GPs have an important role in child protection and are often the first professionals to raise concerns. Studies that may help us identify those children at most risk need careful attention.

This paper, from Philadelphia, indicates that boys growing up in one-parent families are twice as likely to report sexual abuse as boys from two-parent families. The study initially recruited 298 men, though around a third dropped out, leaving a more highly educated remainder of 197.

Of these 186 lived with at least one parent.

The study found that men from one-parent families were more likely to have been sexually abused by a woman, and by someone who was not a relative. Female baby-sitters were cited as the perpetrators in several cases.

On the other hand, men from two-parent families were more likely to have been sexually abused by a man, and also more likely to have been sexually abused by a relative. The suggestion is that, because one-parent families need additional support, the involvement of third parties coming into the home may put boys at increased risk.

There are some concerns about this study, including the relatively small number of men identified, the high dropout rate and the social background: the study took place in a relatively impoverished area with a high incidence of HIV seroconversion. How representative was this population, and is the study applicable to the UK?

There were other flaws. The history of parenting was a 'summary', with the man being asked to indicate whether his childhood was with one or two parents. In many cases matters would have been far more complex.

Nevertheless, the study does emphasise that one-parent families are under increased stress, a fact that is well recognised by GPs, and that this may have implications for the risk of sexual abuse. It would be good to see some work on this topic from the UK.

Holmes WC. Men's childhood sexual abuse histories by one-parent versus two-parent status of childhood home J Epidemiol Community Health 2007;61:319-325