Risk Factors for Domestic Child Sex Trafficking in the United States

Abstract

Despite increased effort to respond to human trafficking at national and state levels, very little empirical research has been conducted on domestic child sex trafficking. This study retrospectively examines associations between multiple risk factors and domestic child sex trafficking (i.e., entry into the commercial sex industry under the age of 18) in a sample of individuals aged 16 and older currently involved in the commercial sex industry (N = 273). Two primary research questions are addressed: (1) What set of risk factors, prior to entering the commercial sex industry, are associated with domestic child sex trafficking and (2) what group differences, if any, exist in risk factors between current or former domestic child sex–trafficking victims and non-trafficked adults engaged in the commercial sex industry? A cross-sectional survey was administered using Respondent-Driven Sampling (RDS) in five cities in one Midwestern state. Overall, 115 participants (48.3%) were identified as current or former domestic child sex–trafficking victims. Bivariate results suggest that childhood emotional and sexual abuse, rape, ever running away from home, having family members in sex work, and having friends who purchased sex were significantly associated with domestic child sex trafficking. Multivariate results indicate that domestic child sex trafficking victims were significantly more likely to have ever run away and to be a racial/ethnic minority than non-trafficked adults engaged in the commercial sex industry. Findings can inform state-level policies on human trafficking and assist child protection and juvenile justice agencies in developing prevention and intervention responses to commercial sexual exploitation.

Keywords

prostitution human trafficking risk factors sexual exploitation child abuse women offenders

Introduction

Human trafficking in the United States and, specifically domestic child sex trafficking (also referred to as domestic minor sex trafficking [DMST] or commercial sexual exploitation of children [CSEC]), has received increased attention in recent years through federal initiatives aimed at implementing policies to address the problem (Finklea, Fernandes-Alcantara, & Siskin, 2015; U.S. State Department Office to Monitor and Combat Trafficking in Persons, 2014). All 50 states and the District of Columbia have now passed anti-trafficking legislation, and in 2014, at least 31 states enacted new anti-trafficking legislation (often referred to as “Safe Harbor” laws) that focuses on rehabilitating, instead of criminalizing, commercially sexually exploited youth (National Conference of State Legislatures, 2014). Despite increased effort to respond at national and state levels, very little empirical research has been conducted on the problem of domestic child sex trafficking. Consequently, insufficient empirical data are available to inform local and state anti-trafficking efforts, including legislation that strengthens systems responses to child sex–trafficking victims. This study aims to address this gap by identifying the risk factors associated with domestic child sex trafficking in the United States. Specifically, we assess a range of experiences among individuals (aged 16 and older) that occurred prior to entering the commercial sex industry and compare these experiences between current or former child sex–trafficking victims (i.e., entered the commercial sex industry under the age of 18) and non-trafficked adults engaged in the commercial sex industry.

Prevalence of Domestic Sex Trafficking in the United States

Existing estimates on the prevalence of domestic sex trafficking in the United States are widely discrepant and have largely been discredited due to use of unreliable methods. Specifically, prior scholarly works have identified weak, non-replicable, or non-transparent methodology used to derive estimates from the U.S. State Department as well as other commonly cited sources (Fedina, 2014; Stransky & Finkelhor, 2008; Tyldum, 2010; U.S. Government Accountability Office, 2006). Incident reporting data, however, may provide more useful insights into current domestic sex-trafficking trends. In 2011, the Bureau of Justice Statistics reported that 2,065 suspected sex-trafficking cases were investigated between 2008 and 2010, and among these incidents, 40% involved commercial sexual exploitation of a minor (N = 1,106). In addition, data from the National Human Trafficking Resource Center (NHTRC; 2013) identified that 5,932 suspected sex-trafficking cases were reported to the NHTRC over a 5-year period (2007-2012). Among all suspected domestic trafficking cases reported to the NHTRC over this time period, pimp-controlled prostitution was the most commonly reported form of human trafficking, which involved predominately female victims (88.72%) and a substantial proportion of minor victims (40.69%).

