Help-Seeking Among Children Impacted by Commercial Sexual Exploitation: A Scoping Review.

This scoping review aims to summarize current research on help-seeking behaviors and patterns among children who have experienced commercial sexual exploitation of children (CSEC) victimization and/or are at high risk of exploitation. Because the literature on help-seeking specific to CSEC victimization is limited, the current review was expanded to summarize findings from help-seeking research for children who have experienced harms that often co-occur with CSEC, such as maltreatment and homelessness. The authors searched three large article databases (PsycInfo, Ovid MEDLINE, and Web of Science) for articles that were (a) empirical; (b) measured or used the term "help-seeking" in their framing and/or results; (c) included children between the ages of 12 and 18; (d) primarily focused on children from the United States; (e) published in English. Ultimately, 22 articles met all inclusion criteria and were included in the final review. Results suggest that cisgender white females are the most likely to seek help, followed by sexual and gender minority children. Cisgender male children were the least likely to engage in help-seeking behaviors. Universally, children were more likely to engage in informal help-seeking rather than formal help-seeking, with younger children being more likely to reach out to parents and older children more likely to reach out to friends. Importantly, ethnically diverse children were under-represented, leading to limited information about how and why these children seek help. Implications for help-seeking by children impacted by commercial sexual exploitation are discussed, providing guidance for programming and research related to CSEC prevention.

Identification and responses by nurses to sexual exploitation of young people.

BACKGROUND: Nurses are uniquely positioned to identify and respond to the sexual exploitation of young people. They treat sexually transmitted infections, unplanned pregnancies, and mental health issues, often collaborating with social services and law enforcement to safeguard young people. AIM: This narrative review explores the pivotal role of nurses in identifying and responding to sexual exploitation among young people. METHODS: Empirical evidence from 1997 to 2021 was examined through a comprehensive search of databases such as CINAHL-EBSCO, ASSIA, PubMed (including Medline), and manual screening of abstracts. The PRISMA guideline was applied. Thematic analysis of 12 selected studies revealed three overarching themes. FINDINGS: The themes identified were the influence of technology on the sexual exploitation of young people, identification and response to sexual exploitation in both clinical and non-clinical settings, and organisational support. CONCLUSION: These findings shed light on sexual exploitation and underscore the significance of a person-centred approach to nursing care that addresses the health and social impacts of sexual exploitation. It emphasises the importance of interagency collaboration and appropriate clinical interventions to effectively support young people at risk. Increased professional development, support, and supervision for nurses are relevant to identifying, responding to, and preventing the sexual exploitation of young people.

Organized sexualized and ritual violence: Results from two representative German samples.

BACKGROUND: Organized sexualized and ritual abuse (ORA), a contentious issue since the 1980s, remains a polarizing topic. Although there is much debate about the existence of this phenomenon, a differentiated perspective is lacking, and no representative study has yet addressed the frequency. OBJECTIVE: This paper aims to investigate the frequency of ORA in Germany using two representative datasets. PARTICIPANTS AND SETTING: Data were collected from representative samples of the German population (N = 2522, N = 2515). Participants aged 16 to 96 years (50 and 53 % female) were recruited. They were selected by a random route procedure and asked to fill out a paper-pencil-questionnaire. METHODS: The four aspects of ORA (severe sexual violence, perpetrator networks, commercial exploitation, ideology) were assessed based on the definition provided by an expert group. Additionally, in the second survey, a direct yes/no question about the experience of ORA as well as details on perpetrators and offense characteristics were surveyed. RESULTS: Frequency of ORA was low. The direct question on ORA was affirmed by 0.5 % (n = 13), while according to the criteria of the definition, only 0.2 % or less of individuals experienced organized sexualized abuse, and <0.1 % experienced ritual abuse. CONCLUSION: Although ORA is discussed thoroughly, frequencies in the German population are low. This may be due to inconsistent terminology and operationalization of definitions with lack of precision. However, an intersection of conspiracy beliefs and the topic of ritual violence sheds another light on this issue that should receive more attention.

