Specific youth behaviors linked to risk for sexual exploitation

Youth who experienced sexual exploitation exhibited high levels of sexual risk taking, multiple sexual partners, PTSD, child pornography exposure and childhood trauma, according to study results published in JAMA Network Open.

“Previous research has identified numerous vulnerability factors associated with [child sexual exploitation], including psychological distress, emotion dysregulation, psychiatric symptoms, childhood trauma, poverty, single-parent families, criminality and age,” Jessica J. Laird, GradDip (Hons), of the School of Psychology at Deakin University in Australia, and colleagues wrote. “However, although these studies make an important contribution through the identification of discrete factors, no systematic synthesis of findings has been conducted to identify and quantify which factors are most critical and should be prioritized in [child sexual exploitation] screening and intervention programs, for example, to investigate whether running away is associated with risk for [child sexual exploitation], a protective factor or even unrelated.”

Laird and colleagues conducted the current systematic review and meta-analysis to synthesize evidence of risk and protective factors linked to child sexual exploitation and their estimated effect sizes. They searched five databases up to June 2019 and included 37 unique quantitative investigations of sexual exploitation and mean sample age of 18 years or younger, and they included 67,453 unique participants. The investigators defined child sexual exploitation as coerced sexual acts between a child, or a young person aged 18 years and an individual or a group in exchange for substances, gifts, money or other commodities and related factors.

The meta-analysis revealed several factors significantly associated with exposure to sexual exploitation, including sexual risk behaviors (OR = 6.31; 95% CI, 3.12-12.76), having more than five sexual partners (OR = 5.96; 95% CI, 1.63-21.87), a PTSD diagnosis (OR = 5.29; 95% CI, 3.4-8.22), historical exposure to child pornography (OR = 5.5; 95% CI, 0.99-30.53) and a history of childhood sexual abuse (OR = 3.8; 95% CI, 3.19-4.52).

The investigators observed moderate to strong association among numerous other potentially modifiable factors.

“Adolescents or children presenting to primary or tertiary services with risky sexual behaviors, prior exposure to sexual violence online and offline and mental health risk factors associated with trauma warrant further assessment for [child sexual exploitation],” they wrote. “Trauma-informed intervention planning and design for youth affected by [child sexual exploitation] should incorporate the psychological treatment of trauma symptoms alongside supportive psychoeducation regarding sexual safety online and offline. This review informs the current evidence base and the design of initiatives seeking to prevent and intervene early for [child sexual exploitation] among children and adolescents.”

In a related editorial, Julian D. Ford, PhD, of the department of psychiatry at the University of Connecticut School of Medicine, highlighted the importance of these findings for research related to child sexual exploitation.

“The array of factors identified provides a foundation for more systematic and theoretically informative prospective research on the risk and protective factors, concurrent effects and long-term outcomes in childhood, adolescence and across the life span of [child sexual exploitation],” Ford wrote. “The findings point to the need for a consolidated meta-theory that accounts for not only sexual exposure but also other developmental, relational and traumatic precursors that may place children at risk for, protect against, and exacerbate or mitigate the adverse impact of [child sexual exploitation].”