Sexual Abuse and Sexual Exploitation
Sexual Abuse is defined in the Care Act 2014 Care and Support Statutory Guidance as:
- Rape.
- Indecent exposure.
- Sexual harassment.
- Inappropriate looking or touching.
- Sexual teasing or innuendo.
- Sexual photography.
- Subjection to pornography or witnessing sexual acts.
- Indecent exposure.
- Sexual assault.
- Sexual acts to which the adult has not consented or was pressured into consenting.
Facts and figures
- 798,000 women are raped or sexually assaulted every year. That is 1:30 women. Source: Office for National Statistics (2023).
- There were in the region of 1,000 sexual offences reported to police in Lewisham in the 12 months to December 2024.
- More than 1:4 women have been raped or sexually assaulted as an adult and 1:18 men. Source: Office for National Statistics (2023).
- 5:6 women who are raped do not report to police and 4:5 men. Source: Office for National Statistics (2021)
- Lots of these survivors tell someone else what happened. So, why don’t they tell the police?
- 40% said ‘embarrassment’.
- 38% said they did not think the police could help.
- 34% said they thought it would be humiliating.
- Less than 5% of Safeguarding Enquiries conducted in Lewisham and England are for Sexual Abuse and less than 1% for Sexual Exploitation. This has remained relatively unchanged for the last 7 years.
- The overall volume of local authority led Safeguarding Enquiries in Lewisham has more than doubled in the last 7 years.
- Adults aged 65+ are 10 times more likely to be the subject of a Safeguarding Enquiry in Lewisham than those aged under 65.
- Data from the Crime Survey for England and Wales (CSEW, 2019) indicates that people living with a disability aged 16 to 59 are almost twice as likely to have experienced sexual assault in the past year than non-disabled people.
- Around 1:3 adults living with a learning disability experience sexual abuse in adulthood (four times higher than the general population). Behind Closed Doors: Preventing sexual abuse against adults with a learning disability
- Research highlights significant under-reporting of sexual abuse in care settings. Sexual Abuse in Care Homes - SCIE
- 35,000 sexual safety incidents were reported to 212 NHS trusts in England between 2017 and 2022. 58% involved patients abusing staff, with patients abusing other patients the next most common type of incident (20%). British Medical Journal
- Detailed research found in 2023 that roughly 10% of women and 3% of men with severe mental illness had experienced recent sexual violence. Ministry of Justice: Formal support needs of disabled adult victim-survivors of sexual violence
"Rape and sexual assault can happen to anyone at any age, from the very young to the very old".
What to do if someone tells you they have been sexually abused - including historical abuse
When someone tells you they have been sexually assaulted or abused, it can be a lot to handle. A supportive reaction is essential to diminish any shame or blame that person might be feeling as a result of experiencing sexual abuse. Encouraging words and phrases can avoid judgment and show support.
The most important thing that you can do is to listen empathetically and tell the person that you believe them. Acknowledge the harm done to them and recognise the courage and strength it has taken for that person to disclose to you.
If the person is still in contact with the perpetrator, try to avoid saying anything negative about them as the person may still have complicated feelings about the perpetrator. Instead, focus on the victim-survivor and what they need now to help them:
- Be honest that you will have to tell somebody about some of what you have been told.
- Include the victim-survivor as much as possible with information sharing, such as telling them exactly what details you need to share, who with and when. Offer the option to be present when you share information.
- Reassure the person that they are doing the right thing by telling you.
- It is important to let them know that they have not done anything wrong and will not get into trouble.
- Try and establish if the person is still at risk of harm from the perpetrator, or if any other person is, by asking gentle exploratory questions, for example: ‘Are you comfortable sharing with me how you know this person?’ or ‘Are you worried it will happen again?’
- Think Family and follow child safeguarding procedures if relevant.
- If the person is not comfortable disclosing certain information or does not want to, then that is okay. You should not try and pressure them for information.
- Follow the guidance on 'How to Respond' outlined below.
- Do not assume someone else has raised concerns or has shared the same information that you have.
- Let the person know that they do not have to talk about what happened with anyone unless they want to.
- Offer to support or assist them if they want to make a report themselves.
