A Short Screening Tool to Identify Victims of Child Sex Trafficking in the Health Care Setting
OBJECTIVES:
The
aim of this study was to describe characteristics of commercial sexual
exploitation of children/child sex trafficking (CSEC/CST) victims and to
develop a screening tool to identify victims among a high-risk adolescent
population.
METHODS:
In this
cross-sectional study, patients aged 12 to 18 years who presented to 1 of 3
metropolitan pediatric emergency departments or 1 child protection clinic and
who were identified as victims of CSEC/CST were compared with similar-aged
patients with allegations of acute sexual assault/sexual abuse (ASA) without
evidence of CSEC/CST. The 2 groups were compared on variables related to
medical and reproductive history, high-risk behavior, mental health symptoms,
and injury history. After univariate analysis, a subset of candidate variables
was subjected to multivariable logistic regression to identify an optimum set
of 5 to 7 screening items.
RESULTS:
Of 108
study participants, 25 comprised the CSEC/CST group, and 83 comprised the ASA
group. Average (SD) age was 15.4 (1.8) years for CSEC/CST patients and 14.8
(1.6) years for ASA patients; 100% of the CSEC/CST and 95% of the ASA patients
were female. The 2 groups differed significantly on 16 variables involving
reproductive history, high-risk behavior, sexually transmitted infections, and
previous experience with violence. A 6-item screen was constructed, and a
cutoff score of 2 positive answers had a sensitivity of 92%, specificity of
73%, positive predictive value of 51%, and negative predictive value of 97%.
CONCLUSIONS:
Adolescent
CSEC/CST victims differ from ASA victims without evidence of CSEC/CST across
several domains. A 6-item screen effectively identifies CSEC/CST victims in a
high-risk adolescent population.
- 1From the *Children's Healthcare of Atlanta and †Emory University School of Medicine, Atlanta, GA.
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