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Mercera G, Kooijmans R, Leijdesdorff S, Heynen E, van Amelsvoort T. Risk and Protective Factors for Sexual Exploitation in Male and Female Youth From a Cross-Cultural Perspective: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1966-1984. [PMID: 37818954 DOI: 10.1177/15248380231201815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Youth are at elevated risk of becoming victims of sexual exploitation, which has a detrimental impact on their physical and psychological well-being. Understanding factors associated with sexual exploitation is key for prevention efforts and adequate and timely treatment. This systematic review sheds more light on this by providing an overview of both risk and protective factors for sexual exploitation in male and female youth from a cross-cultural perspective. In all, 65 studies were selected meeting the inclusion criteria: qualitative or quantitative peer-reviewed studies in English, Dutch, or German with findings on risk and protective factors associated with sexual exploitation in youth aged up to 24 years. Results show that there are common risk factors in male and female youth worldwide (e.g., adverse childhood experiences, lack of a social network, substance use, and running away). Positive and supportive relationships are an important protective factor in mitigating the risk of sexual exploitation. Geographic differences were found. In non-Western continents, more environmental factors (e.g., economic vulnerabilities, residential instability) were cited. Research in countries outside the United States is limited and protective factors and males are underexamined. To fully understand vulnerabilities in youth, their interactions, and possible gender differences and to address the needs of diverse populations, more insight should be gained into the broader range of risk and protective factors worldwide. This systematic review has made a valuable contribution to this by providing practice, policy, and research guidance in the establishment of more targeted prevention efforts, adequate treatment, and areas to address in future research.
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Affiliation(s)
- Gabriëlle Mercera
- Koraal Center of Expertise, Sittard, The Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
| | - Roel Kooijmans
- Koraal Center of Expertise, Sittard, The Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, The Netherlands
| | - Sophie Leijdesdorff
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
| | - Evelyn Heynen
- Department of Clinical Psychology, Open University, Heerlen, The Netherlands
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Roe-Sepowitz D, Lantsman-Waugh M, Puigvert L, Merodio G, Melgar P. Dating Violence Experiences Among Sex-Trafficking Youths in Juvenile Detention. Violence Against Women 2024:10778012241259716. [PMID: 38860339 DOI: 10.1177/10778012241259716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
Juvenile justice involvement is a risk factor for sex trafficking, as is teen dating violence (TDV). However, little is known about how TDV victimization correlates with sex-trafficking victimization among girls in juvenile detention. This study was conducted with 111 detained female minors from two Arizona juvenile detention centers. All female detainees were screened for sex-trafficking risk factors by a clinical staff member and completed a series of surveys about their life experiences and a dating violence history survey. Nearly half of the participants, 42.3% (n = 47), reported having experienced sex trafficking. Girls in juvenile detention who reported sex-trafficking victimization were significantly more likely to report higher scores on the TDV scale.
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Raj A. Streamlining healthcare delivery for sex-trafficked adolescents. Curr Probl Pediatr Adolesc Health Care 2024; 54:101553. [PMID: 38161099 DOI: 10.1016/j.cppeds.2023.101553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Recent years have elucidated that trafficking in the pediatric population constitutes a broader pattern of child maltreatment. Given the inconsistent engagement with the medical system that trafficked youth can experience, there is growing advocacy promoting streamlined provision of specialized services. One innovative example includes the Adolescent Protection Collaborative (APC) launched at the Children's Hospital of Philadelphia in 2021. The APC was conceptualized to serve the overlapping populations of youth impacted by sex trafficking victimization and child welfare involvement. In an effort to consolidate care and address a range of needs across the biopsychosocial spectrum, the APC brought together a child abuse pediatrician, adolescent medicine physician, and social worker to provide coordinated, real-time care during each clinic visit. It is hoped that the APC may represent a novel approach to balancing the medico-legal aspects of trafficking aftercare with the youth-empowering features of adolescent medicine and social care.
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Affiliation(s)
- Anish Raj
- WakeMed Children's Hospital, Raleigh, NC, United States; SAFEchild Advocacy Center, Raleigh, NC, United States.
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Jones J, Testa A, Jackson DB, Nagata JM, Ganson KT. Sex Work and Educational Mobility: Results from the National Longitudinal Study of Adolescent to Adult Health. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:9-15. [PMID: 37845418 DOI: 10.1007/s10508-023-02709-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/18/2023]
Abstract
The purpose of the study was to assess the relationship between sex work involvement and education mobility among a national sample of US young adults. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 7732) were analyzed to explore the prospective association between lifetime sex work involvement measured in young adulthood (Wave III; ages 18-26) and educational mobility measured in adulthood (Wave V; ages 33-43). Multinomial logistic regression analyses were conducted, adjusting for relevant demographic and control variables. Results indicated that young adults who reported ever having been paid for sex by the ages of 18-26 had twofold greater risk (95% confidence interval 1.26-3.18) of having downward educational mobility compared to a stable level of education, or the same education, relative to their parents in adulthood. Given that education, by means of regular social connectedness to social supports, may be the most salient resiliency factor protecting adolescents from potential risks associated with sex work involvement (e.g., stigma, isolation from services), the findings from this study support the promotion of inclusive engagement from school settings to foster educational attainment and prevent poorer health and psychosocial outcomes that research to date has associated with sex work involvement.
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Affiliation(s)
- Jori Jones
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S 1V4, Canada.