Definitions of Domestic Sex Trafficking in the United States

The United States is both a recruitment and destination country for sex trafficking of women and children (U.S. State Department Office to Monitor and Combat Trafficking in Persons, 2014). Sex trafficking is defined as the recruitment, transportation, transfer, harboring, or receipt of persons through force, fraud, coercion, or abuse for the purposes of commercial sexual exploitation (Trafficking Victims Protection Act [TVPA] of 2000, 2010). The TVPA recognizes all persons under the age of 18 who are engaged in commercial sex acts as victims of sex trafficking, regardless of whether force, fraud, or coercion is involved. Notably, there is disagreement among researchers and practitioners on federal definitions of domestic child sex–trafficking and some scholars have called for a more nuanced legal understanding that more accurately captures the range of experiences of youth involved in the commercial sex industry (Lutnick, 2016). Consistent with federal guidelines, this study’s definition of domestic child sex–trafficking victims includes all minors engaged in the commercial sex industry. Specifically, we view commercial sexual exploitation to include both circumstances of force, fraud, and/or coercion by any third party, such as pimp-controlled prostitution, and in the absence of force, fraud, and coercion, such as the selling or exchange of sex for money, food, drugs, and/or shelter to survive (referred to as “survival sex”; Ennett, Bailey, & Federman, 1999). It is important to understand that the experiences of children, adolescents, and young adults engaged in the commercial sex industry vary, and at different points during their involvement, youth may be recruited, forced, and/or manipulated by third parties (e.g., intimate partners, family members, friends) and also engage in commercial sex acts “independently” to meet their needs (e.g., engaging in street-based prostitution to obtain money for shelter and food). Ultimately, recognizing the variability of youths’ experiences in the commercial sex industry is necessary to ensure appropriate treatment and service provision for this population.

Consequences of Domestic Sex Trafficking in the United States

Empirical knowledge on the consequences of domestic sex trafficking in the United States is limited; however, studies on adult women’s and youths’ involvement in pimp-controlled and street-based prostitution have been linked to a number of harms and consequences. Women engaged in pimp-controlled and street-based prostitution often experience high rates of physical violence, sexual violence, and harassment and are at increased risk of HIV/AIDS, sexually transmitted infections (STIs), Hepatitis, and other infectious diseases (Aron, Zweig, & Newmark, 2006; Mont & McGregor, 2004; Raphael, Reichert, & Powers, 2010; Williamson & Cluse-Tolar, 2002). Similarly, commercially sexually exploited youth experience physical and sexual violence perpetrated by pimps, customers, and others engaging in the commercial sex industry (Klain, 1999; Miller & Schwartz, 1995) and are at high risk of HIV/AIDS, STIs, unintended pregnancy, and overall poor physical health (Farrow, Deisher, Brown, Kulig, & Kipke, 1992; Haley, Roy, Leclerc, Boudreau, & Boivin, 2004; Klain, 1999). Research also suggests that commercially sexually exploited youth often face complex and untreated mental health issues, such as depression and suicidal ideation (Farrow et al., 1992; Klain, 1999). Moreover, without early intervention, children engaged in the commercial sex industry are at high risk of continued involvement in the commercial sex industry into adulthood (Ventura et al., 2007), which can lead to long-term physical, mental, and behavioral health consequences.

Risk Factors for Early Involvement in the Commercial Sex Industry

Poverty, homelessness, substance abuse and addiction, mental health issues, and early exposure to sexual abuse and trauma have been strongly correlated with street-based and pimp-controlled prostitution in samples of adult women (Brown, Cavanaugh, Penniman, & Latimer, 2012; Roe-Sepowitz, Hickle, & Cimino, 2012). Extensive research has examined similar experiences among minors engaged in the commercial sex industry, particularly in samples of at-risk youth populations (e.g., runaway and homeless youth, child welfare or juvenile justice–involved youth). However, the extent to which these experiences, which often co-occur, are truly antecedents to entering the commercial sex industry is not entirely clear. Certain risk factors (e.g., running away from home, homelessness) may lead some youth to engage in “survival sex” (defined as the selling or exchange of sex for money, food, drugs, and/or shelter) whereas others risk factors (e.g., peer influences such as having friends who sell sex) may lead some youth to be recruited and coerced into the commercial sex industry (Ennett et al., 1999; Tyler, Whitbeck, Hoyt, & Cauce, 2004). Furthermore, pathways into the commercial sex industry for youth may be markedly different than pathways into the commercial sex industry for adults. Researchers suggest that there is no one clear pathway, but a combination of risk factors that create situations that lead to involvement in the commercial sex industry (Chesney-Lind & Sheldon, 1992; Roe-Sepowitz, 2012).

High rates of commercial sexual exploitation have been documented in runaway and homeless youth populations, and thus, the vast majority of research on risk factors for child commercial sexual exploitation has been conducted within these groups. Childhood abuse is often viewed as a risk factor for running away, which then increases youths’ risk for engaging in survival sex (McClanahan, McClelland, Abram, & Teplin, 1999). When comparing characteristics between runaway and homeless youth who engage in survival sex and those who do not, studies consistently identify correlations between survival sex and histories of childhood abuse (Greene, Ennett, & Ringwalt, 1999; McClanahan et al., 1999). Tyler and colleagues (2004) found that lesbian, gay, and bisexual runaway adolescents were more likely to experience physical and sexual child abuse and to engage in survival sex than heterosexual runaway youth.

