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

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.