- Avoid pressuring them into disclosing to someone else but offer to support them if they want to do so
- Do not suggest that they are responsible for the behaviour of the perpetrator. Avoid phrases such as: ‘If you don’t report this it could happen to someone else.’
- If you do not know something, say that you do not know and offer to find out. You are not expected to have all the answers.
Supporting Survivors – The Survivors Trust
How To Support A Survivor - The Survivors Trust
Sexual violence in later life
Both women and men can be victims of sexual offences, although most recorded offences involve a female victim and male offender. Offenders can be partners, spouse, family members, acquaintances, neighbours, friends or strangers.
Research found that most offenders were known to victims, and most were younger than victims.
Research found that most rapes happened in the victim’s home, however sexual offences can also be perpetrated in other locations including the offender’s home, or other private, or public, places. They can also happen in care homes; the second most common location in the research was a care home.
Rape of Older People in the United Kingdom: The British Journal of Criminology
Hourglass is a charity that aims to end the harm, abuse, and exploitation of older people in the UK. Hourglass recently hosted The Sexual Abuse of Older Adults - Webinar 2025 which included some excellent speakers talking about this subject and the extent of this problem, which is significantly under reported/ researched.
This presentation from the London SAB Conference in November 2024 also links to this subject: Systematic Invisibility of Older Victims of Domestic Abuse - Amanda Warburton-Wynn
What is Adult Sexual Exploitation?
There is no national definition of Adult Sexual Exploitation (ASE) and this is often only seen as a form of sexual abuse, but there are differences and this is a distinct and separate type of abuse.
Adult Sexual Exploitation occurs where a person or a group of people (including grooming gangs) take advantage of someone else, normally using an imbalance of power, to coerce, manipulate or deceive an adult into sexual activity:
- In exchange for something the adult needs or wants (food, drugs, money, cigarettes etc); and or
- For the financial advantage or increased status of the perpetrator.
“Sexual exploitation happens when a person is coerced, forced or manipulated into engaging in sexual activities”
The adult may have been sexually exploited even if the sexual activity appears consensual. It is important to note that those living with *mental ill health and/or a learning disability may appear to consent to sexual activity but may lack capacity to do so. Lewisham Safeguarding Adults Board - Mental Capacity, DoLS and Advocacy
* The Sexual Offences Act 2003 contains a number of offences in relation to those who have a mental disorder.
ASE does not always involve physical contact; it can also occur through the use of technology:
- Being forced to take part in or watch pornography.
- Being victim to revenge porn - when a previously taken video or photograph, which was taken with or without consent, is shared online.
- Sextortion – which is a type of online blackmail where criminals threaten to share sexual pictures, videos, or information. Victims are often tricked into sharing sexual images or the abuser has hacked into a victim’s electronic device(s).
- More broadly, the internet acts as an enabler of trafficking for sexual exploitation: 75% of victims of trafficking for sexual exploitation are advertised online. This is often in the form of Adult Service Websites (ASWs) - which are unregulated. These can allow traffickers to anonymously advertise victims of sexual exploitation. Independent Anti-Slavery Commissioner
It is important to understand the difference between a capacitated adult consensually engaging in ‘sex work’ and an adult who takes part in sexual activity as a result of being exploited.
Many leading charities argue that more effort is needed to completely eliminate sex work or ‘survival sex’ which links in with the wider initiatives to end violence against women and girls.
UK charity working to end sexual exploitation | Beyond The Streets
Sexual Exploitation can happen in lots of different ways, including:
- Sex for rent arrangements, where a landlord offers accommodation in exchange for sexual activity.
- Being forced to exchange sex for money, accommodation, food in order to survive – also known as ‘survival sex’.
- Being coerced into the sex industry by a third party – such as a partner or friend.
- Being coerced into unwanted sexual activities with third parties by a partner, family member or friend.
- Being trafficked for the purpose of performing sexual acts. Lewisham Safeguarding Adults Board - Modern Slavery & Human Trafficking
What is grooming?
Grooming happens when someone builds a relationship or connection with a person in order to abuse or exploit them.
