One in four girls and one in six boys will become victims of child sexual abuse by the time they reach the age of 18; most at the hands of someone they know and trust. Data from the Pennsylvania Department of Public Welfare Child Abuse Report indicate that most perpetrators of child sexual abuse are fathers (19 percent), followed by babysitters, other household members, paramours of parents, and siblings. Only about half of child victims report their sexual victimization to an adult. The impact of child sexual abuse on victims is discussed and includes such negative outcomes as teenage runaways, prostitution, increased cases of chronic pain and illness, and mental health disorders. Child sexual abuse emerged into the public consciousness in the 1970s as activists began defining the problem as one of social oppression and violence against women. Since then, the focus has shifted from discovering the extent of the problem and its consequences to seeking prevention strategies that address the risk factors for child sexual abuse. The Pennsylvania Coalition Against Rape's (PCAR's) HERO Project is described, which actively educates and encourages adults to take action to prevent child sexual abuse, as is PCAR's Vision of Hope Fund to promote strategies and activities that encourage adults to take responsibility and accountability for the prevention of child sexual abuse. Contact information is offered for more information about the programs. Endnotes