Prevalence estimates and nature of online child sexual exploitation and abuse: a systematic review and meta-analysis

Deborah Fry; Anna Krzeczkowska; Jungru Ren; Mengyao Lu; Xiangming Fang; Into the Light Index Study Group

doi:10.1016/S2352-4642(24)00329-8

Prevalence estimates and nature of online child sexual exploitation and abuse: a systematic review and meta-analysis

Lancet Child Adolesc Health. 2025 Jan 21:S2352-4642(24)00329-8. doi: 10.1016/S2352-4642(24)00329-8. Online ahead of print.

Authors

Deborah Fry¹, Anna Krzeczkowska², Jungru Ren³, Mengyao Lu¹, Xiangming Fang⁴; Into the Light Index Study Group

Collaborators

Into the Light Index Study Group:
Deborah Fry, Anna Krzeczkowska, Niall Anderson, Jingru Ren, Mengyao Lu, Wuwenhao Jin, Wei Liu, Inga Vermeulen, Ashleigh McFeeters, Arturo Harker-Roa, Katherine Jaramillo Diaz, Zain Kurdi, Maria Paula Marmolejo Lozano, Louis Olié, Sabina Savadova, Shuangyue Shangguan, Jinjin Zhang, Hanqing Zhu, Yuchen Zhu, Yaoyue Lu, Jiaming Hu, Jingxin Liu, Xudong Gong, Bridget Steele, Xiangming Fang

Affiliations

¹ Global Child Safety Institute-Childlight, University of Edinburgh, Edinburgh, UK; Usher Institute, University of Edinburgh, Edinburgh, UK.
² Global Child Safety Institute-Childlight, University of Edinburgh, Edinburgh, UK.
³ The Center for Health Economics and Policy, China Agricultural University, Beijing, China.
⁴ The Center for Health Economics and Policy, China Agricultural University, Beijing, China; School of Public Health, Georgia State University, Atlanta, GA, USA. Electronic address: xfang1@gsu.edu.

PMID: 39855238
DOI: 10.1016/S2352-4642(24)00329-8

Abstract

Background: Online child sexual exploitation and abuse (OCSEA) is a global health issue. The aim of this global systematic review and meta-analysis was to better understand the prevalence and nature of OCSEA on a global scale.

Methods: Comprehensive literature searches were done in six UN languages (Arabic, Chinese, English, French, Russian, and Spanish) and multiple databases, for records published between Jan 1, 2010, and Sept 30, 2023. Studies were evaluated independently by two different authors for inclusion according to eligibility criteria. Eligible studies included children younger than 18 years or adults retrospectively reporting OCSEA. Studies used general population samples and were representative at the national and sub-national level. Risk of bias in prevalence studies was assessed and a synthesis of the findings produced. A random-effects model was conducted for meta-analysis of studies to calculate prevalence estimates with 95% CIs for past year recall and lifetime recall of four OCSEA subtypes and overall OCSEA (from studies that measured at least three different sub-types within the same sample). This study was pre-registered with Open Science Framework (osf.io/6vux2).

Findings: Of the 47 097 records derived from literature searches, 86 records reporting on 123 studies were included in this systematic review and meta-analysis. Pooled mean prevalence for past year recall of OCSEA subtypes was estimated: online solicitation (12·5% [95% CI 10·5-14·7]); non-consensual taking, sharing, and exposure to sexual images and videos (12·6% [9·7-16·2]); online sexual exploitation (4·7% [2·9-7·3]); and sexual extortion (3·5% [1·9-6·4]). The mean prevalence of past-year recall for overall OCSEA was 8·1% (4·9-13·0). Heterogeneity of individual estimates was high, influenced by research design factors including the method of data collection and variability in definitions used.

Interpretation: Heterogeneity in prevalence estimates identified across studies and regions indicates that more research is required to draw stronger conclusions about the scale of OCSEA. However, the findings of this study are of great relevance to policy makers, practitioners, and researchers to make informed decisions about allocating resources and designing effective prevention and response programmes to protect children worldwide.

Funding: The Human Dignity Foundation.