Abstract
Background: Child sexual abuse means any kind of sexual contact with a child under the age of 18 years. It is a common and serious public health problem affecting millions of people each year worldwide. It is the most neglected and least documented form of violence in Ethiopia among school girls. So, this study aimed to assess the magnitude and its associated factors among high school female students in Dire Dawa, Eastern Ethiopia.Methods: An institutional-based, cross-sectional study was conducted, March, 1-23/2021. A stratified multistage sampling technique was used for quantitative data and 794 participants from selected high schools were included. A pre-tested, self-administered questionnaire was used, and data were analyzed using SPSS software version 24. For qualitative data, sixteen in-depth interviews and five focus group discussion were conducted and analyzed thematically. Result: The magnitude of at least one form of sexual abuse were 384 (48.9%), of these, 150 (19.1%) were rape. 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. The odds of experiencing life time sexual abuse among students of rural residence were 2 times higher than their urban counter part (AOR=2.1; 95% CI: 1.79-3.45). Students who don’t drink alcohol were 70% more protective than those who drink alcohol (AOR=0.70: 95% CI: 0.28-0.97).Conclusion: This study revealed that the magnitude of child sexual abuse among female students in Dire Dawa is high. Lack of discussion about sexual issue with parents, living without both parents, drinking alcohol, being rural residence had significant association with child sexual abuse. Unwanted pregnancy, abortion, and STIs were the most common reproductive consequences of sexual abuse. So, community-based comprehensive awareness creation on sexual and reproductive health issues, are recommended especially, at rural area.