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S 1V4, Canada
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Raj A, Krass P, Hackett K, Green S, Wood JN. Integrating Social Care Into a Specialized Medical Home for Sex-Trafficked Youth. Pediatrics 2024; 153:e2023062394. [PMID: 38124620 DOI: 10.1542/peds.2023-062394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 12/23/2023] Open
Abstract
After a series of meetings between medical personnel and community stakeholders, the Children's Hospital of Philadelphia successfully launched the Adolescent Protection Collaborative in July 2021. This novel clinic created a specialized medical home for sex-trafficked youth. The clinic was staffed by a core team of child abuse pediatrics and adolescent medicine physicians and a social worker who provided coordinated evaluations and same-day services, followed by ongoing long-term care. The Adolescent Protection Collaborative model was built on interdisciplinary collaboration with the goal of consolidating medical services and reducing fragmentation of care. A Community Advisory Committee was formed and aided in linking interested youth with additional services. Healthcare navigation was facilitated through support of a clinic-specific social worker, and transportation barriers were largely eliminated through a grant-funded program. Pilot data from the initial 21 months of clinical operations revealed that 88% of 43 referred patients (ages ranging from 13-22 years with a mean of 16 years) attended a scheduled appointment with 55% returning for follow up. Most patients (68%) identified as Black. All (100%) had past or present involvement with child protective services. Fifty percent of referrals tested positive for a sexually transmitted infection with a total of 33 sexually transmitted infections diagnosed and treated. Patient-desired contraception was facilitated for approximately 67% of referrals. Social care needs, such as referrals for educational support, case management, housing and employment resources, and mental health linkages, were offered alongside standard medical services. The described clinic model demonstrates promise in meeting the unique healthcare needs of sex-trafficked youth.
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Affiliation(s)
- Anish Raj
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Polina Krass
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kali Hackett
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sarah Green
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Joanne N Wood
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Laird JJ, Klettke B, Hall K, Hallford D. Toward a Global Definition and Understanding of Child Sexual Exploitation: The Development of a Conceptual Model. TRAUMA, VIOLENCE & ABUSE 2023; 24:2243-2264. [PMID: 35603675 DOI: 10.1177/15248380221090980] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Child sexual exploitation (CSE) is a serious and persistent global issue affecting up to 5% of the child and youth population worldwide; yet there is no universally accepted definition. To develop a theoretically robust definition of CSE, this review systematically synthesized literature examining CSE definitions aiming to develop a conceptual model and typology. Electronic databases were searched to February 2021, yielding 384 nonduplicative records. Inclusion criteria were peer-reviewed and grey literature investigations of sexual exploitation, with a mean sample age of 18 years or younger, available in the English language. Literature review and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Sixty-six studies met final inclusion criteria. Two independent reviewers extracted relevant data and used an epistemological approach to thematically analyse meaning and patterns across CSE definitions. Key findings demonstrate that CSE nomenclature is widely inconsistent, and despite growing awareness of this severe form of abuse, language continues to perpetuate stigma and criminalisation, utilising terms such as 'adolescent or child prostitute'. Our findings propose a scientifically and trauma-informed definition and conceptualisation of CSE, based on the following four-dimensional components: (1) A child/young person; (2) sexual acts; (3) abuse; and (4) exploitation (abuse + exchange). In this systematic review, a unified definition and conceptual model aims to advance knowledge and understanding of CSE, contributing to the progression of social norms which embrace nuances of trauma-informed practice and support for the identification and recovery of children, young people and families affected by sexual exploitation.
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Affiliation(s)
- Jessica J Laird
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Bianca Klettke
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Addictive and Anti-social behavior Research, Deakin University Centre for Drug Use, Burwood, VIC, Australia
| | - David Hallford
- School of Psychology, Deakin University, Geelong, VIC, Australia
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Scott S, Lavage DR, Acharya G, Risser L, Bocinski SG, Walker EA, Randell KA, Ragavan MI, Miller E. Experiences of Exploitation and Associations With Economic Abuse in Adolescent Dating Relationships: Findings From a U.S. Cross-Sectional Survey. J Trauma Dissociation 2023:1-17. [PMID: 37183437 DOI: 10.1080/15299732.2023.2212404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Adolescent relationship abuse (ARA) (i.e. physical, sexual, psychological, or economic abuse in the context of romantic relationships) is associated with adverse health outcomes, including anxiety, depression, suicidality, unintended pregnancy, and substance misuse. A related phenomenon, reproductive coercion involves interference with the reproductive decision making of a partner with the intention of promoting pregnancy or controlling outcomes of a pregnancy. Reproductive coercion is associated with unintended pregnancy, partner violence, and sexually transmitted infections. Little is known about the intersection between economic ARA, sexual exploitation, and reproductive coercion. This paper explores the intersections between reproductive coercion, transactional sex, and economic abuse victimization in adolescent dating relationships. In an online survey, 1,752 adolescents (ages 13-17) were asked about economic adolescent relationship abuse (educational, employment and financial interference), transactional sex, reproductive coercion, and contraceptive access within their relationships. We assessed associations with chi-square tests and logistic regression analysis. Youth who experienced economic ARA (70%, 1,232) reported financial dependence on their partner, contraceptive access, and reproductive coercion (74-83%; p-values<0.001) more often than their counterparts without economic ARA. Adolescents experiencing economic abuse were more likely to report transactional sex (aOR = 2.76, CI [2.12, 3.60], p < .001), depending on a partner to pay for contraception or birth control (aOR = 2.20, CI [1.71, 2.84], p < .001), and reproductive coercion (aOR = 3.20, CI [2.37, 4.32], p < .001). Youth-serving providers and agencies should be aware of intersections between economic ARA, transactional sex, financial dependence, and reproductive coercion, particularly for adolescents with health-related social needs.