Some research has examined risk factors for commercial sexual exploitation among other at-risk or vulnerable populations. At least one study found that a history of childhood sexual molestation and rape was significantly associated with engaging in transactional sex ever and in the past year in a sample of youth aging out of foster care (Ahrens, Katon, McCarty, Richardson, & Courtney, 2012). Varma, Gillespie, McCracken, and Greenbaum (2015) recently compared the characteristics between youth with and without histories of commercial sexual exploitation in a sample of child sexual abuse victims presenting for medical treatment. Findings from Varma et al. (2015) suggested that victims of commercial sexual exploitation were more likely to experience substance abuse, running away, and involvement with child welfare and/or juvenile justice compared with child abuse victims with no histories of commercial sexual exploitation.

Although childhood abuse in general is a well-documented risk factor for youths’ involvement in the commercial sex industry, existing research has focused primarily on sexual and physical abuse. Consequently, the impact of childhood emotional abuse on youths’ involvement in the commercial sex industry is less understood. In the one known study of this phenomenon, Roe-Sepowitz (2012) sampled adult women in a residential prostitution-exiting program and found that childhood emotional abuse was significantly associated with entering the commercial sex industry as a minor, whereas childhood physical and sexual abuse were not.

Current Study Purpose

Prior studies on the experiences of commercially sexually exploited youth and adults who entered the commercial sexual industry under the age of 18 help to provide an understanding of the characteristics of domestic child sex–trafficking victims in the United States (Clawson, Dutch, Solomon, & Goldblatt Grace, 2009). However, many challenges exist to accessing and recruiting hidden, transient, and marginalized populations, including individuals involved in the commercial sex industry, and methodological limitations in prior studies have limited the generalizability of existing knowledge (e.g., small sample sizes, convenience samples of youth and women in service settings, lack of group comparisons). This study improves upon methodological limitations by using a rigorous sampling method (i.e., Respondent-Driven Sampling [RDS]) and retrospectively measuring multiple risk factors to determine their associations with domestic child sex trafficking (i.e., entry into the commercial sex industry under the age of 18). Furthermore, risk factors for domestic child sex trafficking likely co-occur, but few studies have examined the interrelationship among risk factors and their occurrence prior to entering the commercial sex industry. Identifying risk factors associated with domestic child sex trafficking can highlight appropriate entry points for intervention that can prevent child sex trafficking as well as long-term consequences from youths’ continued involvement in the commercial sex industry as adults. Thus, two primary research questions are addressed:

Research Question 1: What set of risk factors, prior to entering the commercial sex industry, are associated with domestic child sex trafficking.

Research Question 2: What group differences, if any, exist in risk factors between current or former domestic child sex–trafficking victims and non-trafficked adults engaged in the commercial sex industry?

Method

Sampling and Data Collection Procedures

The current study was designed to retrospectively investigate the risk factors for domestic sex trafficking, as well as the experiences and characteristics of sex-trafficking victims, in one Midwestern state. University institutional review board (IRB) approval was obtained. A cross-sectional survey was administered in the state’s five largest urban municipalities over a 6-month period (January 2011-June 2011). A 76-item survey was developed and piloted during the formative research process, which included focus group interviews and collaboration among community-based organizations, local and state officials, and researchers. Participants completed either paper or computer-based surveys (via Survey Gizmo). English-speaking individuals above the age of 16 and who engaged in commercial sex acts in the past 6 months were eligible for participation. To protect participants and to maintain anonymity, a waiver of documentation of consent was granted by the IRB.

RDS methods were used to recruit participants to the study. RDS is often used to recruit probabilistic samples of hidden, difficult-to-reach populations, and/or stigmatized populations such as individuals with HIV/AIDS, men who have sex with men, and intravenous drug users (Salganik & Heckathorn, 2004). RDS methods have also been used to recruit and study exploitation among youth involved in the commercial sex trade in New York City (Curtis, Terry, Dank, Dombrowski, & Khan, 2008) and labor trafficking among unauthorized migrant workers in San Diego (Zhang, 2012). RDS is similar to other types of link-tracing sampling methods, including snowball and chain-referral sampling, where sampling relies on access to social networks through peer recruitment and referrals to the research study (Heckathorn, 1997, 2002). However, RDS differs from these techniques by rewarding participants with financial incentives for both participating in the study and recruiting peers to the study (Heckathorn, 1997, 2002). Stigmatized populations may often be reluctant to provide information about their peers, and thus, RDS provides additional confidentiality and protection to participants and does not require participants to provide researchers with the contact information of peers but, instead, provides participants with a limited number of “referral coupons” (marked with unique serial numbers) to refer several of their peers to the study. RDS improves upon estimation bias and duplication issues often found in traditional link-tracing methods by limiting the number of referral coupons provided to participants and tracking initial seeds and participants through coupon serial numbers (Salganik & Heckathorn, 2004).

