Violência sexual infantil no Brasil: uma análise utilizando os dados do Sistema de Informação de Agravos de Notificação (SINAN) de 2011 a 2021 e capacitação sobre abuso infantil

Abstract

Sexual violence against children is a rights violation frequently observed in the Brazilian social context. The incidence of this type of violence is alarming, especially among children aged 0 to 9 years, with severe long-term physical and psychological consequences. Brazil has been striving to combat this violence through policies and laws, emphasizing the importance of the comprehensive protection of children within the Unified Health System. Collaboration among professionals and sectors is crucial for the protection of children, with the role of the Information and Notification of Diseases (SINAN) system being particularly noteworthy in collecting epidemiological data and planning health actions. The aim of the study was to describe reported cases of child sexual violence using public SINAN data and to compare rates by age group (0-4 and 5-9 years) and sex, in Brazil and its regions from 2011 to 2021. Additionally, the study aimed to develop a technical training product on child abuse for health professionals, educators, social workers, guardianship counselors, and managers. This is an epidemiological, retrospective, observational study described through secondary, publicly available data from SINAN. Case proportions were obtained to characterize the victim, the occurrence, and the perpetrator. Notification rates were calculated by sex and age group for each year and Brazilian region, and rate ratios were obtained for comparison between groups. During the period, 107,250 cases were reported, with rape being the most frequent type of sexual violence (69,8%). Higher proportions of notifications were observed for children aged 5 to 9 years (55.5%), female children (75,6%), black race (53,8%), occurring in residences (88,9%), and recurrent cases (52,9%). In both age groups, the highest proportions of cases were observed among female children, where the perpetrator was an acquaintance/friend, followed by the father and stepfather. Notification rates were higher for females, regardless of age group, with rate ratios ranging from 2.0 to 7.52. Additionally, the rate ratios for child sexual violence between girls and boys were higher in the 0-4 years age group compared to the 5-9 years group. There was regional variation in Brazil with lower notification rates in the Northeast region. Regarding the technical product, training participants discussed with the FAO/UFMG Professional Master's team about the identification and notification of child abuse, pointing out barriers and facilitators for addressing child abuse, as well as clarifying doubts about the notification flow with interactive and participatory methodologies. This study concluded that child sexual violence was high, primarily affecting girls aged 0-4 years, with regional disparities and lower rates in the Northeast region, and the training conducted was evaluated by participants as very good/good with suggestions for new trainings.