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Affiliation(s)
- Sarah Scott
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Daniel R Lavage
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Geeta Acharya
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Lauren Risser
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Elizabeth A Walker
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kimberly A Randell
- Department of Pediatrics, Children's Mercy, Kansas, Missouri, USA
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas, Missouri, USA
- Department of Pediatrics, University of Kansas School of Medicine, Kansas, Kansas, USA
| | - Maya I Ragavan
- Division of General Academic Pediatrics, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Meza JI, Godoy SM, Nguyen PT, Perris GE, Barnert ES, Bath EP. Risk profiles of suicide attempts among girls with histories of commercial sexual exploitation: A latent class analysis. CHILD ABUSE & NEGLECT 2023; 137:106036. [PMID: 36680963 PMCID: PMC10226678 DOI: 10.1016/j.chiabu.2023.106036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Girls impacted by commercial sexual exploitation (CSE) in the juvenile legal system are three times more likely to have suicide attempts than girls without histories of exploitation. Yet, research on risk profiles and correlates that contribute to elevated suicide risk among girls with CSE histories remains scant. OBJECTIVE We sought to examine suicide attempts profiles among CSE-impacted girls in the juvenile legal system. PARTICIPANTS AND SETTING We partnered with a specialty court for CSE-impacted youth in Los Angeles County. METHODS Data were collected from case files of the 360 girls participating in the court from 2012 to 2016. Latent class analysis was used to identify their profiles of risk indicators. RESULTS Four risk profiles for suicide attempts emerged: (1) Parental Incarceration (PI; 30 %), (2) Child Welfare Contact (CWC; 25 %), (3) Disruptive Behavior and Sleep Problems (DBS; 25 %), and (4) Pervasive Risk (PR; 22 %). Among youth in the PI group, 5 % had a suicide attempt; however, contrary to our hypothesis, no youth in the CWC group had a suicide attempt. Rates of suicide attempt were significantly higher among youth in the DBS group, as 14 % had a suicide attempt. As hypothesized, youth in the PR were associated with higher risk of suicide attempts, with 28 % reporting a prior suicide attempt. CONCLUSIONS Findings underscore the need for standardized suicide screenings and treatment referrals for girls with CSE histories and suggest an important opportunity for multidisciplinary collaboration with courts to improve suicide prevention strategies. The present study also supports the importance of examining risk across the socioecological context.
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Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 300 Medical Plaza Driveway, Room 3308, Los Angeles, CA 90095, United States.
| | - Sarah M Godoy
- School of Social Work, University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, 325 Pittsboro Street, Room 400-I, Chapel Hill, NC 27599, United States.
| | - Phuc T Nguyen
- Department of Psychology, UC Berkeley, Berkeley Way West Building, 2121 Berkeley Way, Berkeley, CA 94720, United States.
| | - Georgia E Perris
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA Semel Neuropsychiatric Institute, 760 Westwood Plaza, Room A8-232, Los Angeles, CA 90024, United States.
| | - Elizabeth S Barnert
- Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, UCLA Pediatrics BOX 951752, 12-467 MDCC, Los Angeles, CA 90095, United States.
| | - Eraka P Bath
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA Semel Neuropsychiatric Institute, 760 Westwood Plaza, Room A8-228, Los Angeles, CA 90024, United States.
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9
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Commercial Sexual Exploitation Outcomes in a Community Sample of Youth. J Adolesc Health 2023; 72:51-58. [PMID: 36224063 DOI: 10.1016/j.jadohealth.2022.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/16/2022] [Accepted: 08/31/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Researchers have suggested that victims of commercial sexual exploitation (CSE) have deleterious long-term outcomes; however, longitudinal trajectories of youth who experience CSE have not been explored. For the current study, the National Longitudinal Study of Adolescent to Adults Health (Add Health) survey was used to compare trajectories of youth who had experienced CSE with their nonexploited peers. METHODS Propensity score matching was used to match youth at waves 1 and 2 who experienced CSE and who did not experience CSE but had similar risk profiles. Youth with low-risk profiles were also matched. Our sample included 430 youth who experienced CSE, a matched sample of 430 youth who did not experience CSE but had a similar risk profile, and a sample of youth who did not experience CSE and had low-risk profiles (n = 782). Outcomes of interest included psychological, behavioral, physical, and interpersonal well-being. RESULTS Youth who had experienced CSE had higher levels of injection drug use, more police stops, more emergency room visits, and lower relationship satisfaction than their nonexploited peers. Well-being for individuals who experienced CSE as youth changed some over time, but those changes were comparable to the changes experienced by individuals of similar risk who did not experience CSE. Well-being measures for low-risk youth were universally higher compared to high-risk youth, regardless of CSE. DISCUSSION Youth receiving drug treatment, experiencing delinquency, or being seen in emergency medical settings may benefit from CSE screening, so that victims can be identified and provided immediate and comprehensive services.
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Baird K, Connolly J. Recruitment and Entrapment Pathways of Minors into Sex Trafficking in Canada and the United States: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:189-202. [PMID: 34184579 PMCID: PMC9660274 DOI: 10.1177/15248380211025241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The domestic sex trafficking of minors is occurring across Canada and the United States. Understanding the routes into sex trafficking, including the way traffickers target, recruit and enmesh youth in the sex trade is invaluable information for service providers and law makers developing prevention and intervention initiatives. This review synthesized research on the exploitation processes and tactics employed by traffickers in the sex trafficking of domestic minors in Canada and the US. The authors comprehensively and systematically searched five electronic databases and obtained additional publications and grey literature through a backward search of the references cited in articles reviewed for inclusion. Inclusionary criteria included: Studies published in the English language between January 1990 and June 2020 containing original research with quantitative or qualitative data on the recruitment or pathways into sex trafficking for minors trafficked within the US and Canada. The search yielded 23 eligible studies. The synthesis of the studies in the review converged on the notion of sexual exploitation occurring on a continuum comprising of three components; the recruitment context, entrapment strategies utilized by traffickers, and enmeshment tactics used to prolong exploitation. Findings highlight the significant physical, psychological and emotional hurdles faced by youth victims of sex trafficking and point to the importance of comprehensive and holistic approaches to prevention and intervention practices.