Reoffending after convictions related to child sexual exploitation material: Data from the German Federal Central Criminal Register.

BACKGROUND: As digitalization has made it easier to produce, copy, and distribute child sexual exploitation material (CSEM), the possession and distribution of child sexual abuse images has become more widespread. Thus, the need to assess the risk of subsequent sex offenses - above all, sexual abuse of children by individuals who have been convicted of CSEM offenses - becomes more and more important. OBJECTIVE: The main objective of this paper is to contribute to the understanding of the respective size of two groups of offenders: first, offenders who commit CSEM offenses without ever crossing the line to sexual abuse of children, and second, so-called crossover offenders, that is, individuals who commit CSEM offenses and engage in child sexual abuse. Identification of differences between these two groups facilitates analyzing the risk that someone convicted of a CSEM offense might in the future sexually assault children. METHOD: We used data from the German Federal Central Criminal Register (Bundeszentralregister), a data set that includes information about all persons convicted of any criminal offense, including "child pornography" offenses, by a court in Germany. RESULTS: For persons convicted of CSEM offenses only, with no additional concurring sex offenses, the rate of subsequent convictions for child sexual abuse is very low (1.1 % after a six-year follow-up period, adult offenders). This risk is even lower if offenders are older than 30 years of age, and it is slightly higher for offenders with previous offense-specific convictions (i.e., previous sex offenses). CONCLUSIONS: The mere existence of a conviction for a CSEM offense is not an indication that the convicted person poses a significant risk of committing child sexual abuse. To pinpoint such a risk more accurately, the following factors should be examined: the existence of offense-specific prior records, the presence of crossover-offending in the form of concurring offenses, and the age of the offender.

Sexual exploitation of young men: Background characteristics and needs from a life-course perspective.

BACKGROUND: Sexually exploited young men are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent young men to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame. OBJECTIVE: By gaining more insight into the background characteristics of young men who experienced sexual exploitation and their needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts. METHODS: Twenty-six young men (age 14-32) who experienced sexual exploitation or other forms of sexual violence in their youth or were at high-risk, participated in this qualitative study that was conducted in The Netherlands. By means of semi-structured interviews and case-file analyses, data was collected to identify risk and protective factors in their life-course and support needs. RESULTS: Several vulnerabilities (e.g. previous experiences of abuse and neglect, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led young men into high-risk situations. Among these were involvement in pay dates, criminality and having to survive from day to day, which contributed to victimization. Prevailing gender norms and experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support. CONCLUSIONS: These results will contribute to adequate prevention and trauma-informed intervention strategies that meet the unique needs of young men at risk for, or victim of sexual exploitation.

What is Known About the Magnitude, Trend, and Risk for Child Sexual Abuse and the Commercial Sexual Exploitation of Children in the United States?

Many nationally representative datasets are available for assessing the magnitude, trend, and risk for child sexual victimization in the United States. Unfortunately, the disaggregation of sexual violence into more specific sex crimes and the reliable measurement of these specific acts are often avoided by researchers due to the methodological limitations of victimization data. For example, previous scholars have successfully measured the strength of the relationship between the commercial sexual exploitation of children (CSEC) and child sexual abuse (CSA) within their respective samples; however, little is known about the extent to which CSEC occurs in the larger U.S. population, irrespective of past CSA. This study presents new analyses of publicly available representative data on the incidence, trend, and risk for CSA and CSEC independent of one another. We find that significantly more is known about CSA than CSEC. In addition, while victims of CSA and CSEC share many risk factors, CSA is far more common than CSEC, and their trends are going in different directions. We find that rates of CSA and CSEC are often derived from data with significant methodological limitations, such as administrative datasets that are limited to only victimizations reported to governmental agencies or representative surveys that measure the incidence/prevalence in one year alone, not repeatedly as required to assess trends. We fill in some of the gaps existing in our analyses with a review of other studies examining CSA and CSEC, as well as discuss future directions in research that researchers and child welfare practitioners should consider.

Technical profiles of child sexual exploitation material offenders.