This might appear as forming a friendship, offering help with money or housing, or creating dependency on the groomer. This position of trust is then used to coerce someone into exploitation, often under the pretence of repayment for the help provided.
It is important to remember that exploitation can still be happening, even if the sexual activity appears to be consensual.
Who are the victims of Adult Sexual Abuse and Adult Sexual Exploitation (ASE)?
While the majority of victims are women, men can also experience sexual abuse and ASE. Adults can be groomed and sexually exploited in many different ways, e.g. online, street, gangs, leisure industry, religion, position of authority, celebrity. Perpetrators may work together in groups, or as individuals. At one end of the scale adult sexual exploitation can be described as a one-off situation between two adults, while at the other end it may include instances of Serious and Organised Crimes (SOC) with multiple adults and/or multiple perpetrators. The common theme in all cases is the imbalance of power and the control exerted over the victims.
Risk or vulnerability factors (not exhaustive):
- Age: Older adults can be victims: Sexual Incidents in Adults Social Care; Evidence Review Briefing - SCIE
- Cognitive impairment.
- Isolation, lack of strong social networks.
- Breakdown of family relationships.
- Victims of domestic abuse/ coercive and controlling behaviour including force marriage. Lewisham Safeguarding Adults Board - Domestic Abuse and Safeguarding
- Lack of engagement or inconsistent engagement with support networks.
- History of local authority care (looked after children).
- Previous trauma or experience of abuse as a child.
- Low self-esteem.
- Bereavement or loss.
- Adults who are ‘missing’, and in particular repeated missing episodes.
- Dependency on the alleged perpetrator (including caring responsibilities).
- Substance misuse or dependency.
- Victims coerced into county lines (drug gangs) activity. Lewisham Safeguarding Adults Board - County Lines & Cuckooing
- Learning disability or difficulty.
- Mental ill-health.
- Insecure housing or homelessness (including rough sleeping).
- Insecure immigration status.
- No recourse to public funds.
Sexual exploitation has a very serious effect on the physical and mental health of adults.
Physical and sexual violence can lead to victims having long-term injuries that impact on their ability to have children, and mental health problems that have a lasting and severe impact on the person.
Sexual Harassment
"Sexual harassment is unwanted behaviour of a sexual nature which makes the victim feel intimidated, humiliated or that their dignity has been violated".
These unwanted behaviours may only happen once or be an ongoing series of events. Objecting is not a prerequisite for defining an event or pattern of behaviour as harassment. Even if the perpetrator did not mean to offend, having the effect without intent is sufficient for the behaviour to be categorised as sexual harassment. Sexual harassment may include sexual comments or jokes; sexualised emails; displaying photos of a sexual nature; unwelcome sexual advances and various forms of sexual assault. Sexual harassment is a form of unlawful discrimination under the Equality Act 2010. Defining sexual exploitation and abuse and sexual harassment | UNHCR UK
Why don’t victims just tell someone?
Victims can be fearful of perpetrators and the potential consequences if they refuse sex. They may feel it is ‘safer’ to comply. Perpetrators may intimidate their victims so that they don’t talk to professionals.
Victims can depend on perpetrators to provide a roof over their head, money, food, drugs or alcohol. This makes it more difficult for them to report abuse or escape because they rely on them for their basic care needs.
Victims may witness/be involved in crimes and do not often report to services for fear of going to prison or being deported.
Victims may have been groomed and sexually exploited as a child and as an adult their understanding of ‘normal’ relationships can be misconstrued, truly believing that they are consenting to sex. They may not believe they are a victim at all or understand that they are being exploited.
Lack of prosecutions can lead to victims feeling unsafe/ withdrawing their statements and can increase the perpetrators’ power over them.
How to Respond?
- Follow the detailed guidance in the Lewisham Adult Safeguarding Pathway:
- Talk to the adult (unless it is not safe to do so).
- If the adult does not wish to report the abuse: Are they in immediate danger or risk of serious harm?
Has a crime been committed? If so, and the adult is in immediate danger or risk of serious harm, then this should be reported to the Police immediately. Help to keep the adult safe until the Police respond. The adult does not need to give their consent under these circumstances due to ‘vital interest’ considerations (immediate danger or risk of serious harm).