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Affiliation(s)
- Kyla Baird
- Department of Psychology, York University, Toronto, Ontario, Canada
- Kyla Baird, Department of Psychology, York
University, 268, Behavioral Sciences Building—BSB Keele Campus, Toronto,
Ontario, Canada M3J 1P3.
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Franchino-Olsen H, Silverstein HA, Kahn NF, Martin SL. Physical Disabilities and Low Cognitive Ability Increase Odds of Minor Sex Exchange among Adolescent Males in the United States. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:967-986. [PMID: 36380509 PMCID: PMC10731614 DOI: 10.1080/10538712.2022.2146560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/02/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Disability is a well-established risk factor for sexual violence victimization among both male and female children. Some research indicates that adolescent females with disabilities are at higher risk of experiencing minor sex exchange (a form of minor sex trafficking victimization) compared to females without disabilities, but there is a dearth of similar research among adolescent males. This study investigates whether physical disability and low cognitive ability are related to sex exchange among minor adolescent males. This cross-sectional analysis using data from a nationally representative cohort study, The National Longitudinal Study of Adolescent to Adult Health (Add Health), included 4,401 male participants who were age 18 or younger at Wave II. Unadjusted and adjusted logistic regression models estimated the odds of adolescent experiences of sex exchange by physical disability and cognitive ability. Both severe physical disability and low cognitive ability in adolescent males were significantly associated with increased odds of exchanging sex, results similar to those found in studies of adolescent females. Because of these associations for both males and females, disability should be taken into account when designing and implementing prevention and intervention programs related to sex trafficking. These results underscore the importance of addressing system-wide gaps contributing to the relationship between disability and the involvement of minors in commercial sex exchange.
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Affiliation(s)
| | - Hannah A Silverstein
- Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Nicole F Kahn
- Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Sandra L Martin
- Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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12
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Trinidad AC. Double-Edged Sisterhoods: Transgender Identity, Peer Groups and the Commercial Sexual Exploitation of Transgender Girls. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:948-966. [PMID: 36217646 DOI: 10.1080/10538712.2022.2133040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/28/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
One of the existing gaps in the literature on the commercial sexual exploitation (CSE) of children is on transgender (trans) girls. Most of the available literature is heavily skewed toward experiences of cisgender girls. However, there is an undeniable need to understand the experiences of trans children given their unique experiences and vulnerabilities to CSE related to their identity. This article is a case study on the complex interaction between trans identity, peer influence, and other micro, meso, and macro factors that have predisposed trans girls to CSE. The paper is based on interviews with six trans girls, complemented by interviews with four social workers, research notes, and a review of related literature. Data was analyzed thematically. Based on the findings, peer groups provide critical support to trans girls, particularly, in terms of trans identity formation, gender transition information, security and protection, and other forms of support. Ironically, they play the contradictory role of priming and initiating them to CSE. Various structural and personal factors have compounded these and predisposed them to victimization. An interplay of macro (societal), meso (interpersonal), and micro (individual) factors have come into play in the commercial sexual exploitation of these trans girls.
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Self-Brown SR, Osborne MC, Lee N, Perry EW, Kinnish K. Exploring the Impact of Trauma History on the Mental Health Presentations of Youth who have Experienced Commercial Sexual Exploitation and Trafficking. Behav Med 2022; 48:261-272. [PMID: 33689585 DOI: 10.1080/08964289.2020.1865255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study explores the types and extent of potentially traumatic events that youth who have experienced commercial sexual exploitation and trafficking (CSE/T) report, and how these experiences influence mental health. CSE/T youth (N = 110, 11-19 years old) referred to Trauma-Focused Cognitive Behavioral therapists affiliated with Project Intersect provided self-report data between August 2013 and March 2020 at the start (baseline), mid-point, and completion of therapeutic services. This study focuses on the baseline data collected. Bivariate relationships were analyzed, and where bivariate associations were statistically significant, associations were assessed in adjusted regression models. Two logistic regressions were performed: one for the adjusted associations between types of potentially traumatic events reported by CSE/T youth and the outcome PTSD, and a second for the outcome emotional distress. Results indicated that polytrauma was significantly associated with PTSD diagnosis among CSE/T youth. Direct violence victimization and polytrauma were significantly associated with CSE/T youth emotional distress. Results inform behavioral medicine practitioner considerations for how to appropriately assess the potentially traumatic experiences of CSE/T youth, and how these experiences may differentially impact the mental health presentations of youth in clinical treatment. Effective treatment may include precision-based customization of evidence-based practices to ensure that the diverse traumatic experiences and related symptomatology of CSE/T youth are effectively addressed.
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Affiliation(s)
| | - Melissa C Osborne
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University
| | - NaeHyung Lee
- School of Public Health, Georgia State University
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14
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Twis MK, Cimino A, Files M. Does individual advocacy work?: A research and evaluation protocol for a youth anti-sex trafficking program. PLoS One 2022; 17:e0270103. [PMID: 35767522 PMCID: PMC9242468 DOI: 10.1371/journal.pone.0270103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Thousands of youth are sexually trafficked each year worldwide. Increased public attention to the commercial sexual exploitation (CSE) of children has resulted in the rapid deployment of hybrid community public health and social service programs for these vulnerable youth. Research on the effectiveness of these advocacy programs is lacking, particularly whether they decrease psychosocial distress and increase readiness to leave CSE. Methods and analysis Cisgender girls under age 18 at the time of CSE, and who were identified as at-risk for sex trafficking revictimization, were included in an evaluation of an anti-trafficking advocacy program in the North Texas region of the United States. The program includes crisis response, case management, referral, and mentoring services in collaboration with multi-disciplinary team (MDT) responses to identified youth sex trafficking. Case management notes, needs assessments and individualized treatment plans were collected at intake and every 30 days until study conclusion. Standardized surveys, including the Multidimensional Scale of Perceived Social Support (MSPSS), the Coping Self-Efficacy Scale, and the University of Rhode Island Change Assessment (URICA) were collected at intake and every 180 days until the study concluded. Analyses included descriptive statistics, paired t-tests, chi-square, multivariate linear and logistic regressions, Poisson regressions, and latent profile analysis. Ethics and dissemination This study was approved by the Texas Christian University’s Institutional Review Board (IRB). Results of this study will be presented to the scientific community at conferences and in peer-reviewed journals and non-scholarly outlets such as public health and social service conferences.