Five data collectors were trained on the research protocol and assigned to each of the five cities. All data collectors had some involvement in service delivery in their respective communities and knowledge of services for individuals in the commercial sex industry. Data collectors identified two individuals known to be currently involved in the commercial sex industry to be the initial seeds in the recruitment process. Most seeds were recruited through community agencies providing services to individuals involved in the commercial sex industry. This recruitment method may account for some characteristics of the population. Initial seeds were screened by data collectors to determine eligibility, completed the survey, and were compensated US$10. Initial seeds were then provided five coupons to give to others they knew to be involved in the commercial sex industry and received an additional US$10 for each peer who participated in the study. All participants who completed the survey were compensated US$10 and were provided with five coupons to refer peers to the study. Participants received an additional US$10 for each peer who completed the study, for a total possible compensation of up to US$60. A total of 328 individuals were recruited to the study.

To track coupons and to identify various social networks within cities, coupons were numbered with each initial seed’s unique identifier to prevent duplication. Coupons were color-coded to track the city in which they were obtained and redeemed. All coupons were redeemable at public libraries in each city on specific days and times identified on the coupon. Local public libraries were designated as the primary survey site to establish both safety precautions (using a public meeting space) and privacy for participants (through the use of private study rooms in libraries). Trained advocates accompanied data collectors to offer participants supportive services or immediate emergency assistance. Advocates were required to have knowledge of community resources and received training for advocate duties by study investigators. If an individual under the age of 16 came in to take the survey, the advocates were prepared to contact local child protection agencies. In addition, advocates were available as requested to discuss resources for food and clothing assistance, housing, and so on.

Measures

Demographics

Current age is a continuous variable measured in years. Annual household income is a categorical variable comprised of 11 response options and measured in US$10,000 increments (recoded and dichotomized to indicate incomes less and greater than US$10,000). Self-reported race/ethnicity (Black/African American, Hispanic, White non-Hispanic, and Other) was measured in a single question and was recoded into one dichotomous variable (White/non-White). Self-reported gender (male, female, or transgender) was assessed through two questions and was recoded into one dichotomous (male or female) variable. A total of two respondents identified as transgender, however, were not included in the multivariate analyses due to the small sample size of this group. Age of first commercial sex act was measured through the question, “at what age did you first receive money for sexual services or acts?” Sample demographics are presented in Table 1.

Table 1.

Sample Demographics.

	Child Trafficking (n = 115)		Adult Non-Trafficked (n = 158)		Total (N = 273)
	n	%	n	%	N	%
Median current age (range)	36.3 (16-60)		37 (18-66)		36 (16-66)
Age of first commercial sex act
Younger than 12	14	12.2	—	—	14	5.1
12-13	30	26.1	—	—	30	11
14-15	32	27.8	—	—	32	11.7
16-17	39	33.9	—	—	39	14.3
18-20	—	—	79	50	79	28.9
21 and older	—	—	79	50	79	28.9
Annual household income
<US$10,000	89	83.2	116	76.3	205	79.2
>US$10,000	18	16.8	36	23.7	54	20.8
Gender
Female	89	77.4	109	69	198	72.5
Male	25	21.7	46	29	71	26
Transgender	0	0	2	1.3	2	0.7
Race/ethnicity
Black/African American	75	65.2	88	55.7	163	59.7
White	30	26.1	59	37.3	89	32.6
Hispanic	4	3.5	5	3.2	9	3.3
Other	2	1.3	5	3.2	7	1.9

Note. Some totals do not add up to 100% due to missing data on some variables.

Domestic child sex trafficking

Participants were asked to retrospectively recall whether they were “over the age of 18 or under the age of 18 when they first got involved in selling sexual services.” Participants who reported being under the age of 18 when first selling sexual services were identified as victims of domestic child sex trafficking, per the federal definition in the TVPA. Participants who were above the age of 18 and who reported not currently being forced and/or manipulated into the commercial sex industry were identified as non-trafficked adults engaged in the commercial sex industry. Current force and manipulation were measured through a single question that asked participants to report whether their current involvement in the commercial sex industry was “forced,” “manipulated by someone,” or “chose to enter on your own.” A total of 42 participants were identified as current adult sex–trafficking victims (i.e., currently above the age of 18 and currently being forced and/or manipulated by someone); however, these individuals were excluded from the sample for the purposes of the current study.

