Impact of the COVID-19 pandemic on child sexual abuse visits in primary health care services in Brazil

Background: During the COVID-19 pandemic, risk factors for child sexual abuse (CSA) increased, yet no study has examined its impact on primary health care (PHC) attendance in Brazil. Purpose: This study assessed how the pandemic affected consultations for sexually abused children in PHC services. Research Design, Study Sample, and Data Collection: We conducted a cross-sectional ecological analysis using data from the Primary Care Health Information System, evaluating monthly consultations for children aged 0–9 from 2017-2020. Analysis: Consultation rates per 100,000 children during April–December 2020 were compared with pre-pandemic period using the Mann–Whitney U test. Month by month rates during the pandemic were compared with the historical limits using 95% confidence intervals. Results: 5,097 consultations of sexually abused children were studied – 25.1% during the pandemic, 79.8% girls and 58.4% 5–9 years old. Considering the first 9 months of the pandemic (overall), the monthly consultation rates fell among boys aged five to nine (35.1%; p < .05). However, considering each of the months included in the study, monthly consultations for abuse exceeded the historical upper limits among younger girls in the fifth and sixth months, among older girls in the seventh and ninth months, and among younger boys in the sixth month. Overall, during the first nine months of the pandemic, consultation rates for CSA decreased significantly among boys aged 5–9 years, while month-specific increases above historical upper limits were observed among girls and younger boys. Conclusions: Measures to mitigate barriers to accessing PHC for CSA need to be considered in preparation for future pandemics.