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Affiliation(s)
- Mary K. Twis
- Department of Social Work, Texas Christian University, Fort Worth, Texas, United States of America
- * E-mail:
| | - Andrea Cimino
- Danger Assessment Training and Technical Assistance Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Morgan Files
- Traffick911, Addison, Texas, United States of America
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Abstract
Human trafficking and child sex trafficking and sexual exploitation in particular are global public health issues with widespread, lasting impacts on children, families, and communities. Traditionally, human trafficking has been treated as a law enforcement problem with an emphasis on the arrest and prosecution of traffickers. However, use of a public health approach focuses efforts on those impacted by exploitation: trafficked persons, their families, and the population at large. It promotes strategies to build a solid scientific evidence base that allows development, implementation, and evaluation of prevention and intervention efforts, informs policy and program development, and guides international efforts at eradication. This article uses the public health approach to address human trafficking, with a focus on child sex trafficking and exploitation. Recommendations are made for public health professionals to contribute to antitrafficking efforts globally.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, Virginia 22314, USA; .,Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, Georgia 30342, USA
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16
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Franchino-Olsen H. Frameworks and Theories Relevant for Organizing Commercial Sexual Exploitation of Children/Domestic Minor Sex Trafficking Risk Factors: A Systematic Review of Proposed Frameworks to Conceptualize Vulnerabilities. TRAUMA, VIOLENCE & ABUSE 2021; 22:306-317. [PMID: 31096869 DOI: 10.1177/1524838019849575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The commercial sexual exploitation of children (CSEC) and domestic minor sex trafficking (DMST) are abusive and exploitative practices occurring to children and youth across the United States. Prevention efforts should understand the factors that increase vulnerability and how these factors interact to eventually lead to exploitation. Understanding the mechanisms of action of these factors is best done within relevant frameworks and models. This review summarizes proposed frameworks for these vulnerabilities as collected via a systematic literature review. Fifteen studies capturing 12 frameworks or theories were selected for inclusion having met the following criteria: original research studies published in English from January 2010 to September 2017 with titles or abstracts that indicated a focus on the risk factors, vulnerabilities, or statistics of CSEC/DMST; a domestic focus on CSEC/DMST (for U.S.-based journals) with findings that did not combine associations between minors and adults in the study; and inclusion or mention of frameworks or theories which considered potential vulnerabilities prior to exploitation. Highly applicable frameworks include the life-course perspective, ecological model, multilevel model, ecodevelopment model, traumagenic factors, and general strain theory. Others found by this review include the age-graded theory of informal social control, career criminal paradigm, revictimization theory, an economic model, feminist theory, and a rights-based model. By mapping known risk factors to their appropriate place in the reviewed and relevant frameworks, this article seeks to enhance our understanding of the connections between and mechanisms of these risk factors, while also clarifying areas where prevention efforts can be targeted.
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Affiliation(s)
- Hannabeth Franchino-Olsen
- Department of Maternal and Child Health, 41474Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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17
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Reid JA, Fox B, Bilali K, Diaz J. Personality traits and male vulnerability to commercial sexual exploitation victimisation. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2021; 31:120-130. [PMID: 33443782 DOI: 10.1002/cbm.2189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND There has been little research into whether personality traits increase vulnerability to serious forms of recurring victimisation, such as commercial sexual exploitation of young people. AIMS To investigate whether impulsivity, emotional dysregulation or high psychopathy scale scores indicative of personality traits increase vulnerability to commercial sexual exploitation. METHODS Data were used from the longitudinal Pathways to Desistance Study 1170 justice-involved men who were aged 14-19 at baseline data collection. Ninety-eight (8%) reported having been commercially sexually exploited during adolescence or young adulthood. We investigated whether personality traits measured at baseline were related to such victimisation. RESULTS Results of binomial logistic regression among the young men in this sample indicated that Factor 1 scores on the Psychopathy Checklist-Youth Version (PCL-YV), reflecting affective and interpersonal features, are associated with having been commercially sexually exploited, while impulsivity, emotional dysregulation and Factor 2 PCL-YV, reflecting antisocial activities, were not. Having been a victim of other violence and being a member of a cultural or ethnic minority group were also independently related to being exploited. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Our findings show that individual differences in personality, such as fearless temperament and boredom susceptibility, could differentially disadvantage young people, and put them at greater risk of commercial sexual exploitation. This knowledge could be beneficial to prevention efforts supporting male adolescents at risk for victimisation by commercial sexual exploitation, and to shed new light on the theoretical understanding of vulnerability to it.
