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Gerassi LB, Zimmerman L, Walsh K. Toward a Multi-item Measure to Identify Involvement in and Circumstances of the Sex Trades: Findings from Cognitive Interviews. JOURNAL OF SEX RESEARCH 2024; 61:1062-1072. [PMID: 37410675 PMCID: PMC10836029 DOI: 10.1080/00224499.2023.2228768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Quantitative studies in the United States that identify involvement in the sex trades predominantly use a single item to address a complex, stigmatized phenomenon. This item typically does not differentiate between in-person or virtual forms, nor does it assess the associated compensation types, circumstances, and perceived consequences. University students' involvement in the sex trades is also critically understudied. Therefore, we sought to adapt, develop, and refine a multiitem measure from the perspectives of undergraduate and graduate students who were familiar with sex trading. We conducted 34 cognitive interviews with students to understand how they perceived items on our measure. Results indicated that language used in single item studies may not reflect participants' views of the sex trades. Participants suggested the necessity of introducing survey items with inclusive introductory statements that recognize the range of circumstances, benefits, and potential harms. Items that address the circumstances of sex trading (including economic needs, wants, exploitation, empowerment/pleasure) were important in capturing diverse experiences. We make recommendations for multi-item measures to identify involvement in and circumstances of the sex trades. Implications for future research using this measure to broaden the field's understanding of the sex trades are discussed.
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Affiliation(s)
- Lara B. Gerassi
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Laura Zimmerman
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kate Walsh
- Department of Psychology/Gender & Women’s Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Gerassi LB, Zimmerman L, Walsh K. Students' perspectives of providing sexual acts, materials, and services for financial compensation at a large, public, Midwestern university. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38995624 DOI: 10.1080/07448481.2024.2367995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 04/12/2024] [Accepted: 06/09/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE To understand university students' experiences with sex trading for financial compensation at a large public, Midwestern university. PARTICIPANTS 34 university students (26.5% graduate, 70% white, 70% cisgender women, 38% heterosexual). METHOD We used a community-engaged, directed content analytic approach to analyze semi-structured, in-depth interviews with st udents who were familiar with sex trading. RESULTS Students perceive sex trading to include (1) selling personal items or fluids for another's sexual pleasure, (2) virtual sex trades, and (3) in-person sex trades. Students were motivated by financial needs and wants, work flexibility and conditions, curiosity and empowerment. Consequences were positive (e.g., supporting themselves, community) and negative (e.g., blackmail, detrimental health effects). While negative consequences had deleterious effects on students' wellbeing, the benefits were viewed as critical. CONCLUSIONS Findings call for harm reduction approaches that span campus services, university and federal policies. Future research should explore students' experiences in differing academic and regional contexts.
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Affiliation(s)
- Lara B Gerassi
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison Sandra Rosenbaum, Madison, Wisconsin, USA
| | - Laura Zimmerman
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison Sandra Rosenbaum, Madison, Wisconsin, USA
| | - Kate Walsh
- Department of Psychology/Gender and Women's Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Gerassi LB, Zimmerman L, Walsh K. Psychometric Properties of the Sexual Services Acts Materials for Pay (SSAMP) Index: Identifying the Virtual, In-Person, and Material Sex Trades for Financial Compensation. JOURNAL OF SEX RESEARCH 2024:1-12. [PMID: 38913784 DOI: 10.1080/00224499.2024.2362897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Exchanging sex for financial compensation is thought to be underreported primarily because extant studies (1) use a single item to capture a complex, stigmatized phenomenon, and (2) do not capture the complex types or reasons why people engage in the sex trades. Few survey studies have explored the sex trades among university students. This study evaluated the psychometric properties of a newly developed measure, the Sexual Services Acts and Materials for Pay (SSAMP), among university students. Surveys were administered to undergraduate (N = 544, time 1; N = 362, time 2) and graduate (N = 331, time 1; N = 187, time 2) students two weeks apart at a predominantly White, public, Midwestern university. Findings suggested that our index had (1) strong convergent validity with the single item used in prior studies, (2) identified more cases of sex trading than the single item, (3) good internal consistency reliability (4) moderate to strong test-retest reliability, and (5) strong discriminant validity. Exploratory factor analysis revealed that items loaded above .59 on a single factor. To our knowledge, this study is the first to evaluate a multi-item sex trades measure in the U.S. Future research should continue to advance the SSAMP and adapt this index to provide credible estimates and nuanced understanding of the sex trades across contexts.
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Affiliation(s)
- Lara B Gerassi
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison
| | - Laura Zimmerman
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison
| | - Kate Walsh
- Department of Psychology/Gender & Women's Studies, University of Wisconsin-Madison
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Gnaim-Mwassi N, Avieli H, Band-Winterstein T. Prostitution in the shadow of life-long sexual abuse: Arab women's retrospective experiences. J Elder Abuse Negl 2024; 36:117-147. [PMID: 38566491 DOI: 10.1080/08946566.2024.2331503] [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: 04/04/2024]
Abstract
The present study uses the life-course and intersectionality perspectives to explore the meaning that aging Arab women attribute to their lived experiences of life-long sexual abuse in the shadow of engaging in prostitution. Interpretive phenomenological analysis was used to analyze the narratives of 10 older Arab women in Israel who were engaged in prostitution. Four themes emerged: experiencing childhood in the shadow of sexual abuse, becoming a prostitute, being entrapped in prostitution, and settling accounts with the native culture. Women aging in prostitution experience a harsh reality of abuse and loss. The present study points to multiple channels of abuse throughout the life course, from childhood until old age.
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Affiliation(s)
- Nora Gnaim-Mwassi
- Minerva Center on Intersectionality in Aging, Department of Gerontology, University of Haifa, Haifa, Israel
| | - Hila Avieli
- Department of Criminology, Ariel University, Ariel, Israel
| | - Tova Band-Winterstein
- Minerva Center on Intersectionality in Aging, Department of Gerontology, University of Haifa, Haifa, Israel
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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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Scaggs SJA, Starseed SC, Kluckman M, Tueller S, Yu L. A state-wide analysis of characteristics and predictors of dual system involvement among child victims of human trafficking. CHILD ABUSE & NEGLECT 2024; 147:106530. [PMID: 37979486 DOI: 10.1016/j.chiabu.2023.106530] [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: 04/28/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND The child welfare system is pivotal in identifying and responding to child (younger than age 18) human trafficking victims. Children who have experienced human trafficking-or are at risk of victimization-are increasingly recognized as also being served in the juvenile justice system. Yet little is known about human trafficking victimization among children in the juvenile justice population or among children with child welfare and juvenile justice involvement. OBJECTIVE Building on previous research with child welfare-and juvenile justice-involved children, we investigated characteristics and system experiences among children who have experienced a human trafficking abuse allegation in Florida. PARTICIPANTS AND SETTING The overall study population included all children born on or after January 1, 1993, who had at least one DCF-documented maltreatment allegation before March 1, 2020. This study examined a total of 12,167 allegations in the first set of analyses and the first human trafficking allegation for each child (N = 9300) in the second set of analyses. METHODS Analyses are based on linked administrative data for a cohort of children involved with Florida's Departments of Juvenile Justice (DJJ) and/or Children and Families (DCF). We used descriptive and multivariate logistic regression analyses to document the characteristics of single and dual system-involved children and examine predictors of child welfare, juvenile justice, and dual system involvement. RESULTS (1) Nearly half of children with a human trafficking abuse allegation are involved in DCF at the time of the allegation, (2) females who experienced trafficking are more likely to be involved in DCF (with or without DJJ involvement) than involved in no system, (3) Black children with an alleged trafficking incident were more likely than White children to be involved in both systems compared with DCF only, and (4) children who experienced labor trafficking abuse allegations were less likely than those who experienced sex trafficking to be involved with either system. CONCLUSIONS This study depicts child victims of sex and labor trafficking who are involved with one or both systems in one state.