The idiographic technical profiles of child sexual exploitation material (CSEM) offenders provide insight into their behaviours and context for their interactions with technology, but minimal quantitative work has been done to evaluate their sociability, technical ability and technophilia compared to non-offenders. This work used an online survey to compare an offender group consisting of English-speaking adults previously convicted of CSEM offenses (N = 78) with a reference population of non-offenders (N = 254). The survey assessed sociability, technical ability and technophilia through self-rating and information on occupation, level of education and device ownership. The study found that CSEM offenders had slightly lower sociability than non-offenders, though not at a level of clinical interest. Additionally, CSEM offenders had no statistically significant difference in technical ability and lower overall technophilia when compared to non-offenders. This study fails to support popular perceptions of CSEM offenders being technically savvy loners who are early adopters of new technologies.

On the Overlap of Commercial Sexual Exploitation and Intimate Partner Violence: An Exploratory Examination of Trauma-Related Shame.

Every year, millions of people experience intimate partner violence (IPV) and commercial sexual exploitation (CSE), with researchers increasingly discussing the overlap between these two forms of interpersonal violence. However, researchers have not yet used quantitative methods to examine the link between IPV and CSE or to explore potential mechanisms underlying the overlap, including child maltreatment risk factors and psychological mechanisms. One potential mechanism is trauma-related shame, a symptom of post-traumatic stress disorder commonly experienced by both victims of CSE and IPV. The current study explores trauma-related shame, childhood maltreatment, and IPV and their associations with CSE using a sample of 174 primarily Black women. Binomial logistic regression is used to analyze the impact of IPV, child abuse and neglect, and trauma-related shame on CSE. Results indicate that IPV and trauma-related shame are both significant predictors of CSE. Implications for future research and the incorporation of shame in trauma-related treatment are discussed.

Prevalence and correlates of depressive disorders in commercially sexual exploited children: A cross-sectional study in Mombasa, Kenya.

BACKGROUND: Commercial sexual exploitation of children (CSEC) is a global concern and is among the common forms of sexual violence against children. In Kenya, about 32 % of girls and 16 % of boys experience sexual violence before the age of 18 years. While much has been written about the impact of child sexual exploitation, there's little on the prevalence of depressive disorders among CSE children. OBJECTIVES: This study was conducted to assess the prevalence and correlates of depressive disorders among CSE children in Mombasa, Kenya. PARTICIPANTS AND SETTING: The study was conducted among CSE children (10-17 years) in Mombasa County. METHODS: A cross-sectional study conducted between May 2021 and June 2022. A total of 409 CSE children were enrolled, using a case management approach. Data was collected using the child identification tool and the Patient Health Questionnaire (PHQ-9), at the first counselling session to determine the prevalence of depression levels. RESULTS: Of the 409 children, 367 (90 %) were girls while 42 (10 %) were boys. The mean age was 15 years (10-17) (SD = 1.4, t = 0.765). In 286 (70 %) 'Depression unlikely' was recorded, while 123 (30 %) 'Depression likelihood.' Prevalence of mild to severe depression was significantly higher in girls than boys (p = 0.002). Other determinants of depression were having a primary level of education (p = 0.03) and being an orphan. (p = 0.03). CONCLUSION: It is important to prioritize mental health interventions such as screening and early diagnosis of mental health among CSE children in order to prevent and manage both short and long term effects.

Criminological differences between contact-driven and online-focused suspects in online child sexual grooming police reports.