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Affiliation(s)
- Joan A Reid
- Department of Criminology, University of South Florida St. Petersburg, St Petersburg, Florida, USA
| | - Bryanna Fox
- Department of Criminology, Faculty Affiliate, Florida Mental Health Institute, University of South Florida, Tampa, Florida, USA
| | - Klejdis Bilali
- Department of Psychology, University of South Florida St. Petersburg, St Petersburg, Florida, USA
| | - Jennifer Diaz
- Department of Criminology, University of South Florida St. Petersburg, St Petersburg, Florida, USA
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18
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Franchino-Olsen H. Vulnerabilities Relevant for Commercial Sexual Exploitation of Children/Domestic Minor Sex Trafficking: A Systematic Review of Risk Factors. TRAUMA, VIOLENCE & ABUSE 2021; 22:99-111. [PMID: 30712473 DOI: 10.1177/1524838018821956] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The commercial sexual exploitation of children (CSEC) and domestic minor sex trafficking (DMST) occur across the United States, violating the rights and health of far too many children and youth. Adequate prevention efforts should seek to understand the factors that make minors vulnerable to sexual exploitation in order to properly design programs to prevent victimization. This review presents the identified risk factors collected via a systematic literature review. Following full-text review, 15 studies were selected for inclusion by meeting the following criteria: original quantitative or qualitative research studies published in English from January 2010 to September 2017 with titles or abstracts that indicated a focus on the risk factors, vulnerabilities, or statistics of CSEC/DMST and a domestic focus on CSEC/DMST (for U.S.-based journals) with findings that did not combine associations between minors and adults in the study. Relevant risk factors and vulnerabilities found in this review include child abuse and maltreatment, caregiver strain, running away or being thrown away, substance use, peer influence, witnessing family violence or criminality, poverty or material need, difficulty in school, conflict with parents, poor mental health or view of self, involvement in child protective services, involvement in juvenile detention or delinquency, early substance use, and prior rape or adolescent sexual victimization.
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Affiliation(s)
- Hannabeth Franchino-Olsen
- Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Haney K, LeBeau K, Bodner S, Czizik A, Young ME, Hart M. Sex Trafficking in the United States: A Scoping Review. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:714-748. [PMID: 32678726 DOI: 10.1080/26408066.2020.1765934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Human trafficking is a public health social work issue. This review aimed to present the current state (nature and extent) of sex trafficking research, categorize best practices, and identify recommendations for professionals. METHODS Comprehensive literature searches of online databases were conducted to identify eligible articles from January 2000 to March 2019. RESULTS The search yielded 467 studies, 87 met the predetermined criteria for inclusion. Seven themes identified: awareness, identification, at-risk populations, health issues, implementation of trafficking legislation, service and program implementation, and exploiters. DISCUSSION AND IMPLICATIONS FOR PRACTICE Findings indicate the need for additional research to determine the most effective practices to increase awareness and identification, widespread TVPA implementation, reduce risk factors and resulting health disparities, offer services to survivors and prevention of potential victims. CONCLUSION There should be significant efforts to enhance all sex trafficking research in the United States to implement effective, sustainable and evidence-based interdisciplinary interventions.
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Affiliation(s)
- Kanathy Haney
- Health Sciences, Palm Beach State College , Lake Worth, Florida, USA
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Kelsea LeBeau
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Samantha Bodner
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Annika Czizik
- Department of Medical Geography in Public Health, University of Florida , Gainesville, Florida, USA
| | - Mary Ellen Young
- Department of Occupational Therapy, University of Florida , Gainesville, Florida, USA
| | - Mark Hart
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
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20
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Laird JJ, Klettke B, Hall K, Clancy E, Hallford D. Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2017682. [PMID: 32960280 PMCID: PMC7509625 DOI: 10.1001/jamanetworkopen.2020.17682] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. OBJECTIVE To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance. DATA SOURCES Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019. STUDY SELECTION Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger. DATA EXTRACTION AND SYNTHESIS Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020. MAIN OUTCOMES AND MEASURES Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors. RESULTS Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment.
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Affiliation(s)
- Jessica J. Laird
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| | - Bianca Klettke
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - Kate Hall
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Addictive and Anti-Social Behaviour Research, Deakin University Centre for Drug Use, Geelong, Australia
| | - Elizabeth Clancy
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - David Hallford
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
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Souza VPD, Gusmão TLDA, Neto WB, Guedes TG, Monteiro EMLM. Fatores de risco associados à exposição de adolescentes à violência sexual. AVANCES EN ENFERMERÍA 2019. [DOI: 10.15446/av.enferm.v37n3.77050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: analisar as evidências científicas sobre os fatores de risco associados à exposição de adolescentes à violência sexual.Síntese de conteúdo: revisão integrativa da literatura, realizada em quatro bases de dados e duas bibliotecas virtuais, sem limites do ano de publicação, utilizando-seos descritores: “delitos sexuais”, “adolescentes” e “fatores de risco”. Utilizou-se, também, a palavra-chave “violência sexual” e equivalentes, no idioma inglês. Na análise dos 22 artigos incluídos, os fatores associados à exposição dos adolescentes à violência sexual foram classificados em “abuso sexual” e “exploração sexual”. O consumo de álcool e/ou drogas foi o fator mais evidente, seguido do sexo casual, dabaixa escolaridade, da baixa renda, da violência familiar, dos relacionamentos em ambientes virtuais, da estigmatização do trabalho sexual e falta de moradia.Conclusão: os fatores apresentados devem ser considerados pela enfermagem para o reconhecimento de adolescentes vítimas de violência sexual, além de contribuir na prevenção de novos casos e na minimização dos efeitos que tal ato pode causar na vida desse público.