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Affiliation(s)
- Samuel J A Scaggs
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States.
| | - Stacey Cutbush Starseed
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Marianne Kluckman
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Stephen Tueller
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Lilly Yu
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
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Gerassi LB, Cruys C, Hendry N, Rosales MDC. An Exploration of Sex Trading for Compensation and LGBTQ+ Inclusive Screening Practices: Perspectives of Young People who have Experienced Sex Trading and/or Homelessness. CHILDREN AND YOUTH SERVICES REVIEW 2024; 156:107314. [PMID: 38074081 PMCID: PMC10704958 DOI: 10.1016/j.childyouth.2023.107314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Young people's perspectives on social and healthcare providers' assessments of sex trading for financial compensation are lacking. This is particularly important for LGBTQ+ youth who experience substantial barriers in navigating health and social services. Further, increased internet access (because of COVID-19 and other factors) has changed the landscape of the sex trades in ways that are not fully understood. Our study aimed to understand (1) how young people trade sex, and (2) provider strategies that increase youths' comfort in disclosing sex trading and related risks. This community-based participatory research study surveyed currently or formerly homeless youth (ages 16-29). We co-created a cross sectional survey that explored youths' perceptions of: (1) sex trading type, compensation, and meaning; and (2) practices to increase youths' comfort in disclosing sex trading. Participants (N = 103; Mage = 22.9 [SD = 3.5]; 34% white, 55% ciswomen/21% trans; 51% queer) reported that "sex trading" signified multiple meanings, ranging from sex work/occupation to exploitation/trafficking, and included diverse in-person and virtual forms for varied compensation types. Youth reported being more comfortable disclosing when the provider indicated they would advocate for them if they are victims of discrimination. Compared to cisgender youth, trans youth reported feeling significantly more comfortable disclosing sexual activity when a service provider used gender/sexuality inclusive practices (e.g., pronoun pins). Findings suggest important implications for gender-inclusive practice strategies to ultimately reduce potential harms of sex trading and multi-item measures to assess the complexity of sex trading.
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Affiliation(s)
- Lara B. Gerassi
- University of Wisconsin-Madison Sandra Rosenbaum School of Social Work, United States
| | - Caro Cruys
- University of Wisconsin-Madison Sandra Rosenbaum School of Social Work, United States
| | - Nicole Hendry
- University of Wisconsin-Madison Sandra Rosenbaum School of Social Work, United States
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Lipira LE, Glick JL, German D, Glick SN, Moreno C, Elimam D, Brantley ML, Pichon LC, Barak N, Booth MM, Flynn C, Menza T. Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3313-3327. [PMID: 37612535 DOI: 10.1007/s10508-023-02663-x] [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: 01/06/2023] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 08/25/2023]
Abstract
Exchange sex is associated with sexual risk behaviors and poor outcomes and different types may incur different levels of risk. We assessed risk profiles of different types of exchange sex among non-injecting cisgender men and women who participated in the 2019 National HIV Behavioral Surveillance project at six sites. Six percent of men and 19% of women reported exchange sex in the past year; most engaged in non-commercial exchange sex for drugs/money with smaller percentages reporting formal sex work or non-commercial exchange sex for goods or services other than drugs/money. Exchange sex was associated with sexual risk and prevention behaviors and psychosocial and sexual health outcomes and associations varied by type of exchange sex. Efforts to improve access to STI/HIV testing and PrEP may benefit from tailoring based on type of exchange sex. Findings indicate value in a broader definition of exchange sex with follow-up assessment of exchange sex typology.
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Affiliation(s)
- Lauren E Lipira
- Regional Research Institute, Portland State University, Portland, OR, USA.
- Public Health Division, Oregon Health Authority, 800 NE Oregon St, Portland, OR, 97232, USA.
| | - Jennifer L Glick
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Danielle German
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sara N Glick
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
- HIV/STD Program, Public Health-Seattle & King County, Seattle, WA, USA
| | - Courtney Moreno
- HIV/STD Program, Public Health-Seattle & King County, Seattle, WA, USA
| | - Dena Elimam
- Epidemiology Section, Georgia Department of Public Health, Division of Health Protection, Atlanta, GA, USA
| | - Meredith L Brantley
- HIV/STI/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | | | - Colin Flynn
- Maryland Department of Health, Baltimore, MD, USA
| | - Timothy Menza
- Public Health Division, Oregon Health Authority, 800 NE Oregon St, Portland, OR, 97232, USA
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
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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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Tucker JS, D'Amico EJ, Rodriguez A, Garvey R, Pedersen ER, Klein DJ. A randomized controlled trial of a brief motivational interviewing-based group intervention for emerging adults experiencing homelessness: 12-Month effects on substance use and sexual risk behavior. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209114. [PMID: 37355155 PMCID: PMC10530378 DOI: 10.1016/j.josat.2023.209114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023]
Abstract
INTRODUCTION Few brief evidence-based risk reduction programs for emerging adults experiencing homelessness focus on the interrelated problems of substance use and sexual risk behavior. This study examines outcomes from a 12-month evaluation of AWARE, a brief Motivational Interviewing (MI)-based group risk reduction intervention for this population. METHODS In a cluster randomized crossover trial, N = 276 18-25-year-olds received AWARE or usual care at drop-in centers serving homeless youth in Los Angeles County. We evaluated intervention effects on substance use and condomless sex (primary outcomes), as well as drinking consequences and protective strategies, number of casual partners, self-efficacy, and motivation for change (secondary outcomes). RESULTS AWARE participants self-reported reductions in their alcohol use and negative consequences from drinking, and an increase in use of drinking protective strategies. AWARE participants also reported an initial decrease in drug use other than marijuana, followed by a slight uptake later on, as well as an initial increase in importance of cutting down on other drug use followed by a decrease. Control group participants did not show change in these outcomes. Among those who reported casual sex partners at both baseline and 12-month surveys, exploratory analyses indicated that AWARE participants had a 29 % decline in condomless sex with casual partners compared to a 6 % decline for control group participants. CONCLUSIONS Findings build on our pilot work by demonstrating that AWARE has long-term benefits on drinking among emerging adults experiencing homelessness. Further work should seek to strengthen its long-term effectiveness in reducing drug use in this population.