- If it is reported as a crime still consider reporting the incident as a Safeguarding Concern.
- Refer to the Think Family page where you will find the Lewisham Think Family Protocol, the Think Family Practice Guidance and resources.
- Consider if this matter meets the Section 42 (1) criteria within the Care Act 2014 as a Safeguarding Concern:
a. do I have reasonable cause to suspect that the adult has needs for care and support; and
b.do I have reasonable cause to suspect that the adult is at risk, or, experiencing abuse or neglect.
It must be noted that the third criteria (c) under the legal duty for a Section 42 Enquiry (1) is not relevant 'for the referrer' at the Concern Stage. This is for the local authority to determine, but referrers should pass on any evidence to help support decision making.
c. as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it.
- Seek the adult’s consent to submit a Safeguarding Concern to the Local Authority.
- Gather as much information as possible.
- Submit the Adult Safeguarding Concern. How to Report Your Concerns About an Adult
Do not ignore sexual abuse in hospitals or care settings, including incidents between patients and residents: Lewisham Safeguarding Adults Board - Safeguarding in Care Homes Guidelines and Tools
Think about what support can be offered to the victim (see below).
Sexual Assault Referral Centres (SARCs)
SARCs provide a safe space and dedicated care, through the NHS, for people who have been raped, sexually assaulted or abused, regardless of when the incident happened. They offer specialist practical, medical and emotional support 24/7.
SARCs offer a range of services, including crisis care, medical and forensic examinations, emergency contraception and testing for sexually transmitted infections. They can also arrange access to an independent sexual violence advisor, as well as referrals to mental health support and voluntary sector sexual violence support services.
There are three SARCs in London – The nearest to Lewisham is Camberwell Haven, near to King’s College Hospital The Havens
Rape Crisis South London
Rape Crisis South London are a registered charity and a member of Rape Crisis (England and Wales) we run the national Rape Crisis Helpline, and provide specialised counselling, support and independent advocacy for women who have experienced sexual violence both recently and/or in the past. Our helpline also provides information, referrals and short term support to family, friends and partners of survivors.
For confidential, free and specialist support please contact the 24/7 Rape and Sexual Abuse Support Line on 0808 500 222
For general enquiries: info@rasasc.org.uk
For confidential, free and specialist support please contact the 24/7 Rape and Sexual Abuse Support Line on 0808 500 2222
National Association for People Abused in Childhood (NAPAC)
NAPAC offers support to adult survivors of all types of childhood abuse, including physical, sexual, emotional abuse or neglect. Information including opening hours can be found on NAPAC’s website which offers a large range of resources for survivors, as well as those who care for and work with them. NAPAC also offer a support email service for those who feel more comfortable seeking support in writing.
Private and confidential helpline: 0808 801 0331
Email: support@napac.org.uk
Victim Support
Victim Support operates a free and confidential 24/7 Support Line offering specialist support to anyone who has been a victim of crime or a witness.
Telephone: 0808 16 89 111
Live chat: victimsupport.org.uk/live-chat
My Support Space: mysupportspace.org.uk/MoJ
More information can be found at www.victimsupport.org.uk
The Survivors Trust
The Survivors Trust provides confidential information, advice and support for women, men and young people, their parents/carers or partners via a helpline or email.
Telephone: 08088 010818
Email: info@thesurvivorstrust.org
More information including opening hours can be found at www.thesurvivorstrust.org
National Male Survivor Helpline and Online Service
The National Male Survivor Helpline is a confidential helpline for male victims of sexual violence and abuse. They also provide emotional support via telephone, SMS (text), live chat and email.
Telephone: 0808 800 5005 Email: support@safeline.org.uk Text: 07860 065187
Please access our live chat service via our website at https://www.safeline.org.uk/contact-us
Now open 7 days a week. For more information, including specific opening hours, visit www.safeline.org.uk
Galop - for members of the LGBT+ community
If you are a member of the LGBT+ community and experienced sexual assault, abuse, or violence, Galop runs a specialist helpline.
Telephone: 0800 999 5428
Email: help@galop.org.uk
More information including opening hours can be found at Galop.