Citation

Greenbaum VJ, Livings MS, Lai BS, Edinburgh L, Baikie P, Grant SR, Kondis J, Petska HW, Bowman MJ, Legano L, Kas-Osoka O, Self-Brown S. J. Adolesc. Health 2018; 63(6): 745-752.

Affiliation

School of Public Health, Georgia State University, Atlanta, Georgia.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jadohealth.2018.06.032

PMID

30293860

Abstract

PURPOSE: Estimate the prevalence of child sex trafficking (CST) among patients seeking care in multiple healthcare settings; evaluate a short screening tool to identify victims in a healthcare setting.

METHODS: This cross-sectional observational study involved patients from 16 sites throughout the U.S.: five pediatric emergency departments, six child advocacy centers, and five teen clinics. Participants included English-speaking youth ages 11-17years. For emergency department sites, inclusion criteria included a chief complaint of sexual violence. Data on several domains were gathered through self-report questionnaires and examiner interview. Main outcomes included prevalence of CST among eligible youth; sensitivity, specificity, positive/negative predictive values, and positive/negative likelihood ratios for a CST screening tool.

RESULTS: Eight hundred and ten participants included 91 (11.52%) youth from emergency departments, 395 (48.8%) from child advocacy centers, and 324 (40.0%) from teen clinics. Overall prevalence of CST was 11.1%: 13.2% among emergency department patients, 6.3% among child advocacy center patients, and 16.4% among teen clinic patients, respectively. The screen had a sensitivity, specificity, and positive likelihood ratio of 84.44% (75.28, 91.23), 57.50% (53.80, 61.11), and 1.99% (1.76, 2.25), respectively.

CONCLUSIONS: This study demonstrates a significant rate of CST among patients presenting to emergency departments (for sexual violence complaints), child advocacy centers, and teen clinics. A six-item screen showed relatively good sensitivity and moderate specificity. Negative predictive value was high. Intervention for a "positive" screen may identify victims and help prevent high-risk youth from becoming victimized. This is one of the first CST screening tools specifically developed and evaluated in the healthcare setting.

Copyright © 2018 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Adolescent; Child sex trafficking; Commercial sexual exploitation; Healthcare; Human trafficking; Identification