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA.
| | | | | | - Rick Garvey
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA
| | - Eric R Pedersen
- University of Southern California, Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, 250 Alcazar Street, Suite 2200, Los Angeles, CA 90033, USA
| | - David J Klein
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA
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Dickson MF, Tillson M, Calvert JM, Staton M. Transactional sex among rural, justice-involved Appalachian women who use drugs. J Rural Health 2023; 39:789-794. [PMID: 36648452 PMCID: PMC10350464 DOI: 10.1111/jrh.12741] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Transactional sex is associated with an array of other health risk behaviors and adverse health outcomes, including HIV. However, despite concerns regarding a potential HIV outbreak, there is limited understanding of transactional sex among rural Appalachians who engage in high-risk behaviors. Thus, the current study describes the prevalence and correlates of transactional sex among a sample of rural, justice-involved Appalachian women who use drugs. METHODS Participants (N = 400) were randomly selected, screened, and interviewed face-to-face at 3 rural Appalachian jails in Kentucky. Bivariate analyses were used to examine differences between those who reported trading sex for drugs, money, goods, or services in the year prior to incarceration and those who had not, and multivariable logistic regression was used to examine independent correlates of transactional sex. FINDINGS On average, participants were 33 years old with 11 years of education. They were predominantly White (99.0%), about half (43.7%) reported lifetime transactional sex, and 25.9% reported past year transactional sex. Past year transactional sex was positively associated with experiencing money problems, substance use problem severity, injection drug use, unprotected sex with a casual partner, and number of sexual partners in the year prior to incarceration. CONCLUSIONS Results suggest that transactional sex is fairly common among rural Appalachian women who use drugs and are justice-involved and may signal other HIV-related risk behaviors. Given limited service availability throughout rural Appalachia, findings emphasize a need for increased access to risk-reduction interventions, including jail-based interventions, to educate vulnerable, hard-to-reach populations on the risks associated with HIV.
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Affiliation(s)
- Megan F. Dickson
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
- Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA
| | - Martha Tillson
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Joseph M. Calvert
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Michele Staton
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
- Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA
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Malefo MA, Ayo-Yusuf OA, Mokgatle MM. A Qualitative Study of the Benefits and Utility of Brief Motivational Interviewing to Reduce Sexually Transmitted Infections among Men Who Have Sex with Men. Behav Sci (Basel) 2023; 13:654. [PMID: 37622794 PMCID: PMC10451619 DOI: 10.3390/bs13080654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/13/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Abstract
Several studies have demonstrated the effectiveness of motivational interviewing (MI) in reducing sexual risk behaviors. However, limited information is available on the acceptability of brief MI among men who have sex with men (MSM) in poor resource settings like sub-Saharan Africa. The objective of this study was to assess the views of MSM about the benefits and utility of brief MI (bMI) in changing their risky behavior. A qualitative study among men who have sex with men (MSM) who were enrolled in a longitudinal observational study between December 2021 and May 2023. The setting was in Tshwane North and participants were scheduled for baseline, 6-month, and 12-month visits. All participants received 20 min one-on-one face-to-face brief motivational interview (bMI) sessions during their follow-up visits. At month 12, an exit interview was conducted with consenting conveniently sampled participants (n = 23) who had completed all scheduled visits and received three bMI sessions. The findings indicated that the most recalled conversation was related to multiple sexual partners, having sex under the influence of alcohol, and MSM learned more about sexually transmitted diseases. Many expressed being comfortable with the sessions because the counselor was respectful and non-judgmental. Most found the bMI sessions to have a positive impact on changing and reducing risky sexual behaviors, particularly it reportedly increased their use of condoms and reduced the number of multiple partners. MSM found the bMI to be useful and acceptable in reducing sexual risk behaviors among MSM.
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Affiliation(s)
- Matshidiso A. Malefo
- School of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
| | - Olalekan A. Ayo-Yusuf
- School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa;
| | - Mathildah Mpata Mokgatle
- School of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
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Chen JK, Wang SC, Wang LC. Syndemic Profiles and Sexual Health Risks Among Sexually Exploited Adolescent Girls in Taiwan: A Latent Class Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1631-1641. [PMID: 36749407 DOI: 10.1007/s10508-023-02545-2] [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: 08/29/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Sexually exploited adolescent girls are disproportionately affected by adverse psychosocial conditions, such as intra-familial child physical and sexual abuse, extra-familial violence and sexual assault, alcohol and drug use, and suicide. Syndemic theory suggests that these adverse psychosocial or syndemic conditions are concentrated and co-occurring in socially marginalized populations, including sexually exploited adolescents, and increase their sexual health risks, including pregnancy, abortion, and the acquisition of sexually transmitted diseases (STDs). To examine clusters of syndemic conditions, latent class analysis (LCA) was conducted to classify 335 sexually exploited girls in Taiwan into subgroups based on their probability of experiencing each syndemic condition. We used syndemic class membership to predict their sexual health outcomes, specifically pregnancy, abortion, and the acquisition of STDs. The results of LCA revealed three classes, which were "low-risk syndemic," "moderate-risk syndemic," and "high-risk syndemic." The risk of acquisition of STDs among sexually exploited girls in the "high-risk syndemic class" and "moderate-risk syndemic class" was 239% and 135% higher, respectively, than the risk of acquisition of STDs among sexually exploited girls in the "low-risk syndemic class." Differences between these three classes in pregnancy and abortion were not significant. Our findings support the syndemic theory that a pattern of syndemic conditions is associated with an increased risk of acquiring STDs. Interventions aimed at reducing the acquisition of STDs among sexually exploited girls in Taiwan should adopt a comprehensive approach to address co-occurring conditions.
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Affiliation(s)
- Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Sha Tin, Hong Kong.
| | - Shu-Chen Wang
- National Academy for Educational Research, New Taipei, Taiwan
| | - Li-Chih Wang
- Department of Special Education, National Tsing Hua University, Hsinchu City, Taiwan
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14
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Martin L, McMorris BJ, Rider GN. Sex Trading Among Adolescent Cisgender Boys. Pediatrics 2023; 151:191102. [PMID: 37082916 DOI: 10.1542/peds.2022-058729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVES Cisgender girls and boys report trading sex for something of value at roughly equal proportions; yet, boys are understudied and underserved. We compare boys who reported trading sex to those who never traded sex to address this gap in knowledge and practice. METHODS The study is a secondary analysis of the Minnesota Student Survey, a triannual, census-style survey. The sample included 32 311 cisgender boy students in ninth and 11th grades who answered a question about sex trading. Bivariate descriptive statistics and multivariate logistic models were used to identify associated factors and determine the odds of trading sex on the basis of specific experiences. RESULTS We found that 1.2% of boys reported trading sex. In bivariate analyses, boys who reported trading sex were more likely than those who did not to: identify as Black or Indigenous; report a marginalized gender identity or sexual expression; have had sexual intercourse; have experienced sexual harassment and harassment on the basis of sexual identity and race, ethnicity, and national origin; and to have experienced homelessness, food insecurity, foster care, and substance treatment (P < .001). In multivariate models, we found increased odds of trading sex for some variables, including a marginalized sexual identity, identifying as Black, and experiences of unstable housing, foster care, substance treatment, sexual harassment, and harassment based on gender (P < .001). CONCLUSIONS These findings contribute new knowledge about boys who trade sex using a large, population-based sample and counter false assumptions and stereotypes. These data suggest new avenues of research, intervention, and prevention.
