

Of all the unwed adolescent girls interviewed, majority (51.56%) belonged to the ≥18 -<20 years of age, educated up to higher secondary (43.4%), worked as labourers in their own farms (36.5%) and belonged to lower economic class (77.4%). Of these 2500 unwed adolescent girls interviewed, 1158(46.3%) reported SV at home with 927(80.1%) day and night, and 231(19.9%) anytime at home. Of these 1158 girls facing SV, 893(77.1%) reported SV outside home with majority by friends (63.7%), neighbours (35.1%), and distant relatives (35.1%) and by her own father or brother outside home (0.1%). SV was more commonly experienced by girls between ≥18-<20 years of age, educated up to higher secondary, worked as laborers and belonged to lower socioeconomic classes (p<0.05). Table I depicts the sociodemographic features of girls in relation to the SV suffered by them at home and outside home by other persons (Table I).

Of these 2500 unwed girls, 1342(53.7%) reported SV at home and workplaces both. Of these 1342 girls, 75.9% suffered SV at their place of work and 24.1% suffered on their way to the workplace. Of 1342 girls, 67.8% reported SV by the employer, 27.6% by co-workers and the remaining 4.5% by other persons like visitors, friends of co-workers or employers, etc. Furthermore, of these 1342 girls, 1298(96.7%) reported SV once whereas 44(3.3%) reported multiple times. Table II depicts the sociodemographic features of girls in relation to the SV suffered at workplaces and on their way to workplaces (Table II).

Of 1342 unwed girls who suffered SV at home, and at workplaces, 971(72.4%) informed someone, with majority to their family members (84.8%), followed by police (13.4%), and others like neighbors, friends, and distant relatives (1.9%) (Table III). All these 1342 girls who suffered SV, 640(65.9%) sought healthcare-related help with 73.6% from Sub Centres (SC) or Primary Health Centres (PHC), 21.7% from Sub-district hospital (SDH)/District hospital (DH), and remaining 4.7% from private hospitals or dispensaries. The relationship of the action taken and health care sought for SV suffered and demographic factors is shown in table III (Table III).

Table I: Relation of socio-demographic features with sexual violence against unwed adolescent girls at home

Table II: Relation of socio-demographic features with Sexual violence against unwed adolescent girls at workplaces

Table III: Relation between socio-demographic features and action taken about Sexual violence by unwed adolescent girls

SC – Subcenter; PHC – primary health care; DH – district hospital; SDH – sub district hospital

Hence, it was observed that of a total of 2500 unwed adolescent girls interviewed, 53.7% suffered SV at home and workplaces, with 1158(86.3%) suffering SV both, at home and workplace and 184(13.7%) at workplace only. Most girls informed family members about SV at home and workplaces with very few reporting to police. A significant correlation was observed between rural adolescent girls' abuse and socio-demographic features like age, education, occupation and economic status.

Discussion

SV is a significant public health issue that carries severe long-term repercussions for survivors. The impact extends beyond immediate physical harm, affecting mental health, social relationships, and overall quality of life. Addressing this pervasive problem is crucial for promoting individual and community well-being [7]. SV is frequently underreported by victims for a variety of reasons, including feelings of shame, guilt, and fear. This silence means that the true extent of these incidents is likely to be much higher than reported. The estimated number of girls who experience sexual abuse is deeply concerning and highlights the urgent need for awareness and intervention [8]. Sexual trauma has a profound negative impact on adolescents, affecting girls psychological well-being, social adjustment, and family dynamics. Experiences of maltreatment during this critical developmental period can lead to significant challenges, including the increased risk of developing personality disorders. Addressing these issues is essential for fostering healthy futures for affected individuals [9-11]. In the present study it was revealed that of a total of 2500 unwed adolescent girls interviewed, 53.7% suffered SV at home and workplaces. SV was more commonly observed in girls between ≥18-<20 years of age, educated up to higher secondary, labourer by occupation and those belonging to lower economic class. Moreover, it was observed that the majority of the girls informed family members after SV at home and workplaces with very few reporting to police.

A recent study conducted in Italy involving 731 adolescent girls highlighted alarming statistics about SV. It revealed that 80% of participants experienced penetrative SV. Key vulnerability factors associated with a heightened risk of rape included being over 17 years old and the consumption of alcohol or other drugs. Additionally, the study found that 55% of the victims had at least one genital lesion, underscoring the severe physical consequences of such trauma [2]. Another similar study from India indicated that between 13% and 32% of boys and 12% to 42% of girls reported experiences of unwanted touching, while 4% to 15% of boys and 3% of girls had forced physical relationships. Vulnerable populations, such as street children, are particularly at risk for these adverse experiences. The most commonly reported perpetrators include older children, neighbours, and strangers. They also reported several associated factors, including having friends of the opposite gender, poor academic performance, compromised mental and physical health, substance abuse, and strained parental relationships. Additionally, disparities between urban and rural areas were also found to be associated with the risk and exposure to coercive behaviors [12]. A study revealed that adolescent victims of SV tend to seek help later than adult victims, which poses significant challenges in addressing these crimes effectively. Notably, most perpetrators were well known to the victims in both age groups. This delay in disclosure among adolescents may hinder the timely intervention and management of such incidents, making it crucial to promote a supportive environment that encourages prompt reporting and assistance [13]. A study conducted in Sub-Saharan Africa examines the prevalence of physical and SV against adolescent girls, comparing those who are enrolled in school with those who are not. The findings reveal alarmingly high rates of violence, with 28.8% of girls reporting experiences of physical or sexual abuse. Importantly, the data indicates that girls encounter substantial rates of violence regardless of their school enrolment status, highlighting a pervasive issue that affects adolescent girls in the region [14]. A recent study conducted in Peru involving 1,579 youths aged 12 to 17 across 93 schools found that 18.68% had experienced some form of sexual assault, specifically, 9.75% reported being touched inappropriately, while 1.84% identified as victims of rape. Within the microsystem, age emerged as a significant risk factor, whereas the age at which individuals first encountered sexual violence served as a protective factor. Additionally, within the macrosystem, the belief that violence predominantly occurs outside the home was linked to an increased risk of victimization [15].

Conclusion

In the present study, it was revealed that the rural, young girls between ≥18-<20 years of age, labourers and those belonging to lower socio-economic status were more at risk of suffering SV at the hands of their family members, close and distant relatives, friends and at workplaces. Of all the 2500 adolescent girls interviewed, 53.7% reported SV at home and at workplace. Furthermore, only 72.4% of girls suffering from SV informed about the incident with only 13.4% informing to police. Of all these girls who suffered SV, 65.9% sought help from various health centres regarding SV-related injuries. Hence SV against rural unwed adolescent girls is a critical issue that demands urgent attention and action. These young girls often face unique vulnerabilities due to social isolation, limited access to resources, and cultural stigmas surrounding their status.

Declarations

The present study was conducted after approval of the Ethics Committee and informed

Consent of participants.

Funding was only for Field work Authors are grateful.

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