Commercial Sexual Exploitation of Children in the United States, 1997-2000

Child Sex Trafficking and Commercial Sexual Exploitation: Health Care Needs of Victims

“…However, some youth are at further risk because of individual, family, and community factors. Runaway and homeless youth, as well as thrownaway youth (those who are told to leave home or not allowed to return), are at especially high risk, 20,21 as are children with a history of sexual or physical abuse or neglect, 12 those from families with other dysfunction (eg, caregiver substance misuse, untreated psychiatric problems, intimate partner violence, criminality), 13 youth with a history of juvenile justice or child protective services (CPS) involvement, 22 and those who are lesbian/gay/bisexual/transgender or questioning. 12 Youth with substance use problems, behavioral and mental health problems, or learning disabilities may also be at increased risk, 13 as are girls associated with gangs 23 and children living in regions with high crime rates, adult prostitution, or poverty and areas with transient male populations (military bases, truck stops, convention centers).…”

“…Once recruited into trafficking and CSEC, many children experience repeated physical violence (eg, beating, choking, burning), sexual assault and gang rape, psychological abuse and manipulation, threats, and blackmail at the hands of the trafficker, facilitators in the trafficking trade, and buyers. 4,13,20 Traffickers use these strategies to establish and maintain total control over a victim. Alternating acts of violence and cruelty with acts of kindness and "love" helps to build strong bonds between trafficker and victim, making it very difficult for the victim to leave.…”

“…13,20 Recruitment may begin over the Internet using social media or may involve face-to-face encounters. The process may be abrupt or prolonged; it may be dominated by manipulation and deceit or by violence.…”

Medical Providers’ Understanding of Sex Trafficking and Their Experience With At-Risk Patients

“…3,4 The US government estimates that 14 500 to 17 500 people are brought to the United States annually for the purposes of labor or sexual exploitation, but this estimate does not include those who are trafficked domestically. 5,6 An estimated 100 000 to 300 000 youth each year are at risk for sexual exploitation in the United States. However, victims are difficult to identify, and no comprehensive centralized database of victims exists, making it difficult to quantify the prevalence of trafficking among minors.…”

Stopping rape

“…It can be a two-way relationship. For example, Estes and Weiner (2001) found 61 per cent of homeless girls reported sexual abuse as the reason for leaving home. Without access to adequate economic resources, these girls are forced to live on the streets or 'sofa surf ' where they are more vulnerable to rape, sexual exploitation and 'survival sex'.…”