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Affiliation(s)
- Lauren Martin
- School of Nursing, University of Minnesota, Minneapolis, Minnesota
| | | | - G Nic Rider
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
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15
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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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16
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Gerassi LB, Lowe S, Walsh K. University Students Who Report Exchanging Sex for Money or Other Compensation: Findings from a Public University Sample. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:459-468. [PMID: 35554760 DOI: 10.1007/s10508-021-02215-1] [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: 04/20/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 06/15/2023]
Abstract
Whether and how university students exchange sex for financial compensation in the USA is critically understudied. The purpose of this secondary analysis was to determine whether undergraduate and graduate students at a large public university report exchanging sex for financial or other compensation, and identify factors (e.g., demographics, childhood adversity, mental health) associated with exchanging sex. Participants were 600 college students (Mage = 21.3 years [SD = 3.8]); 72% cisgender women; 43.4% racial/ethnic minority) from a large public university in the Northeastern USA who completed cross-sectional, online questionnaires about lifetime trauma, adversity exposure, sexual behaviors, and current mental health and substance use symptoms. A total of 4.5% of participants reported exchanging sex for money, alcohol/drugs, or other forms of compensation. Bivariate analysis revealed that lesbian, gay, bisexual, and trans students (versus cisgender, heterosexual students), students who had more severe childhood trauma, who reported being removed from their family home in childhood, and students who were diagnosed with a mental health disorder before age 18 were more likely to report exchanging sex. In a multivariable model, only emotional neglect and greater alcohol use problems were significantly associated with likelihood of exchanging sex. To our knowledge, this is the first US study to determine whether university students exchange sex for money, alcohol/drugs, or other compensation. Findings suggest that universities could consider addressing exchanging sex in person-centered, supportive sexual health programming, university health services responses, and community spaces that support LGBTQ+ students. Future research is needed to understand students' circumstances in exchanging sex and differentiate compensation type.
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Affiliation(s)
- Lara B Gerassi
- University of Wisconsin-Madison, Sandra Rosenbaum School of Social Work, 1350 University Avenue, Madison, WI, 53706, USA.
| | - Sarah Lowe
- Yale University School of Public Health, New Haven, CT, USA
| | - Kate Walsh
- University of Wisconsin-Madison, Department of Psychology/Gender & Women's Studies, Madison, WI, USA
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17
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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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18
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Khetarpal SK, Szoko N, Culyba AJ, Shaw D, Ragavan MI. Associations Between Parental Monitoring and Multiple Types of Youth Violence Victimization: A Brief Report. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP19216-NP19227. [PMID: 34348500 PMCID: PMC9115795 DOI: 10.1177/08862605211035882] [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] [Indexed: 06/13/2023]
Abstract
Youth violence victimization continues to be pervasive and a significant cause of adolescent mortality. Since their 2014 "Connecting the Dots" report, the Centers for Disease Control and Prevention have encouraged researchers to identify shared protective factors that prevent multiple forms of youth violence. Parental monitoring, a bidirectional construct encompassing parental knowledge and regulation of their child's activities with children's concurrent perception of their parent's awareness of such activities, could be such a cross-cutting protective factor. In this study, we examined associations between parental monitoring and multiple types of violence victimization among a school-based sample of adolescents. We conducted a cross-sectional analysis of an anonymous survey of health risk and protective behaviors completed by students across Pittsburgh Public Schools (N = 2,426). In separate analyses, we used logistic regression to examine associations between youth-reported parental monitoring and multiple experiences of youth violence victimization, ranging from school- and electronic-based bullying to different forms of sexual and physical violence. We found that many experiences of youth violence victimization were consistent with nationally representative data. In addition, we determined that higher parental monitoring was significantly and inversely associated with all violence victimization outcomes examined (school-based bullying, electronic-based bullying, threatening someone with a weapon, adolescent relationship abuse, sexual assault, and exchange sex) at the p < .05 threshold. Overall, this study is one of the first that examines how parental monitoring relates to multiple forms of youth violence victimization, including exchange sex, which is a critical but less-studied violence experience. This work adds to the growing literature on how parental monitoring may serve as a shared protective factor for multiple forms of violence victimization.
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Affiliation(s)
| | - Nicholas Szoko
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alison J. Culyba
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daniel Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maya I. Ragavan
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of General Academic Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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19
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Franchino-Olsen H, Martin SL, Halpern CT, Preisser JS, Zimmer C, Shanahan M. Adolescent Experiences of Violence Victimizations Among Minors Who Exchange Sex/Experience Minor Sex Trafficking. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP16277-NP16301. [PMID: 34192962 PMCID: PMC9465536 DOI: 10.1177/08862605211021967] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This work investigates the associations between experiences of domestic minor sex trafficking and adolescent interpersonal violence victimizations, including intimate partner violence (IPV) and community violence. Abuse and violence in childhood are commonly proposed as risk factors for domestic minor sex trafficking. However, less is known about how interpersonal violence victimizations in adolescence connect to domestic minor sex trafficking experiences. The poly-victimization framework provides a means to understand domestic minor sex trafficking as a type of violence amid a web of additional interconnected violence victimizations. Efforts to better understand the interpersonal violence experienced by survivors of domestic minor sex trafficking are valuable in contextualizing trafficking experiences for adolescents. Data from The National Longitudinal Study of Adolescent to Adult Health, a population-based sample of adolescents in the United States (n = 12,605) were used to examine experiences of domestic minor sex trafficking for minor respondents, as measured through questions about exchanging sex for money or drugs. A multivariable logistic regression model was used to estimate the associations between domestic minor sex trafficking and IPV or community violence, while controlling for demographic variables and adolescent risk behaviors. Minors who experience community violence had significantly greater odds of having exchanged sex (aOR: 1.86; 95% CI: 1.32 -2.64). However, IPV was not significantly associated with minors' experiences of sex exchange (aOR: 1.14; 95% CI: 0.85 -1.54). Alcohol or drug use (aOR: 1.87; 95% CI: 1.32 -2.65) and having run away (aOR: 2.04; 95% CI: 1.53 -2.72) were also significantly associated with minor sex exchange. As experiences of domestic minor sex trafficking were significantly associated with community violence victimizations, prevention and intervention efforts targeting youth at high risk for or survivors of domestic minor sex trafficking should consider how community violence victimizations impact these adolescent populations, and programming/messaging should be adjusted to account for these additional violence victimizations.