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22
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Bond C, Morgenstern J, Heitz C, Milne WK. Hot Off the Press: SGEM #237. Screening Tool for Child Sex Trafficking. Acad Emerg Med 2019; 26:823-825. [PMID: 30609119 DOI: 10.1111/acem.13679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 12/15/2018] [Indexed: 11/27/2022]
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23
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Investigating the association between age at first alcohol use and suicidal ideation among high school students: Evidence from the youth risk behavior surveillance system. J Affect Disord 2019; 242:60-67. [PMID: 30172226 DOI: 10.1016/j.jad.2018.08.078] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although various studies have investigated and found a significant link between age at first alcohol use and health risk behaviors, few studies have investigated the effect of age at first alcohol use on suicidal ideation among adolescents. The objective of this study was to investigate the effect of age at first alcohol use on suicidal ideation. METHODS Data for this study were obtained from the 2015 Youth Risk Behavior Surveillance system. A sample of 10,745 adolescents aged 14-18 years (50.9% males) were analyzed using logistic regression with suicidal ideation as the outcome variable and age at first alcohol use as the main explanatory variable. RESULTS About 17% of adolescents experienced suicidal ideation during the past 12 months and 15.6% started having alcohol before age 13. Adolescents who started having alcohol before age 13 had 1.60 times higher odds of experiencing suicidal ideation and adolescents who started having alcohol by age 13 or over had 1.47 times higher odds of experiencing suicidal ideation. Other significant factors associated with suicidal ideation include experience of forced sex, physical teen dating violence, bullying, and feeling sad or hopeless. Having sufficient sleep lowered the odds of suicidal ideation. LIMITATIONS The use of cross-sectional data limits the extent to which we can make causal claims regarding age at first alcohol use and suicidal ideation. CONCLUSIONS Younger age at first alcohol use was associated with increased likelihood of suicidal ideation. Public health initiatives that seek to address the co-occurring problems of alcohol use and mental health illness, sexual violence, and victimization among sexual minority youth could help in reducing suicidal ideation.
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24
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Greenbaum VJ, Livings MS, Lai BS, Edinburgh L, Baikie P, Grant SR, Kondis J, Petska HW, Bowman MJ, Legano L, Kas-Osoka O, Self-Brown S. Evaluation of a Tool to Identify Child Sex Trafficking Victims in Multiple Healthcare Settings. J Adolesc Health 2018; 63:745-752. [PMID: 30293860 DOI: 10.1016/j.jadohealth.2018.06.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/13/2018] [Accepted: 06/29/2018] [Indexed: 11/15/2022]
Abstract
PURPOSE Estimate the prevalence of child sex trafficking (CST) among patients seeking care in multiple healthcare settings; evaluate a short screening tool to identify victims in a healthcare setting. METHODS This cross-sectional observational study involved patients from 16 sites throughout the U.S.: five pediatric emergency departments, six child advocacy centers, and five teen clinics. Participants included English-speaking youth ages 11-17 years. For emergency department sites, inclusion criteria included a chief complaint of sexual violence. Data on several domains were gathered through self-report questionnaires and examiner interview. Main outcomes included prevalence of CST among eligible youth; sensitivity, specificity, positive/negative predictive values, and positive/negative likelihood ratios for a CST screening tool. RESULTS Eight hundred and ten participants included 91 (11.52%) youth from emergency departments, 395 (48.8%) from child advocacy centers, and 324 (40.0%) from teen clinics. Overall prevalence of CST was 11.1%: 13.2% among emergency department patients, 6.3% among child advocacy center patients, and 16.4% among teen clinic patients, respectively. The screen had a sensitivity, specificity, and positive likelihood ratio of 84.44% (75.28, 91.23), 57.50% (53.80, 61.11), and 1.99% (1.76, 2.25), respectively. CONCLUSIONS This study demonstrates a significant rate of CST among patients presenting to emergency departments (for sexual violence complaints), child advocacy centers, and teen clinics. A six-item screen showed relatively good sensitivity and moderate specificity. Negative predictive value was high. Intervention for a "positive" screen may identify victims and help prevent high-risk youth from becoming victimized. This is one of the first CST screening tools specifically developed and evaluated in the healthcare setting.
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Affiliation(s)
- V Jordan Greenbaum
- Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, Georgia.
| | | | - Betty S Lai
- School of Public Health, Georgia State University, Atlanta, Georgia
| | - Laurel Edinburgh
- Midwest Children's Resource Center, Children's Hospital and Clinics of Minnesota, St. Paul, Minnesota
| | - Peggy Baikie
- Denver Health, Now at Colorado Department of Human Services, Denver, Colorado
| | | | - Jamie Kondis
- Washington University School of Medicine, St. Louis, Mississippi
| | - Hillary W Petska
- Medical College of Wisconsin, Milwaukee, Wisconsin; Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | | | | | - Oriaku Kas-Osoka
- Las Vegas School of Medicine, University of Nevada, Las Vegas, Nevada
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25
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Kaltiso SO, Greenbaum VJ, Agarwal M, McCracken C, Zmitrovich A, Harper E, Simon HK. Evaluation of a Screening Tool for Child Sex Trafficking Among Patients With High-Risk Chief Complaints in a Pediatric Emergency Department. Acad Emerg Med 2018; 25:1193-1203. [PMID: 30381877 DOI: 10.1111/acem.13497] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/06/2018] [Accepted: 06/08/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The objective was to apply and evaluate a screening tool to identify victims of child sex trafficking (CST) in a pediatric emergency department (PED) population. METHODS This prospective, observational study was conducted from July 2017 to November 2017 at the PED of a free-standing, inner-city children's hospital. Patients 10 to 18 years of age presenting with chief complaints related to high-risk social or sexual behaviors were recruited in a representative convenience sampling. A previously developed six-item screening tool was administered verbally to participants. A positive screen was defined as two positive answers from the six items. A patient was considered a "true" CST victim if any information obtained during the visit indicated that their circumstances fulfilled the federal definition of CST. Descriptive statistics were calculated for all variables of interest. CST screening tool analysis included sensitivity, specificity, and positive and negative predictive values (PPV, NPV). Those patients identified as positive for CST were referred to social services and received the current standard of care. RESULTS A total of 254 patients met chief complaint screening criteria and eligibility; 215 were approached to participate and 203 agreed to participate. Of the 203 participants, 100 screened positive with the tool (49%). The total number of CST victims identified was 11 (5.4%), 10 of whom screened positive. With a cutoff score of two positive answers the tool demonstrated a 90.9% (95% confidence interval [CI] = 58.7%-99.8%) sensitivity, 53.1% (95% CI = 45.6%-60.4%) specificity, 10.0% (95% CI = 5.0%-17.6%) PPV, and 99.0% (95% CI = 94.7%-99.9%) NPV. CONCLUSIONS Applied to an inner-city PED population of 203 participants with high-risk chief complaints, the screening tool has high sensitivity and high NPV. This makes it appropriate for an initial screening to rule out CST in this high-risk population. Applicability for broader use and additional practice settings are warranted given the significant positivity rate among those presenting with high-risk concerns.