Risk factors

To measure risk factors, participants were asked to endorse whether a series of statements (presented below) applied to them during two time frames: less than 1 year before entering the commercial sex industry and/or more than 1 year before entering the commercial sex industry. Variables were coded to indicate the presence of the risk factor at either point in time prior to entering the commercial sex industry.

Running away as a minor was assessed through two indicators, “I ran away from home once” and “I ran away from home more than once,” and were collapsed into one variable to indicate ever having run away from home as a minor. Child welfare and juvenile justice involvement were assessed through endorsement of having “involvement in Child Protection Services as an abused/neglected child,” “currently/was in foster care,” and “spent time in juvenile detention.” Childhood abuse was assessed through three separate questions to indicate type of abuse: “I was a victim of childhood sexual abuse,” “I was a victim of childhood physical abuse,” and “I was a victim of childhood emotional abuse.” Experiences of rape were assessed through a single indicator of “I was raped.” Participants were also asked about economic stressors, including, “I was worried about how I would eat or where I would sleep” and “I was homeless.” Family and peer influences were measured through endorsement of the following: “I had close family members involved in sex work,” “I had much older boyfriends or girlfriends,” “I had friends who bought sex,” “I had friends who sold sex,” and “I was involved in a gang.” Other risk factor indicators included whether the participant “dropped out of school” and “identified as gay, lesbian, bisexual, and/or transgender” prior to entering. Finally, participants were asked to report whether they had been diagnosed with various mental health conditions (i.e., depression, anxiety, posttraumatic stress disorders [PTSD], or other mental illness), and the responses were recoded into one dichotomous variable indicating any diagnosis of a mental health condition. Participants were also asked to report on substance using behaviors, including frequent alcohol and drug use (i.e., marijuana, prescription drugs, crack cocaine, alcohol, or other illegal drugs), which was recoded to indicate frequent use of any drug and/or alcohol use.

Analyses

Analyses were conducted using SPSS (Version 22.0, Armonk, New York). Pearson’s chi-square tests were used to examine associations between risk factor variables and domestic child sex trafficking. Multivariate binary logistic regression analyses were conducted using statistically significant risk factor variables (at the bivariate level) to assess the relationship among risk factors and to control for participant demographics (i.e., age, gender, race, and income). Multivariate analyses are based on a sample size of 238 due to missing data on 35 cases.

Results

Survey respondents (N = 273) were on average, currently, 36 years of age. Among all respondents in the sample, 72.5% were female, 26% were male, and .7% identified as transgender. The majority of the sample was Black or African American (59.7%) and non-Hispanic (96.7%), and had annual household incomes less than US$10,000 (75.1%). A total of 115 (48.3%) participants were identified as current or former domestic child sex–trafficking victims (current = four; former = 111) and 158 (51.7%) participants were identified as non-trafficked adults engaged in the commercial sex industry (i.e., entered commercial sex industry above the age of 18 and not currently forced and/or manipulated). Child sex–trafficking victims (n = 115) were, on average, 36 years of age (SD = 11.36), female (77.4%), Black or African American (65.2%), and had annual household incomes less than US$10,000 (77.4%). Most child sex–trafficking victims engaged in their first commercial sex act between ages 14 and 17 (61.7%). No statistically significant group differences were found between current/former child sex trafficking and non-trafficked adults engaged in the commercial sex industry with regard to age, race/ethnicity, gender, and income.

Results from chi-square tests reveal several significant risk factors associated with domestic child sex trafficking (see Table 2). Running away as a minor (ever) is significantly associated with domestic child sex trafficking (χAppendi2 = 34.19; p < .001). Specifically, 62.6% of child-trafficking victims ran away as a minor compared with 27.2% of non-trafficked adults engaged in the commercial sex industry. Childhood sexual abuse (χ² = 8.18; p < .01), childhood emotional abuse (χ² = 4.68; p < .05), and being raped (χ² = 9.16; p < .01) are also significantly associated with domestic child sex trafficking. Childhood sexual abuse was experienced by 44.6% of child-trafficking victims, compared with 27.7% of non-trafficked adults; childhood emotional abuse was experienced by 40.9% of child-trafficking victims, compared with 28.2% of non-trafficked adults; and rape was experienced among 50% of child-trafficking victims, compared with 31.6% of non-trafficked adults. Having family members involved in sex work (χ² = 4.28; p < .05) and having friends who bought sex (χ² = 4.77; p < .05) were also significantly associated with domestic child sex trafficking; that is, 35% of child-trafficking victims had family members engaged in sex work and 39.4% had friends who bought sex prior to entering the commercial sex industry, compared with 23.6% and 26.8%, respectively, of non-trafficked adults.