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20
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Franchino-Olsen H, Martin SL. The Associations Between Gang Membership and Domestic Minor Sex Trafficking: Findings From a Nationally Representative Study. VIOLENCE AND VICTIMS 2022; 37:479-496. [PMID: 35577530 PMCID: PMC10765547 DOI: 10.1891/vv-2021-0070] [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] [Indexed: 06/15/2023]
Abstract
Adolescent gang membership has been proposed as a risk factor that creates individual-level vulnerability for domestic minor sex trafficking (DMST) and/or a context in which DMST may occur. This study investigates the gang membership-DMST association using data from The National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of adolescents in the United States (n = 12,605). Bivariate results found gang-involved minors had 4.39 greater odds of experiencing DMST compared to non-gang-involved peers. Multivariable results found gang membership, violence victimization, delinquency, and certain demographic characteristics to be significantly associated with DMST. These findings emphasize the need to consider the context in an adolescent's life beyond DMST when designing policies and programs, and highlight the need for additional research into the gang membership-DMST association.
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Affiliation(s)
- Hannabeth Franchino-Olsen
- The University of Edinburgh, School of Social and Political Science Ringgold standard institution-Social Work, Chrystal Macmillan Building 15a George Square, Edinburgh EH8 9LD, United Kingdom of Great Britain and Northern Ireland
| | - Sandra L Martin
- University of North Carolina at Chapel Hill Gillings, School of Global Public Health Ringgold standard institution-Maternal and Child Health Chapel Hill, North Carolina, United States
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21
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Barnert ES, Bath E, Heard-Garris N, Lee J, Guerrero A, Biely C, Jackson N, Chung PJ, Dudovitz R. Commercial Sexual Exploitation During Adolescence: A US-Based National Study of Adolescent to Adult Health. Public Health Rep 2022; 137:53S-62S. [PMID: 35775919 DOI: 10.1177/00333549211054082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES National data on the health of children and adolescents exposed to commercial sexual exploitation (CSE) are lacking, during both adolescence and adulthood. Using nationally representative data, we examined the health of male and female adolescents in grades 7-12 who experienced CSE exposure and subsequent adult health outcomes and access to health care. METHODS Our retrospective cohort study used data from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health (1994-2008) to characterize relationships between CSE exposure before or during adolescence and health during adolescence and adulthood. The analytic sample included 10 918 adult participants aged 24-34 in Wave IV. We performed bivariate analyses, stratified by sex, to quantify the relationship between CSE exposure before or during adolescence and adolescent and adult health outcomes. RESULTS Four percent of participants reported having a CSE exposure before or during adolescence (5% of males, 3% of females). Factors associated with CSE exposure among adolescents included race/ethnicity, parental education level, previous abuse, same-sex romantic attractions, history of ever having run away from home, and substance use. During adolescence, exposure to CSE was associated with worse overall health, depressive symptoms, and suicidal thoughts for both males and females. In adulthood, adolescent CSE exposure was associated with depression among males and functional limitations among females. A higher percentage of males with CSE exposure before or during adolescence, compared with their non-CSE-exposed peers, used the emergency department as their usual source of care during adulthood. CONCLUSIONS CSE exposure before or during adolescence was associated with poor adolescent and adult health outcomes and health care access. Observed differences between males and females warrant further exploration.
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Affiliation(s)
- Elizabeth S Barnert
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Nia Heard-Garris
- 2429 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Joyce Lee
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alma Guerrero
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Christopher Biely
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nicholas Jackson
- 155697 Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Paul J Chung
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,6470 Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Los Angeles, CA, USA.,Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Rebecca Dudovitz
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
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22
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Greenbaum J. Child Labor and Sex Trafficking. Pediatr Rev 2021; 42:639-654. [PMID: 34850175 DOI: 10.1542/pir.2020-001396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Regardless of their practice setting or subspecialty, pediatricians are likely to encounter children who have experienced sex or labor trafficking or who are at risk for exploitation. Only 24.1% of health professionals in one study reported receiving previous training on human trafficking; after a brief presentation on the topic, 39.6% indicated that they knew or suspected they had cared for a trafficked person in the past 3 months. Trafficked and exploited children can present with myriad physical or mental health conditions; most have experienced repeated, significant trauma; and few are likely to spontaneously disclose their exploitative situation. As a result, clinicians face challenges in recognizing and appropriately responding to potential human trafficking. Knowledge of common risk factors and potential indicators of exploitation can assist the pediatrician in recognizing affected and at-risk youth. However, health professionals report that existing training tends to focus on general information about trafficking, with relatively little time spent discussing the specifics of the trauma-informed approach to patient interactions. Given the critical importance of building patient trust, empowering patients to share their concerns, and engaging them in their own care and safety planning, this article focuses on the practical aspects of working with trafficked and exploited children. A brief overview of human trafficking is followed by an extensive discussion of rights-based, culturally sensitive, trauma-informed strategies for interacting with vulnerable patients.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA.,Institute on Healthcare and Human Trafficking, Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, GA
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23
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Surís JC, Stadelmann S, Auderset D, Barrense-Dias Y. Transactional sex among young people in Switzerland: a cross-sectional study. Sex Health 2021; 18:445-452. [PMID: 34823645 DOI: 10.1071/sh21104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 07/08/2021] [Indexed: 11/23/2022]
Abstract
Background The aim of this research was to determine the prevalence and characteristics of youths having ever exchanged sex and to assess if there were differences depending on whether they had done it once or several times. We also investigated what they exchanged sex for and their relationship with the last person they did it with. Methods A cross-sectional national survey was carried out in Switzerland in 2017 among young adults. The 5175 participants (51% males, mean age 26.3years) who answered the question 'Have you ever received something or obtained an advantage in exchange for a sexual act?' were divided into three groups: Never (96.8%), Once (1.5%) and Several (1.7%). Results In the multivariate analysis, compared to the Never group, those in the Once group were significantly more likely to be males, to have a poor mental health, to be non-exclusively heterosexual and to have had 10+ lifetime sexual partners. Those in the Several group reported the same characteristics, but were also more likely to be younger at first sexual contact, to have their parents not living together, to report a lower socioeconomic status and a history of sexual abuse, and to have ever sent sexual images/videos of themselves. They were also less satisfied with their financial situation. Conclusions Results indicate that transactional sex is a reality for some youths in Switzerland, and health professionals dealing with them should include this question in their sexual anamnesis. From a public health perspective, sexual education and prevention campaigns should include this phenomenon.
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Affiliation(s)
- Joan-Carles Surís
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Sophie Stadelmann
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Diane Auderset
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Yara Barrense-Dias
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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24
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McNeal BA. Correlates of Exchanging Sex for Drugs or Money for Adolescent Males: A Hidden Population. JOURNAL OF HOMOSEXUALITY 2021; 68:1950-1978. [PMID: 31990234 DOI: 10.1080/00918369.2020.1715141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Research from prostitution, sex trafficking, and commercial sexual exploitation (CSE) literature have found risk factors that can lead to both male and female youth becoming involved in this sex trade. These behaviors have been clearly defined and institutions have begun to address known risk factors. Youth who have reported involvement in trading/exchanging sex still remain hidden with limited information known about this group. The exchanging/trading sex literature has failed to explore correlates of involvement for adolescent males. This study explores factors found in prior research related to prostitution, sex tracking, and CSE to begin to understand adolescent males who exchanged sex for drugs or money. A secondary data analysis was used to examine the exchange of sex for male youth aged 12 to 18 in the United States. Results reveal that sexual activities were significant in predicting exchanging sex indicating a need for a more in-depth analysis of current and potential correlates for males.
