Healthcare Use and Case Characteristics of Commercial Sexual Exploitation of Children

Abstract

Introduction The overall goal of this study was to provide further information about the characteristics of commercial sexual exploitation of children (CSEC) victims by comparing the characteristics of a known victim pool to high-risk patients identified. The specific objectives of this study were to describe patient demographic characteristics, pediatric healthcare use, familial psychosocial characteristics, and child sexual abuse case characteristics present in youth identified as high risk for CSEC victimization compared with a sample of known victims. Methods A retrospective chart review was conducted on patients presenting to the emergency department or Child Advocacy Center for a concern of sexual abuse/assault at a midwestern U.S. academic pediatric medical center. Adolescents aged 12–21 years were included in the study. Results In the current study, multiple CSEC risk factors were noted to increase odds for CSEC victimization: homelessness or life on the streets, runaway behavior, living with mother only, placement in a juvenile detention center, placement in a residential treatment center or group home, and number of living arrangements (four or greater). Multiple elements of high-risk sexual behavior increased odds of CSEC victimization: legally age-inappropriate sex, gonorrhea diagnosis, trichomonas diagnosis, other sexually transmitted infection (STI) diagnoses, number of STIs, and chlamydia diagnosis. Discussion These findings suggest that age of sexual partners and number and types of STIs are associated with CSEC and should be validated in other groups. In addition, these data suggest that use of cocaine and opiates could serve as an important, yet underrecognized, risk factor.

Risk and Protective Factors for Sexual Exploitation in Male and Female Youth From a Cross-Cultural Perspective: A Systematic Review

“…The lack of education was attributed to family poverty, limited economic opportunities in the community, or the distance to schools. While in other studies, mainly conducted in the United States, youth did have access to education, but problems such as dropping out of school, lack of education about sexual exploitation, and low grades were associated with sexual exploitation (Adjei & Saewyc, 2017;Chohaney, 2016;Greeson et al, 2019a;Hurst, 2021;Hornor et al, 2022;Servin et al, 2015).…”

“…Multiple studies (n = 17), from several continents, found a connection between compromised parenting and family functioning and sexual exploitation (the United States, Canada, Mexico, Brazil, the United Kingdom, Uganda, and the Philippines). This risk factor was captured in these studies via different measures (e.g., poor nurturing, conflicts between child and parents, unhealthy family relationships, parental attachment, and caregiver absence) and was found in both male and female youth (Acharya & Bryson Clark, 2021;Alderson et al, 2021;Chohaney, 2016;Cole, 2018;Fraley & Aronowitz, 2021;Helpingstine et al, 2021;Homma et al, 2012;Hornor et al, 2022;Louie, 2018;Macias-Konstantopoulos et al, 2013McNeal & Walker, 2016;O'Brien, 2018;Reid & Piquero, 2016;Self-Brown et al, 2021;Silverman et al, 2007;Williams et al, 2012). Three studies made a gender comparison, of which two found gender differences.…”

“…Running away from home or residential care was cited as a risk factor for sexual exploitation in both male and female youth by a substantial body of research (n = 15), conducted in the United Kingdom and Spain (Biehal & Wade, 1999;Pereda et al, 2022), Mexico (Servin et al, 2015) but mainly in the United States (Barnertt et al, 2022;Chohaney, 2016;Cimino et al, 2017;Fedina et al, 2019;Franchino-Olsen et al, 2021;Hornor et al, 2022;Panlilio et al, 2019;Pereda et al, 2022;Reid, 2011Reid, , 2018Reid & Piquero, 2016;Roe-Sepowitz, 2012;Varma et al, 2015). No significant differences in gender were found with the exception of the study of Panlilio et al (2019).…”

“…In all, 10 studies which were all conducted in the United States showed that ethnicity was associated with sexual exploitation. Victims were more often from an ethnic or cultural minority compared to youth who were not sexually exploited (Barnert et al, 2022;Fedina et al, 2019;Reid et al, 2021), such as African American (Franchino-Olsen et al, 2021;Franchino-Olsen & Martin, 2022;Hornor et al, 2022;O'Brien et al, 2017;Reid & Piquero, 2014), Latino (Greeson et al, 2019), or multiracial (Chohaney, 2016).…”

Exploitation, Labor and Sex Trafficking of Children and Adolescents: Health Care Needs of Patients

“…exploitation (T/E) may seek health care in a variety of settings, [1][2][3] making it essential that pediatric providers anywhere are equipped to recognize potential T/E and respond appropriately. The guidance offered here is aimed to assist health care professionals in recognizing previously unidentified T/E, as well as in providing a basic initial response to suspected and confirmed cases of exploitation.…”