Table 2.

Risk Factors Before Entry Into the Commercial Sex Industry (N = 273).

Risk Factor	Child Trafficking (n = 115)		Adult Non-Trafficked (n = 158)		χ²	p	Phi
Risk Factor	n	%	n	%	χ²	p	Phi
Ever ran away*	72	62.6	43	27.2	34.19	<.001	.35
Child welfare involvement	29	25.4	28	17.7	2.38	.12
Currently/was in foster care	18	15.9	21	13.3	.37	.54
Spent time in juvenile detention	22	19.5	19	12	2.84	.09
Childhood sexual abuse*	50	44.6	43	27.7	8.18	<.01	.18
Childhood physical abuse	37	32.5	41	26.3	1.22	.27
Childhood emotional abuse*	45	40.9	44	28.2	4.68	<.05	.13
Worried about eating/sleeping	47	43.9	63	40.1	.38	.54
Homeless	41	37.3	58	36.9	.003	.96
Raped*	55	50	50	31.6	9.17	<.01	.19
Family members in sex work*	39	35.1	37	23.6	4.28	<.05	.13
Much older boyfriend/girlfriend	55	52.9	64	41.3	3.37	.07
Friends who bought sex*	43	39.4	42	26.8	4.77	<.05	.13
Friends who sold sex	45	41.7	66	43.1	.06	.81
Involved in a gang	8	7	8	5.1	.42	.52
Dropped out of school	49	43.8	55	34.8	2.21	.14
Mental health diagnosis	35	31.5	42	26.8	.73	.39
Frequent alcohol and/or drug use	58	53.2	75	49	.48	.50
Identified as LGBT	32	28.6	28	24.5	.55	.46

Note. LGBT = lesbian, gay, bisexual, and transgender.

Significant at p < .05.

Binary logistic regression results suggest that child-trafficking victims are more likely to have ever run away from home as a minor compared with non-trafficked adults, after controlling for demographic variables and other risk factors in the model (see Table 3). The odds are over 5 times greater for child-trafficking victims to have ever run away than for non-trafficked adults (OR = 5.81; 95% confidence interval [CI] = [3.08, 10.97]). In addition, child-trafficking victims are more likely to be non-White (i.e., racial and ethnic minority), compared with non-trafficked adults, after controlling for other variables in the model. Specifically, the odds are more than twice as high for child-trafficking victims to be a racial/ethnic minority than non-trafficked adults (OR = 2.31; 95% CI = [1.17, 4.55]). Childhood sexual abuse, childhood emotional abuse, rape, having family members involved in sex work, and having friends who bought sex are not significantly associated with domestic child sex trafficking.

Table 3.

Binary Logistic Regression Results (N = 238).

	B	SE	df	p	OR (95% CI)
Age	0.004	.01	1	.75	1.00 [0.98, 1.03]
Race*	0.84	.35	1	<.05	2.31 [1.17, 4.55]
Gender	0.12	.34	1	.76	1.11 [0.57, 2.18]
Household income	0.14	.39	1	.72	1.15 [0.54, 2.45]
Ever ran away*	1.76	.32	1	<.001	5.81 [3.08, 10.97]
Childhood sexual abuse	0.80	.51	1	.12	2.21 [0.81, 6.06]
Childhood emotional abuse	0.28	.48	1	.57	1.32 [0.51, 3.39]
Raped	0.32	.37	1	.40	1.38 [0.65, 2.91]
Family members involved in sex work	0.58	.37	1	.12	1.78 [0.86, 3.70]
Friends who bought sex	0.08	.48	1	.83	1.08 [0.52, 2.27]

Note. Reference groups = race (White), gender (male), and income (<10k). OR = odds ratio; CI = confidence interval.

Significant at p < .05.

