Sexual exploitation of children and adolescents is a pressing, yet largely under-recognized form of child abuse. The goals of this review were to identify interventions that have been implemented with sexually exploited children and adolescents and to better understand their effectiveness for fostering healing with this population. Our systematic search generated 4,358 publications of which 21 met our inclusion criteria. Based on their objectives and delivery, we organized the interventions into five categories: (a) focused health and/or social services, (b) intensive case management models, (c) psychoeducational therapy groups, (d) residential programs, and (e) other. Most programs were gender-specific, targeting girls and young women with just one being for boys and young men only. Studies reported on a range of outcomes including psychosocial outcomes, risky behaviors, trauma responses, mental health, protective factors, and public health outcomes. Despite differences in delivery, most of the interventions did, to some degree, appear to foster healing among sexually exploited children and adolescents. Findings from this review have implications for researchers, policy and program developers, and frontline practitioners who, through partnerships with one another, can advocate for the creation of evidence-informed, purpose-built, and thoughtfully delivered interventions.

Research and policies on child and adolescent sexual exploitation frequently focus on the sexual exploitation of girls and fail to recognize the experiences of sexually exploited boys, including their potentially unique health care and social support needs. This oversight limits the ability of health care and social service providers to offer both targeted and evidence informed care to sexually exploited boys. As a first step in a larger grant to understand the experiences of sexually exploited boys and to develop interventions for this specific population, we conducted a systematic review to address the question, "What is the state of the research on sexually exploited boys internationally?" As we undertook this review, we faced a number of significant challenges that made the process more difficult than anticipated. In this paper we discuss four key methodological challenges we encountered: lack of a consistent definition of child and adolescent sexual exploitation, difficulties in differentiating sexual exploitation as a specific concept within child sexual abuse, failure to disaggregate data usefully across multiple variables, and limited epidemiological studies to inform prevalence. We reflect on how these challenges limited our ability to systematically analyze, synthesize, and interpret the available research. We conclude by making recommendations to improve the state of the research regarding sexually exploited boys with the aim of better informing future policy and practice.

This systematic review assessed the current state of the literature on sexually exploited boys internationally. We aimed to describe what is known about sexual exploitation of boys, identify gaps in the literature, provide implications for practice, and make recommendations for future research. Multiple database searches were conducted using a combination of controlled vocabulary and keywords to capture child and adolescent sexual exploitation. Our search identified 11,099 unique references and excluded studies that did not include male participants less than 18 years old or disaggregate results by relevant age groups and/or by sex. This review identified 42 studies from 23 countries, providing evidence that sexual exploitation of boys is an issue in both high- and low-income countries. Seventeen articles had sexual exploitation as their primary variable of interest, the majority of which sampled boys who accessed services (i.e., shelters, health care, social, and justice services). Boys' experiences of sexual exploitation varied in terms of venue, exploiters, and compensation. Compared to their non-sexually exploited peers, sexually exploited boys more commonly reported experiences of child abuse, substance use, conduct problems, and mental health problems such as anxiety, depression, and self-harm. Despite increasing evidence that boys are sexually exploited around the world, the current literature provides limited data about the antecedents, sequelae, and the specific features of sexual exploitation experiences among boys. Further research is needed to inform, policy, social services and health care delivery specific to the needs of sexually exploited boys.

On any given night, thousands of Canadian youth face homelessness in either absolute (living on the street) or relative (couch surfing, staying in emergency shelters) terms.  This study explores influences primary health care access among youth experiencing homelessness in a large Canadian urban centre.  Using a qualitative research design and convenience sampling, 8 youth participated in in-depth individual interviews and 4 clinicians with expertise in working with youth in primary care settings participated in a facilitated solutions-focused dialogue based on findings from the youth interviews.  Data collection occurred from January to November 2016.  Main findings included: (1) Youth experiencing homelessness feel powerless when interacting with health care providers, (2) Health care systems exist as rule-based bureaucracies and (3) Homeless youth are in survival mode when it comes to their health.  The authors offer recommendations to promote more equitable access to primary health care services for homeless youth.

Racism in healthcare is real and it impacts nurses in ways that permeate the culture of healthcare. In the context of increasing social discourse about racism in healthcare, a group of nurses in British Columbia, Canada, felt a moral obligation to expose the social injustice of the systemic racism they had witnessed or experienced. They used film, an arts-based medium, as an innovative tool with the potential to reach an array of viewers, for this nurse activist project in anti-racist action. The creative process allowed for a racially diverse group of nurses to engage in meaningful dialogue about racism in healthcare. The purpose of this descriptive methodological article is to describe how a creative team of novice nurse filmmakers used the nursing process as a framework to carry this project from concept to execution. The stages described include the rationale for developing the film, the process of utilizing this as a means of nurse activism, and the value of using film as a strategy for social activism. Film was used to engage nurses and nursing students in anti-racist work that critically challenges the structural racism embedded in healthcare. We request that all readers view our film in conjunction with reading this article to best grasp how this article and the film complement one another because the film and article are intended to co-exist and not to exist in isolation from one another.