The magnitude of sexual abuse among children varies substantially in different studies. This study revealed that, the life time magnitude of at least one form of sexual abuse were, 384 (48.9%). This finding is consistent with studies conducted among female students in Wolayta Soddo, Ethiopia, 45.4% (27), Mekelle town, Ethiopia, 45.4% (33), Bahir Dar city, Ethiopia, 49.1% (30), India, 47.0% (28), South West Nigeria, 42.1 % (29), and Japan, 52.5% (34). But our study result was much higher than the study conducted among high school adolescents in Addis Ababa, Ethiopia, 12.7 % (35), Harari Regional State, Ethiopia 25% (31), and Butajira, southern Ethiopia, 32.8% (36). But the result was lower than studies conducted in South west Ethiopia, 68.7% (32), and southern brazil 56% (37).
These discrepancies may be due to social and cultural differences between the study subjects in reporting sexual abuse like fear of stigma (because it results decrease the probability of engaging in marriage once disclosed), could be due to lack of knowledge about sexual abuse, could be also due to deference in the time of the study, and could be also the socio-demographic difference of the study populations.
The finding of this study indicated that, the life time magnitude of rape was found to be 19.1 % (95 % CI: 18.3–23.7). This finding is similar with the studies conducted among school adolescents in Bahir Dar city, Ethiopia, 16.7% (30), and in Addis Ababa, 23% (35). But our study result was higher than the studies conducted in Butajira, 6.3% (36), in Arbaminch town, 11.0% (38), and in Debark, Ethiopia, 8.8% (17). These discrepancies may be due to social and cultural differences between the study subjects in reporting sexual abuse like fear of stigma (because it results decrease the probability of engaging in marriage once disclosed), could be due to lack of knowledge about sexual abuse, could be also due to deference in the time of the study, and could be also the socio-demographic difference of the study populations.
Parent-adolescent communication on sexual and reproductive health related issue is crucial for adolescents to learn and share life experiences on SRH from families which help them to prevent risky sexual behavior. This study revealed that, female students who haven’t had open discussions with their parents about SRH, were about 3 times more likely experiencing sexual abuse as compared to those students who have had open discussions with their parents (AOR = 2.93: 95%CI: 1.33–6.45).
This finding is consistent with a study conducted in Bahir Dar town, Ethiopia, and Arbaminch town, Ethiopia where the odds of experiencing lifetime rape was much higher among students who never had open discussions with parents on SRH than those who have had it (30, 38). This might be because most students and families consider open discussions about sexual issues as a shame and taboo in Ethiopian cultures, resulting in reluctance and fear to discuss and address sexual health issues. Consequently, this leads to missing opportunities of getting experiences and life skills from parents on the prevention of sexual abuse.
Our study again showed that, Students who live alone 4.3 times (AOR = 4.30;95 % CI: 1.81–10.24), those who lives with their friends 5 times (AOR = 5.02: 95% CI: 2.24–11.24), and those who lives with their single parent 3 times (AOR = 3.31: 95% CI: 1.23–8.89) more likely experience life time sexual abuse than those living with their both parents. These findings are in line with the studies done among high school students in Arbaminch town, Ethiopia, in Harar, and in South East Nigeria (38, 39, 40). The possible explanation could be, children who live with their parents are under direct monitoring and follow up, and the parents care their daughter more than their friends and relatives, and this minimize their chance of exposure to sexual abuse.
Some studies done in Ethiopia underlined the use of alcohol as contributing factors for sexual abuse (13). Similarly, the finding of this study revealed that, respondents having history of alcohol consumption, and those having drunken peers/friends were higher risk of experiencing sexual abuse than their counter part. Students who don’t drink alcohol were 70% less likely experienced sexual abuse than students who drink alcohol (AOR = 0.70; 95%CI: 0.28–0.97). Moreover, the odds of experiencing sexual abuse were 2 times higher for those respondents who had a close friend drinking alcohol (AOR = 2.0, 95%CI: 1.09–5.43) than their counter part. This finding also supported by the study conducted in Bahirdar town, Ethiopia (30). This could be explained by the fact that, alcohol leads to reduce the decision-making ability of an individual on her own sexual and reproductive health matters.
Some study findings show that socio economic characteristics has nothing to do with child sexual abuse. They found no significant link between child sexual abuse and socioeconomic background such as father’s occupation, residence (urban or rural), and average family monthly income (41).
Contrary to this, our study showed that, rural residence was strongly associated with child sexual abuse. But fathers occupation and education has no association with child sexual abuse.
Students from rural residence were 3.2 times more likely experiencing sexual abuse than those students from urban residence (AOR = 3.2: 95% CI: 3.02–4.51). Similarly, studies conducted in Bahir Dar city, and other part of Ethiopia, among female students showed, female students whose childhood background from rural areas were four times more likely to have had sexual abuse (AOR = 4.51, 95%CI: 1.67–12.16) (27, 30).
The possible explanation could be, students from urban, relatively have better access to information through youth associations, youth centers, the media and the environment itself. However, their counterparts from rural areas might lack such chances because of low awareness of the society which inhibits free and open discussion about reproductive and sexual issues. This can support the existence of sexual abuse.
The most frequently reported reproductive health consequences as a result of sexual abuse (rape) in this study were: 64 (37.9%) ended up with an unwanted pregnancy, 26.0% of them aborted, 39 (26.0%) of them developed STI (vaginal discharge), and 10.1% have had vaginal bleeding immediately after the act. This finding is similar with the study conducted in Harar high school students, which showed that unwanted pregnancy (44.2%), abortion (32.2%), vaginal discharge (28.6%), and genital trauma (25%), were the most common consequences of rape (31). Again, our study result was similar with the studies conducted in Addis Ababa and Debark town of north Gondar zone, which showed consequences of forced sex as reported by the respondents were: injury around the genitalia (33.3%), unusual vaginal bleeding (20%), pregnancy (16.7%), and swelling around the genitalia (13.3%) (35, 17).
This result is also supported by the qualitative findings. A 40 years male key-informant health worker said that “…. a number of students come to health facility for examination had faced some sort of complications after being raped; genital tear and bleeding if examined immediately, unwanted pregnancy, abortion, and STIs lately were the most common ones.
Limitations of the study
Since our study topic assesses personal and sensitive issues related to sexuality, this might have caused underreporting of experiences of sexual abuse. Thus, the findings of this study should be interpreted within these limitations.