BACKGROUND: Differences exist between contact and noncontact-driven online child sexual abuse offenders; however, there is still a notable lack of empirical studies with police samples from non-English speaking countries, including Spain. OBJECTIVE: We address this gap by analyzing the criminological characteristics of online child sexual grooming (OCSG) suspected offenders from de-identified law enforcement investigations in Spain. PARTICIPANTS AND SETTING: We anonymously coded data provided by Spanish law enforcement agencies from 257 OCSG cases (i.e., unique chat logs between a suspect and minor) extracted from 98 police reports with index investigation years from 2008 to 2021. A total of 101,391 messages were analyzed. METHODS: Three distinct datasets were created: 257 OCSG cases, 120 unique suspects (79 online-focused, 41 contact-driven), and 234 unique victims. Each dataset focused on different criminological variables for analysis, such as grooming strategy, motivation, and victim high-risk behaviors. RESULTS: There were no significant differences between suspects on gender, age, or criminal offense history. Contact-driven suspects were more likely to use positive rapport (ɸ = 0.18), send unprompted sexually explicit images of themselves (ɸ = 0.19), and offer something in exchange (ɸ = 0.25). Victims of contact-driven individuals were more likely to be male (ɸ = 0.52) and offer something in exchange for sex or sexually explicit images (ɸ = 0.18). Victims of online-focused individuals were more likely to be younger (r = 0.26). CONCLUSIONS: These findings suggest criminological differences in the online grooming strategies between contact-driven and online-focused suspected offenders in Spain.

Unveiling the shadows: Exploring the reality of commercial sexual exploitation among LGBTQ+ youth in out-of-home care.

BACKGROUND: LGBTQ+ youth frequently encounter familial rejection based on their sexuality and gender identity and are at greater risk of being maltreated by their family, often prompting them to leave or run away from their parents' home. Such youth may find themselves living independently and, once they leave home, tend to be vulnerable to all kinds of abuse and sexual victimization, sometimes leading to different types of commercial sexual exploitation. OBJECTIVE: This study aimed to comprehensively explore the subjective perspectives and understandings of commercial sexual exploitation among LGBTQ+ youth in out-of-home care in Israel. METHODS: The study employed a critical constructivist grounded theory approach. Thirty-one in-depth semi-structured interviews were conducted with LGBTQ+ youth aged 16 to 32 (average 21.6), who aged out of one or more of the out-of-home care services for LGBTQ+ youth in Israel. RESULTS: Our analysis indicates four main constructions of commercial sexual exploitation that depict the experiences of the participants: (1) survival sex; (2) gray prostitution; (3) sugar daddy; and (4) sex work. CONCLUSIONS: Our findings highlight the diverse manifestations of commercial sexual exploitation among LGBTQ+ youth, shedding light on its pervasive nature and significant scale. Several of these manifestations are characterized by ambivalence and are placed in the gray areas of commercial sexual exploitation, making it challenging to identify.

Healthcare providers' experience of identifying and caring for women subjected to sex trafficking: a qualitative study.

BACKGROUND: Men's violence against women, including human trafficking for sexual exploitation, is a severe threat to global health. Healthcare providers are uniquely positioned to identify and care for women subjected to human trafficking for sexual exploitation. They are among the few professionals the women interact with while being exposed to human trafficking for sexual exploitation. This study aims to describe healthcare workers' experience of identifying and caring for women subjected to human trafficking for sexual exploitation seeking women's healthcare. METHOD: A qualitative design was chosen and nine qualitative interviews with healthcare providers were conducted and analyzed using the content analysis method. RESULTS: Three main categories were revealed: (1) the importance of being attentive, (2) the importance of providing safety, and (3) the importance of collaborating, followed by a number of subcategories: behavioral and physical signs, limited time to interact, security measures, value of confidence building, organizational collaboration, essential external network, and information transmission. CONCLUSIONS: As the women subjected to sex trafficking have limited time in healthcare, it is important for healthcare providers to be attentive and act immediately if suspecting human trafficking for sexual exploitation. It may be the only possibility for the healthcare providers to care for these women and reach them. They must endeavor to provide the women with safety due to their vulnerable position at the hospital. However, these women may leave the healthcare setting unidentified and unaided, which highlights the importance of collaboration on multiple levels.

Empowering Young People with Special Educational Needs to Recognize and Report Child Sexual Exploitation and Abuse: A Mixed-Methods Review.