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Affiliation(s)
- Brittani A McNeal
- Department of Criminology, University of West Georgia, Carrollton, Georgia, USA
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25
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Rothman EF, Farrell A, Paruk J, Bright K, Bair-Merritt M, Preis SR. Evaluation of a Multi-Session Group Designed to Prevent Commercial Sexual Exploitation of Minors: The "My Life My Choice" Curriculum. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:9143-9166. [PMID: 31354019 DOI: 10.1177/0886260519865972] [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: 06/10/2023]
Abstract
The commercial sexual exploitation (CSE) of children is a consequential public health and criminal justice problem, but no CSE prevention programs have been evaluated. The Boston-based My Life My Choice (MLMC) program offers a multisession psychoeducation group to girls who are identified as "at-disproportionate-risk" for CSE victimization and trains other agencies throughout the U.S. to offer this curriculum. The curriculum was designed to improve knowledge about the commercial sex industry and shift-related attitudes and behaviors. The current project was a multi-year, multi-site evaluation to assess the effectiveness of the MLMC prevention group. Using a one-group longitudinal design, changes in participant behavior and CSE knowledge were measured at baseline (n = 354), upon group completion (n = 296), and 3 months after group completion (n = 241). The sample was 95% female-identified, 28% Black/African American, 26% White/non-Hispanic, 25% Hispanic/Latina, and 22% other race. The mean age of participants was 15.6 years old. Approximately 28% identified as bisexual, and 10% identified as lesbian, asexual, pansexual, or other. In multivariable-adjusted models, participants reported fewer episodes of sexually explicit behavior at follow up as compared to baseline (relative risk [RR]: 0.52, 95% confidence interval [CI]: 0.37-0.72 at Follow-up 1, and 0.53, 95% CI: 0.35-0.82 at Follow-up 2). Participants were 24% less likely to report dating abuse at Follow-up 2 as compared to baseline (p = .06). In addition, as compared to baseline, participants were 40% more likely to have given help or information about CSE to a friend at Follow-up 2, and participants demonstrated increased knowledge and awareness about CSE and its harms over the follow-up period. Although additional evaluation using a comparison group and long-term follow up would increase confidence that observed changes are attributable to the group instead of other factors, results suggest that the MLMC curriculum may be effective in reducing the risk of CSE and improving other conditions for youth who are at-disproportionate-risk of CSE.
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26
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Gerassi LB, Cheng SY, Muentner L, Benson M. Prevalence and associated characteristics of youth who trade sex in a representative sample of high school students. J Adolesc 2021; 93:1-9. [PMID: 34583197 DOI: 10.1016/j.adolescence.2021.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Our understanding of youths' sex trading predominantly stems from non-representative studies with high-risk populations (e.g. homeless/runaway youth). The purpose of this study is to identify the prevalence and associated characteristics of youth who report sex trading (compared to those who do not) in a representative sample of high school students. METHODS Data comes from the 2018 Youth Assessment, a cross-sectional survey administered to 9th through 12th graders across 24 high schools in Dane County, a predominantly urban area in Wisconsin, U.S.A. All youth who answered the question, "have you ever had sexual contact in order to stay safe or to get something like a place to stay, money, gifts, alcohol or drugs?" were included for secondary data analysis (n = 13,714). Participants were 70% White, 50% female/47% male, and 90% minors. Chi-square tests and logistic regression analyses were conducted. RESULTS 2.47% of youth reported sex trading, of whom 91% were minors. Bivariate analysis revealed significant differences across demographics, economic instability, behavioral health and substance use, delinquency, and romantic/sexual behaviors. Multivariate results suggested that students who reported substance use, cutting class, 3 or more out-of-school suspensions, knowing a friend involved in a gang, dating violence, foster care involvement, or identifying as LGBTQ+ were more likely to report sex trading. CONCLUSIONS Although the causal order of characteristics analyzed in relation to the sex trading is not known, these findings have important implications for sex trading prevention, assessments, and intervention, particularly among youth with marginalized identities and adverse experiences.
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Affiliation(s)
- Lara B Gerassi
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, USA.
| | - Shih-Ying Cheng
- Jane Addams College of Social Work, University of Illinois Chicago, USA
| | | | - Meghan Benson
- Dane County Youth Commission, University of Wisconsin-Milwaukee, USA
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Khetarpal SK, Szoko N, Ragavan MI, Culyba AJ. Future Orientation as a Cross-Cutting Protective Factor Against Multiple Forms of Violence. J Pediatr 2021; 235:288-291. [PMID: 33991542 PMCID: PMC8502014 DOI: 10.1016/j.jpeds.2021.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/13/2021] [Accepted: 05/07/2021] [Indexed: 11/15/2022]
Abstract
Among 9th-to 12th-grade students who completed an anonymous health risk and protective behavior survey (n = 2346), positive future orientation was significantly and inversely associated with multiple forms of interpersonal violence including youth, community, and sexual/relationship violence. Designing interventions to promote future orientation holds promise as a cross-cutting violence prevention strategy.
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Affiliation(s)
| | - Nicholas Szoko
- UPMC Children’s Hospital of Pittsburgh , Pittsburgh, Pennsylvania
| | - Maya I. Ragavan
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,Division of General Academic Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alison J. Culyba
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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Deogan C, Jacobsson E, Mannheimer L, Björkenstam C. Are Men Who Buy Sex Different from Men Who Do Not?: Exploring Sex Life Characteristics Based on a Randomized Population Survey in Sweden. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2049-2055. [PMID: 33354757 PMCID: PMC8275502 DOI: 10.1007/s10508-020-01843-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/09/2020] [Accepted: 09/16/2020] [Indexed: 06/12/2023]
Abstract
The buying and selling of sex is a topic of frequent discussion and a relevant public health issue. Studies of sex workers are available, while studies addressing the demand side of sex are scarce, especially based on robust population data. The current study provides national estimates of the prevalence of and factors associated with having paid for sex among men in Sweden. We used a randomized population-based survey on sexual and reproductive health and rights among ages 16-84 years, linked to nationwide registers. The sample consisted of 6048 men. With a logistic regression, we analyzed what sex life factors were associated with ever having paid for or given other types of compensation for sex. A total of 9.5% of male respondents reported ever having paid for sex. An increased probability of having paid for sex was identified in men who were dissatisfied with their sex life (aOR: 1.72; 95% CI: 1.34-2.22), men reporting having had less sex than they would have liked to (aOR: 2.78; 95% CI: 2.12-3.66), men who had ever looked for or met sex partners online (aOR: 5.07; 95% CI: 3.97-6.46), as well as frequent pornography users (aOR: 3.02; 95% CI: 2.28-3.98) Associations remained statistically significant after adjustment for age, income, and educational attainment. Sex life characteristics such as poor sex life satisfaction, high online sex activity, and frequent pornography use are strongly associated with sex purchase. These findings can help guide and support counselling and prevention activities targeting sex buyers.