Discussion

This study aims to address gaps in research on sex trafficking and identifies risk factors associated with domestic child sex trafficking, or early entrance into the commercial sex trade, which is necessary to prevent exploitation among vulnerable youth and its long-term consequences, including continued involvement in the commercial sex industry into adulthood. In terms of risk factors, all participants in the sample reported high rates of runaway behaviors, childhood abuse, and experiences of rape prior to entering the commercial sex industry. Still, unique differences exist among risk factors associated with domestic child sex–trafficking victims and non-trafficked adults engaged in the commercial sex industry. Consistent with prior research, chi-square results in the current study suggest that running away from home, childhood emotional abuse, childhood sexual abuse, and rape are significantly associated with domestic child sex trafficking or early involvement in the commercial sex industry (Ahrens et al., 2012; Roe-Sepowitz, 2012; Varma et al., 2015). Childhood sexual abuse often acts as a risk factor and antecedent to running away, which then makes youth highly susceptible for commercial sexual exploitation. For example, in Varma et al.’s (2015) study sample of child sexual abuse victims, abused youth who were also victims of commercial sexual exploitation were more likely to have run away from home compared with sexual abuse victims who had not been commercially sexually exploited. Running away from home, which may be prompted by sexual abuse, remains a significant risk factor for early involvement in the commercial sex industry.

Family members and peers appear to influence youths’ involvement in the commercial sex trade. Research on the social networks of runaway and homeless youth suggests that having peers who trade sex or engage in survival sex often influences youths’ involvement in similar behaviors (Ennett et al., 1999; Tyler et al., 2004). A substantial proportion of participants in this study reported having friends who sold sex prior to entering the commercial sex industry (approximately 41% of child sex–trafficking victims and 43% of non-trafficked adults); however, no significant difference was found between groups. Interestingly, having friends who bought sex was significantly associated with domestic child sex trafficking. This finding may be indicative of peer influences that are coercive and manipulate youth into selling sex to friends who are willing to pay money or exchange other items of value to youth. In addition, having family members involved in sex work was significantly associated with domestic child sex trafficking. Several ethnographic studies have explored pimp-controlled prostitution as a “family business,” suggesting that this may be one pathway into commercial sexual exploitation for children (Raphael et al., 2010). Overall, family and peer involvement in the commercial sex industry appear to increase risk of domestic child sex trafficking; however, further research is needed to better understand family- and peer-driven recruitment processes to inform intervention strategies and response protocols in child welfare agencies, juvenile justice, schools, and family support service settings.

Although there were no significant differences between groups, 50% of trafficked youth and 41% of non-trafficked adults had an older boyfriend/girlfriend prior to entering the sex trade. Findings from qualitative studies on domestic child sex trafficking suggest that older male pimps, often acting as boyfriends, lure, coerce, and manipulate younger female adolescents and youth into the commercial sex industry (Williamson & Prior, 2009). Although more research is needed in this particular area, these relationships often resemble the traditional power and control dynamics present in adult intimate partner violence (IPV) relationships, and thus, practitioners working with at-risk youth should be cognizant of much older partners as potential risk factors (in addition to these relationships possibly constituting child maltreatment in and of themselves).

Results from the multivariate analysis reveal several important findings. In the current study’s sample, running away appears to be the strongest predictor for domestic child sex trafficking. Specifically, youth who were trafficked as minors had more than 5 times the odds of running away from home prior to entering the sex trade, after controlling for other risk factors and demographics. The remaining risk factors of childhood sexual abuse, childhood emotional abuse, rape, having family members involved in sex work, and having friends who purchased sex were not significantly associated with child sex trafficking in the model, after accounting for runaway behaviors and demographics. These findings strengthen empirical knowledge on the substantial risks of commercial sexual exploitation after running away from home. Runaway youth are susceptible to both engaging in survival sex to meet their needs and to being coerced or forced into the commercial sex industry by third parties (e.g., peers, family members, boyfriends/girlfriends). Notably, a considerable proportion of trafficked youth (27%) identified as lesbian, gay, bisexual, and transgender (LGBT) prior to entering the commercial sex industry. Therefore, targeted prevention and intervention approaches are necessary to reduce runaway episodes and also to prevent runaway behaviors among particularly at-risk youth (e.g., sexual and emotional abuse victims, LGBT youth). Although there were no statistically significant differences between groups, it is important to highlight that approximately 21% of current/former domestic child sex–trafficking victims were males, which suggests the need for these prevention and intervention strategies to include male adolescents in addition to females.

It is also important to note that our study did not capture whether current or former domestic child sex–trafficking victims were engaging in survival sex or whether they were being recruited and forced or manipulated by third parties when they first entered the commercial sex industry. The needs among youth involved in the commercial sex industry likely vary, and future research is needed to determine what, if any, risk factors differ between youth engaging in survival sex compared with youth involved in forced, coerced, or pimp-controlled prostitution.