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Affiliation(s)
| | | | - Maneesha Agarwal
- Departments of Pediatrics and Emergency Medicine Emory School of Medicine, and Children's Healthcare of Atlanta Atlanta GA
| | | | | | | | - Harold K. Simon
- Departments of Pediatrics and Emergency Medicine Emory School of Medicine, and Children's Healthcare of Atlanta Atlanta GA
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26
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O'Brien JE. "Sometimes, Somebody Just Needs Somebody - Anybody - to Care:" The power of interpersonal relationships in the lives of domestic minor sex trafficking survivors. CHILD ABUSE & NEGLECT 2018; 81:1-11. [PMID: 29689316 DOI: 10.1016/j.chiabu.2018.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/05/2018] [Accepted: 04/13/2018] [Indexed: 06/08/2023]
Abstract
Domestic minor sex trafficking (DMST) is the recruitment, harboring, transportation, provision, or obtaining of U.S. minors for the purposes of a commercial sex act. DMST victims and survivors often become involved with state-level systems including the child welfare and/or juvenile justice systems. This study presents exploratory qualitative findings regarding the role of interpersonal relationships in the lives of system-involved DMST survivors from the perspectives of DMST survivors. Results indicate survivors perceive interpersonal relationships as key to promoting risk, providing protection, and fostering resiliency over DMST. Findings from the current study not only provide a context for understanding the role of interpersonal relationships in the lives of DMST survivors but also point to directions for development of interventions targeted toward this population.
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Affiliation(s)
- Jennifer E O'Brien
- Department of Social Work, The University of New Hampshire, Pettee Hall, Durham, NH 03824, United States.
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27
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Sanchez RV, Pacquiao DF. An Ecological Approach Toward Prevention and Care of Victims of Domestic Minor Sex Trafficking. JOURNAL OF FORENSIC NURSING 2018; 14:98-105. [PMID: 29781969 PMCID: PMC7357858 DOI: 10.1097/jfn.0000000000000205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Sex trafficking is a widespread form of human trafficking that exists globally. The forced sexual exploitation of young women for profit at the hands of traffickers is a human rights violation. Sex trafficking is a form of modern-day slavery where youths are sold as a commodity. It is difficult to determine the wide range of negative health outcomes associated with domestic minor sex trafficking due to the hidden nature of the crime and its lack of statistical data to determine prevalence. Viewing domestic minor sex trafficking through an ecological lens assists in the understanding of the multiple complex interactions between victims, their relationships, and environments that influence their health. Forensic nurses are poised as experts in the healthcare of vulnerable populations and possess the knowledge to understand that social determinants of vulnerability depend on the distinct setting or environment where victims of sex trafficking reside and how different factors affect their victimology, resilience, and well-being.
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Affiliation(s)
- Rosario V. Sanchez
- Doctoral Scholar - Jonas Nurse Leader Scholar, Rutgers University School of Nursing, Address: 16 Huxley Ct, Marlboro, NJ 07746, Telephone (732) 822 - 4319
| | - Dula F. Pacquiao
- Professor of Nursing (retired) and Adjunct Faculty, Rutgers University School of Nursing, Address: 208 Tingley Lane, Edison, NJ 08820, Telephone: 908-420-8733
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28
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O’Brien JE. “What Does It Matter How We Define It?”: Exploring Definitions of DMST Among Service Providers and Victims/Survivors. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23322705.2017.1410415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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29
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Naramore R, Bright MA, Epps N, Hardt NS. Youth Arrested for Trading Sex Have the Highest Rates of Childhood Adversity: A Statewide Study of Juvenile Offenders. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2017; 29:396-410. [PMID: 26337192 DOI: 10.1177/1079063215603064] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
A history of childhood adversity is associated with high-risk behaviors and criminal activity in both adolescents and adults. Furthermore, individuals with histories of child maltreatment are at higher risk for engaging in risky sexual behavior, experiencing re-victimization, and in some cases, becoming sexual offenders. The purpose of the current study was to examine the prevalence of individual and cumulative adverse childhood experiences (ACEs) reported by 102 offending youth who were arrested for trading sex and 64,227 offending youth who were arrested for various other crimes, using Florida's Positive Achievement Change Tool. Youth with violations related to sex trafficking had higher rates for each ACE as well as number of ACEs, particularly sexual abuse and physical neglect. These findings have implications for identifying adverse experiences in both maltreated and offending youth as well as tailoring services to prevent re-victimization.
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Affiliation(s)
| | | | - Nathan Epps
- 2 Florida Department of Juvenile Justice, Tallahassee, USA
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Reid JA. Entrapment and Enmeshment Schemes Used by Sex Traffickers. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2016; 28:491-511. [PMID: 25079777 DOI: 10.1177/1079063214544334] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Emerging research suggests that sex traffickers/pimps control the majority of trafficked girls in the United States. The youthfulness of these victims and their lack of psychosocial maturity severely diminish their ability to detect exploitative motives or withstand manipulation of traffickers. A review of 43 cases of sexually exploited girls involving non-relative traffickers and 10 semi-structured interviews with social service providers revealed numerous scripts and schemes used by sex traffickers to entrap and entangle victims including boyfriend/lover scripts, ruses involving debt bondage, friendship or faux-family scripts, threats of forced abortion or to take away children, and coerced co-offending. These findings inform potential prevention efforts and highlight the need for multi-systemic, victim-centered approaches to intervention.
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Affiliation(s)
- Joan A Reid
- University of South Florida St. Petersburg, FL, USA
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