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Affiliation(s)
- Charlotte Deogan
- The Public Health Agency of Sweden, SE-171 82, Solna, Stockholm, Sweden.
- Karolinska Institutet, Department of Global Public Health Sciences, Social Medicine, Infectious Diseases and Migration Research, Stockholm, Sweden.
| | - Elin Jacobsson
- The Public Health Agency of Sweden, SE-171 82, Solna, Stockholm, Sweden
| | - Louise Mannheimer
- The Public Health Agency of Sweden, SE-171 82, Solna, Stockholm, Sweden
- Karolinska Institutet, Department of Learning, Informatics, Management and Ethics, Stockholm, Sweden
| | - Charlotte Björkenstam
- The Public Health Agency of Sweden, SE-171 82, Solna, Stockholm, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
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Martin L, Rider GN, Johnston-Goodstar K, Menanteau B, Palmer C, McMorris BJ. Prevalence of Trading Sex Among High School Students in Minnesota: Demographics, Relevant Adverse Experiences, and Health-Related Statuses. J Adolesc Health 2021; 68:1011-1013. [PMID: 33032931 DOI: 10.1016/j.jadohealth.2020.08.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/16/2020] [Accepted: 08/20/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Youth who trade sex for something of value experience enduring harm and risk of being trafficked. This study provides empirically-based prevalence estimates to guide policy and practice. METHODS This secondary analysis of 2019 population-level surveillance data from high school students in Minnesota (N = 71,007) uses descriptive statistics and chi-square tests to analyze self-reports of trading sex by demographics, relevant experiences, and health indicators. RESULTS The prevalence of trading sex among high school students in Minnesota was 1.4%. Cisgender boys and girls had similar rates; transgender students were much higher (5.9%). Rates varied significantly across race/ethnicity (e.g., Native youth, 3.1%), school location, and economic indicators. Students indicating other relevant experiences, such as having been treated for alcohol or drug use (15.1%), reported elevated rates of trading sex. CONCLUSIONS Trading sex is a public health issue that affects high school students. The results show disparate rates of trading sex based on race/ethnicity and gender, with elevated rates among youth who engage in other risky behaviors and experienced other adverse experiences.
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Affiliation(s)
- Lauren Martin
- School of Nursing, University of Minnesota, Minneapolis, Minnesota.
| | - G Nic Rider
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
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Head SK, Eaton D, Lloyd PC, McLaughlin A, Davies-Cole J. Exchange Sex Among High School Students-Washington, DC, 2017. J Adolesc Health 2021; 68:350-356. [PMID: 32680800 PMCID: PMC7855387 DOI: 10.1016/j.jadohealth.2020.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE Exchange sex, the exchange of money or nonmonetary items for sex, is associated with sexually transmitted diseases and HIV. We sought to identify prevalence and characteristics associated with exchange sex among District of Columbia (DC) high school students. METHODS We used the 2017 DC Youth Risk Behavior Survey, a cross-sectional survey of students in grades 9-12 (n = 8,578). We performed multivariable logistic regression to examine associations between exchange sex and demographic, home environment, and substance use measures. RESULTS In 2017, a total of 7.4% (95% confidence interval [CI]: 6.6-8.2) of students reported ever having engaged in exchange sex. Odds of exchange sex were higher among males (adjusted odds ratio [AOR]: 2.5; 95% CI: 1.6-4.0) and students who had sexual contact with partners of both sexes (AOR: 2.4; 95% CI: 1.2-4.9), compared with students having sexual contact with partners of opposite sex only. Exchange sex was also associated with having been kicked out, run away, or abandoned during the past 30 days (AOR: 10.7; 95% CI: 7.0-16.3]); going hungry during the past 30 days (AOR: 2.2; 95% CI: 1.1-4.5); and ever using synthetic marijuana (AOR: 2.6; 95% CI: 1.3-5.0) or cocaine, heroin, methamphetamines, or ecstasy (AOR: 2.9; 95% CI: 1.6-5.3]), compared with those who had not. CONCLUSIONS Approximately one in 14 DC high school students engaged in exchange sex. Programs providing services to youth with unstable housing, food insecurity, or who use drugs should incorporate sexual health services to address exchange sex practices.
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Affiliation(s)
- Sara K. Head
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia,Address correspondence to: Sara K. Head, Ph.D., M.P.H., Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia, 30329. (S.K. Head)
| | - Danice Eaton
- Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patricia C. Lloyd
- Center for Policy, Planning, and Evaluation, Department of Health, Washington, DC
| | - Aimee McLaughlin
- Data and Strategic Initiatives, Office of the State Superintendent of Education, Washington, DC
| | - John Davies-Cole
- Center for Policy, Planning, and Evaluation, Department of Health, Washington, DC
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De Vries I, Goggin KE. The Impact of Childhood Abuse on the Commercial Sexual Exploitation of Youth: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2020; 21:886-903. [PMID: 30305008 DOI: 10.1177/1524838018801332] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Scholars and practitioners have drawn attention to the issue of commercial sexual exploitation (CSE) of minors, yet we continue to lack a clear understanding of which factors increase a minor's risk to this type of victimization. The current article reviews the literature about the impact of sexual, physical, or emotional abuse on the risk of CSE. The study utilizes quantitative meta-analytical techniques to estimate an overall impact of prior abuse. Nineteen studies were selected after a comprehensive search of electronic databases covering the fields of social science, criminology, psychology, or related fields. To be included in the analyses, all articles had to measure the direct impact of sexual, physical, and/or emotional abuse on minor's risk to CSE, utilizing multivariate techniques and presenting statistical metrics to assess the impact of prior abuse. Key findings demonstrate that sexual abuse considerably increases the risk of exploitation, especially among female youth in the United States. Physical and emotional abuse show negligible or no significant independent impacts, even though a few studies have begun to suggest that experiencing multiple types of childhood abuse may aggravate a risk of sexual exploitation. Our findings can guide further research on the impact of prior victimizations and inform screening instruments that are being developed to identify youth at risk of CSE.