Young people with special educational needs (SEN), such as intellectual disability and/or autism, are particularly vulnerable to child sexual exploitation and abuse (CSEA). This mixed-methods systematic literature review consolidates findings in respect to how young people with SEN are currently being taught about CSEA in the UK, incorporating empirical and practice-based findings to counteract publication bias. Key databases were searched, and relevant organizations were contacted regarding studies published between 2015 and 2022 (inclusive). Thirteen articles met the inclusion criteria. Of these, 10 adopted a qualitative methodology, and three a mixed-methods approach. The thematic synthesis of the qualitative studies identified the following themes: (a) beliefs and stereotypes about CSEA, vulnerability. and risk have led to young people with SEN being misinformed and misunderstood, and (b) anxiety about the topic of sex and abuse creates polarized views regarding CSEA education in adult guardians of young people with SEN. Themes are discussed in the context of societal biases in respect to vulnerability and risk, and these biases are considered to have a negative effect on how young people with SEN are supported. The findings of this review encourage providers of CSEA awareness education to be mindful of not endorsing harmful stereotypes, and to involve parent-carers as much as possible. This review additionally encourages services and organizations to increase focus on practitioner reflexivity and regular training to counteract potential biases in respect to gender, vulnerability, and risk.

Empowerment at Work?: Examining Employment-Based Economic Empowerment Initiatives for Survivors of Commercial Sexual Exploitation.

Many organizations serving survivors of commercial sexual exploitation (CSE) have begun economic empowerment programs, providing financial literacy education, vocational training, and/or employment opportunities for survivors. Yet, very little research has examined these programs, especially those that employ survivors. This project draws on a qualitative, multi-method study of 15 organizations that serve and employ CSE survivors to examine how economic empowerment is constructed through organizational discourse and practices, what tensions emerge in these processes, and how organizational actors frame and respond to them. The findings outline the components of "economic empowerment" and explicate the key tensions of authority-autonomy and compassion-accountability.

'At the end of their relationship, that man offered her a house': Qualitatively exploring Congolese women's agency in navigating sexual relations with UN peacekeepers within the context of a patriarchal setting in eastern DRC.

The UN's Zero Tolerance Policy, which bans all relationships between UN staff and locals, portrays all relationships as exploitative, fails to account for nuances in these relationships and does not acknowledge the agency of local women or communities. This study uses community-based qualitative data from eastern DRC that shares narratives on a wide variety of consensual relationships between peacekeepers and local women. Our paper uses a data-driven approach, including a post-colonial feminist lens, and ideas of structural agency to provide an expanded definition of agency that invites readers to re-examine their views of women in conflict settings. Finally, we provide clear recommendations for the UN and other international non-governmental agencies on policies related to sexual exploitation and abuse.

Assessing online sexual exploitation among secondary school students in Tanzania from a routine activity theory perspective.

OBJECTIVES: In this study, we first assessed whether four routine activity theory (RAT) variables (Internet exposure, target suitability, proximity to offender, and guardianship) determine Tanzanian adolescents' online sexual exploitation (OSE). Second, we identified two types of guardianship that moderate the relationships between these variables and adolescents' OSE. Third, we assessed the moderating effect of locality (rural area) on the relationships among the RAT variables and OSE. METHOD: Our analysis was based on a stratified random sample of 1014 secondary school adolescents aged 12-20 years (M = 15.67; SD = 1.35) recruited from urban and rural regions of Tanzania. We used Poisson regressions to test the main effects of the RAT variables and the moderating effects of two types of guardianship and locality on OSE. RESULTS: We found that OSE increased with the suitability of the respondents and with online exposure. Social guardianship had a moderating effect on OSE by reducing the positive influence of target suitability. Living in a rural area also had a moderating effect on OSE through reinforcing the effect of proximity to potential perpetrators in cyberspace. CONCLUSION: RAT can effectively increase our understanding of the OSE of minors in Tanzania. Furthermore, social rather than physical guardianship can mitigate the risk factors of OSE.

Livestreaming Technology and Online Child Sexual Exploitation and Abuse: A Scoping Review.