Results from this study also indicate that racial and ethnic minority participants have more than twice the odds of being trafficked as minors compared with White non-Hispanics. In their study of adult women attending a prostitution diversion program, Clarke, Clarke, Roe-Sepowitz, and Fey (2012) found that African American women were more likely to have entered the commercial sex industry under the age of 18 than White women. Few studies, however, have focused on understanding racial and ethnic differences among individuals engaged in the commercial sex industry. Research conducted by Potterat, Rothenberg, Muth, Darrow, and Phillips-Plummer (1998) suggested that racial and ethnic minority women are significantly more likely to engage in street-based prostitution, whereas White women are more likely to engage in other types of non-street-based commercial sex. Notably, the majority of the current study’s sample is African American (60%), female (72.5%), and extremely impoverished with annual incomes less than US$10,000 (70%). Racial and ethnic differences in domestic child sex trafficking must be understood within the context of socioeconomic disadvantage as well; that is, social, educational, and economic disadvantage disproportionately affects racial and ethnic minority girls and women in the United States (Kramer & Berg, 2003; Richie, 1996). Further research is needed to better understand how pathways into the commercial sex industry vary by aspects of socioeconomic disadvantage to develop appropriate and culturally specific interventions. Furthermore, existing anti-trafficking programs serving at-risk or commercially sexually exploited youth should evaluate current program practices to ensure they are adequately reaching racial and ethnic minority youth and providing culturally relevant services.

Limitations

There are several important limitations to note in the current study. First, data are cross-sectional, and causal inferences between study variables cannot be made. Second, the study was conducted in one Midwestern state, and therefore, findings do not necessarily apply to child-trafficking victims or adults in the commercial sex industry in other states and cities in the United States. Despite their benefits and success in recruiting hidden populations, RDS methods are not without limitations. RDS may not reach particularly isolated networks of sex-trafficking victims, and therefore, the largely homogeneous sample (i.e., predominately cisgender female, heterosexual, Black or African American, English-speaking) limits generalizability to other populations (e.g., transgender, non-English speaking) who may be involved or at risk of child sex trafficking in the United States. Findings are also reflective of predominately low-income women engaged in street-based prostitution and not of higher income women engaged in other areas of the commercial sex industry (e.g., escort services). Finally, there are limitations in the study’s measures. Retrospective self-report measures were used to assess risk factor experiences prior to entering the commercial sex industry, and thus, data are susceptible to recall bias. Measures of childhood abuse and rape prior to entering the commercial sex industry were also limited and incident-based, rather than behavior-based, which likely resulted in underestimations of abuse in the sample among participants who may not have acknowledged their experiences as abuse or rape.

Conclusion

Findings from this study identify a set of risk factors that are associated with increased risk of domestic child sex trafficking. These findings can inform state and local policies on human trafficking and assist child protection and juvenile justice agencies in developing screening and response procedures that identify and respond to youth who may be at risk of or currently involved in the commercial sex industry. Substantial progress has been made at the state level through the passage of anti-trafficking legislation, including Safe Harbor laws that recognize commercial sexual exploitation as child abuse. Still, many states do not offer protective provisions to minor victims of sex trafficking and substantial variation exists among current laws, including whether victims receive record cleaning or immunity from prosecution, types of victim assistance offered, and diversion from the juvenile justice system to child protection agencies. Although much more research is needed in this area, findings from this study support the need for continued development and improvement of state anti-trafficking legislation that implement collaborative and inter-agency models to respond to domestic child sex trafficking.

Footnotes

Acknowledgements

The authors thank the individuals who participated in this study and the data collectors and advocates on the research team: Jessica Schart, Trisha Smouse, Renee Jones, Jessica Donohue-Dioh, Erin Michel, Maggie Billings, and Oliva Burns.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this study was provided by the Ohio Department of Public Safety, Office of Criminal Justice Services, through the Edward Byrne Memorial Justice Assistance Grant Program, administered by the U.S. Department of Justice, Office of Justice Programs.

Author Biographies

Lisa Fedina, MSW, is a PhD student in the School of Social Work at the University of Maryland, Baltimore. Her research interests include human trafficking, sexual violence, intimate partner violence, and health outcomes as well as improving systems-level responses to survivors.

Celia Williamson, PhD, is a professor of social work in the College of Social Justice and Human Service at the University of Toledo. She founded the first anti-trafficking program in Ohio in 1993 and has completed nine studies and 17 articles/reports, and edited two books on sex trafficking around the world. She received federal funding from 2002 to 2012 to conduct research in this area. She is the director of the Human Trafficking & Social Justice Institute at the University of Toledo and serves as an editorial manager for the Journal of Human Trafficking.

Tasha Perdue, MSW, is a PhD student at the University of Southern California, School of Social Work. She is currently studying opiate use trajectories among participants in a harm-reduction program located in Skid Row.

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