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Affiliation(s)
- Ieke De Vries
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
| | - Kelly E Goggin
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
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Baiden P, Xiao Y, Asiedua-Baiden G, LaBrenz CA, Boateng GO, Graaf G, Muehlenkamp JJ. Sex differences in the association between sexual violence victimization and suicidal behaviors among adolescents. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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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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Tucker JS, D'Amico EJ, Pedersen ER, Rodriguez A, Garvey R. Study protocol for a group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among young adults experiencing homelessness. Addict Sci Clin Pract 2020; 15:26. [PMID: 32723349 PMCID: PMC7390162 DOI: 10.1186/s13722-020-00201-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/17/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Young people experiencing homelessness have alarmingly high rates of alcohol and other drug (AOD) use, which is associated with sexual risk behaviors such as unprotected sex, trading sex, and sex with multiple casual partners. Few risk reduction programs for this population have been developed and rigorously evaluated, particularly those that address both of these interrelated behaviors, use a collaborative and non-judgmental approach, and are feasible to deliver in settings where homeless young people seek services. This paper describes the protocol of a study evaluating a four-session Motivational Interviewing (MI)-based group risk reduction intervention for this population. The protocol has been shown to be efficacious in pilot work over 3 months with 200 homeless young adults [1]. The current study seeks to refine the intervention protocol and evaluate the program on a larger scale. METHODS/DESIGN In a cluster-cross-over randomized controlled trial, 18-25 year olds will receive the AWARE risk reduction program (n = 200) or standard care (n = 200) at one of three drop-in centers serving homeless youth in the Los Angeles area. We will evaluate intervention effects on primary outcomes of AOD use and sexual risk behavior, as well as secondary outcomes of health-related quality of life and social stability, over a 12-month period. DISCUSSION This project has the potential to fill a significant gap in prevention services by demonstrating that a brief intervention, feasible to deliver within settings where young people experiencing homelessness typically seeks services, can significantly reduce the interrelated problems of AOD use and sexual risk behavior. Trial registration ClinicalTrials.gov Identifier: NCT03735784. Registered November 18, 2018, https://clinicaltrials.gov/ct2/show/record/NCT03735784 (retrospectively registered).
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States.
| | - Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States
| | - Eric R Pedersen
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States.,Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, 250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, United States
| | - Anthony Rodriguez
- RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA, 02116, United States
| | - Rick Garvey
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States
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Rothman EF, Farrell A, Bright K, Paruk J. Ethical and Practical Considerations for Collecting Research-Related Data from Commercially Sexually Exploited Children. Behav Med 2018; 44:250-258. [PMID: 30020869 DOI: 10.1080/08964289.2018.1432550] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article presents seven challenges of collecting primary (i.e., firsthand) data from commercially sexually exploited children (CSEC). We drew on our research team's experience collecting longitudinal data from 28 CSEC survivors with a 12-month follow-up period. We used both face-to-face and electronic group brainstorming methods to nominate a list of research-related challenges. The two main themes that were identified were challenges that can limit data quality and concerns about the impact of research on participants, researchers, and others. The three challenges related to data quality are (1) the age of the research participants; (2) questions about obtaining informed consent from parents or guardians; and (3) the over-interrogation of CSEC youth. The four challenges related to concerns about the impact of research were (4) concerns that research participation may further exploit youth; (5) staying in the role of researcher and refraining from providing advocacy; (6) secondary trauma and burnout experienced by research staff; and (7) the additional burden that research and data collection may place on the advocates and direct service providers. Because the process of collecting data from CSEC youth can be complicated, and rife with ethical and practical challenges, we have relayed our experiences with seven specific research-related challenges in order to stimulate discourse and further progress in the field.
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Affiliation(s)
- Emily F Rothman
- a Boston University School of Public Health , Department of Community Health Sciences , Boston , MA , USA
| | - Amy Farrell
- b Northeastern University, School of Criminology & Criminal Justice , Boston , MA , USA
| | - Katherine Bright
- b Northeastern University, School of Criminology & Criminal Justice , Boston , MA , USA
| | - Jennifer Paruk
- a Boston University School of Public Health , Department of Community Health Sciences , Boston , MA , USA
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Le PD, Ryan N, Rosenstock Y, Goldmann E. Health Issues Associated with Commercial Sexual Exploitation and Sex Trafficking of Children in the United States: A Systematic Review. Behav Med 2018; 44:219-233. [PMID: 30020867 DOI: 10.1080/08964289.2018.1432554] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This article reviews studies examining health issues associated with commercial sexual exploitation and sex trafficking (CSE/ST) of children in the United States. We searched five health and social sciences databases for peer-reviewed articles published in English between January 1990 and April 2017. After independent screening of the records, we identified 27 studies that met the inclusion criteria. Descriptions of the included studies and their definitions of CSE/ST are provided. Most of the studies sampled children and youth in urban, metropolitan areas and employed cross-sectional surveys or reviewed case files and medical records of convenience samples. Studies differed widely in their operationalization of CSE/ST, which limit systematic comparison across studies and the generalizability of findings. Qualitative analysis of the included studies shows that among commercially sexually exploited/trafficked children, there are elevated burdens of substance use and abuse, mental health disorders such as depression, PTSD, suicidal behaviors, and sexual and reproductive health issues including STIs, HIV, and pregnancy. This review underscores the need for more empirical studies, to guide an evidence-based understanding of and response to the range and complexity of the health issues in this population. Of particular utility are studies that address some of the methodological limitations of prior research in this field (e.g., cross-sectional, convenience samples) and those that assess overlooked health issues (e.g., malnutrition, eating disorders, post-trauma growth, and long-term health consequences).
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Affiliation(s)
- PhuongThao D Le
- a Department of Mental Health , Bloomberg School of Public Health, Johns Hopkins University
| | - Nessa Ryan
- b College of Global Public Health, New York University
| | - Yael Rosenstock
- c The Center for Ethnic, Racial, and Religious Understanding (CERRU), Queens College
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Thibodeau ME, Lavoie F, Hébert M, Blais M. Childhood maltreatment and adolescent sexual risk behaviors: Unique, cumulative and interactive effects. CHILD ABUSE & NEGLECT 2017; 72:411-420. [PMID: 28918232 DOI: 10.1016/j.chiabu.2017.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 08/21/2017] [Accepted: 09/03/2017] [Indexed: 05/14/2023]
Abstract
Child maltreatment has been associated with sexual risk behaviors. Previous investigators have typically studied only one form of maltreatment, preventing them from exploring interrelations between forms of maltreatment and their impact on sexual risk behaviors. Thus, this study aims to examine the unique, cumulative, and interactive effects of four maltreatment forms (sexual abuse, physical abuse, neglect, and witnessing interparental violence) on sexual risk behaviors. The sample comprised 1940 sexually active adolescents (Mage=15.6; 60.8% girls) attending Quebec (Canada) high schools. Regression results showed that all maltreatment forms were associated with having a higher number of sexual partners, casual sexual behavior, and a younger age at first consensual intercourse. Physical abuse and witnessing interparental violence were associated with inconsistent condom use, and physical abuse was associated with sexually transmitted infections. After controlling for all forms of maltreatment (unique effects), analyses showed that sexual abuse, physical abuse, neglect or witnessing interparental violence remained statistically associated depending on the sexual risk behavior. A greater number of forms of maltreatment was associated with more sexual risk behaviors (cumulative effect). When sexual abuse was not experienced, neglect was associated with a higher number of sexual partners (interactive effects). In general, associations between maltreatment and sexual risk behaviors were similar for both genders. The magnitude of the relationship between a specific form of child maltreatment and sexual risk behaviors may be inaccurately estimated when not controlling for other forms of maltreatment.
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Affiliation(s)
| | | | - Martine Hébert
- Département de sexologie, Université du Québec à Montréal, Québec, Canada
| | - Martin Blais
- Département de sexologie, Université du Québec à Montréal, Québec, Canada
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