Livestreaming of child sexual abuse (LSCSA) is an established form of online child sexual exploitation and abuse (OCSEA). However, only a limited body of research has examined this issue. The Covid-19 pandemic has accelerated internet use and user knowledge of livestreaming services emphasizing the importance of understanding this crime. In this scoping review, existing literature was brought together through an iterative search of eight databases containing peer-reviewed journal articles, as well as grey literature. Records were eligible for inclusion if the primary focus was on livestream technology and OCSEA, the child being defined as eighteen years or younger. Fourteen of the 2,218 records were selected. The data were charted and divided into four categories: victims, offenders, legislation, and technology. Limited research, differences in terminology, study design, and population inclusion criteria present a challenge to drawing general conclusions on the current state of LSCSA. The records show that victims are predominantly female. The average livestream offender was found to be older than the average online child sexual abuse offender. Therefore, it is unclear whether the findings are representative of the global population of livestream offenders. Furthermore, there appears to be a gap in what the records show on platforms and payment services used and current digital trends. The lack of a legal definition and privacy considerations pose a challenge to investigation, detection, and prosecution. The available data allow some insights into a potentially much larger issue.

The sexual politics of technology industry responses to online child sexual exploitation during COVID-19: "This pernicious elitism".

BACKGROUND: Increasing rates of online child sexual exploitation further spiked during the COVID-19 pandemic at a time of disrupted child protection capacity. While the technology industry is central to coordinated efforts to prevent online abuse and remove harmful content, it is largely exempt from formal child protection obligations. OBJECTIVE: The aim of this study was to examine the response of the technology industry to online child sexual exploitation during COVID-19 from the perspective of anti-exploitation professionals. PARTICIPANTS AND SETTING: An international sample of fifteen anti-exploitation professionals were interviewed as part of a larger study on the impacts of COVID-19 on online child sexual exploitation. METHODS: Interviews were coded based on a template analysis with a focus on interactions with the technology sector during COVID-19. RESULTS: Major themes arising from the analysis were 1) the burden of online safety work on victims and services, 2) the lack of prioritisation of online child protection by technology companies during COVID-19 and 3) the complicity of the technology industry with the online sexploitation of children. CONCLUSIONS: The analysis of the views of anti-exploitation professionals highlights the alignment between the economic interests of the technology sector and the sexual interests of online child abusers in the absence of government oversight. A framework of sexual politics highlights the gendered nature this alignment and emphasises the need for regulatory intervention, harm minimisation and the restructuring of the online environment and technology sector in the interests of child safety.

Instruments for the Identification of Child Sexual Exploitation: A Systematic Review.

To perform a systematic search of instruments for the early identification of risk of sexual exploitation in children (CSE) and appraise their metric properties. Searches were conducted in four electronic databases to identify instruments that only evaluated child sexual exploitation with no restrictions of date or language. Two reviewers independently carried out the initial selection of titles and abstracts, appraisal of the methodological quality, compliance with the entry criteria in the analysis, and extraction of data necessary to systematize the information available. Twenty-three articles were found that used 15 CSE detection instruments. The instruments varied with regard to number of questions, ease of administration, sources of information, rating methods, and the training information provided. What they had in common is that most were designed and used in the English-speaking world, basically in the United States, with few instruments providing solid proof of their validity and reliability in the scores derived thereof. Although instruments were obtained with significant similarities in their conceptualization, differences in multiple characteristics made it difficult to draw clear conclusions regarding their greater or lesser suitability. What did become clear was the need to keep working on obtaining rigorous empirical psychometric evidence.

The Traveling Public as a Witness: Understanding Travelers' Intent to Report Signals of Child Sexual Exploitation Abroad.

European governments encourage their citizens to report signals of child sexual exploitation while traveling abroad. To better understand what inhibits their reporting behavior, this study examines travelers' intent to report signals of sexual exploitation of children in the context of travel and tourism (SECTT). Building on scholarship on crime reporting behavior and (indirect) bystander intervention, travelers from five European countries were surveyed about barriers influencing their reporting decision. Results indicate that barriers related to the interpretation of the situation and cost-benefit reasoning inhibit intent to report. Awareness of the phenomenon and intervention decreases the perceived barriers and positively impact the intents to report. Previous experience with observing signals of SECTT is associated with a lower intent to report. Explanations for this unexpected finding and recommendations for practitioners are explored.