Juvenile Entry Into Prostitution

Abstract

This study seeks to assess the nature and extent of childhood emotional abuse among adult women in a residential prostitution-exiting program. Regression analyses were conducted to assess the unique role of childhood emotional abuse in the prediction of age of entry into prostitution. Childhood emotional abuse, a history of running away during childhood, and participating in survival-based exchanges of sex were significantly associated with the commercial sexual exploitation of girls younger than age 18, while childhood emotional abuse contributed to predicting a younger age of entry. Results are discussed regarding policy, prevention, and future research.

Keywords

age of entry childhood emotional abuse juvenile prostitution prostitution sex work

There has been much discussion in the media and by service organizations about the age at which girls are commercially sexually exploited or, as women, when they first experience prostitution. The current wave of interest in human trafficking and the commercial sexual exploitation of children has exposed a lack of knowledge about the risks of entry into sex work. This knowledge is necessary in the development of effective and purposefully designed prevention and exiting-prostitution programs.

Current knowledge about prostitution entry includes limited explorations of likely predictors, but there is a dearth of published studies exploring age of entry and what variables might increase the likelihood of a girl entering prostitution or being commercially exploited as a juvenile versus entering as an adult. This study explores the life experience of women who entered prostitution as juveniles (also called the commercial sexual exploitation of children) compared to those who entered at age 18 or older. This study also tests whether childhood physical, sexual, and emotional abuse are related to entering prostitution as a juvenile versus an adult.

Literature Review

The findings from commercial sexual exploitation of children, trafficking, and sex work research conducted in different parts of the world vary widely due to important variables, including but not limited to legalization, limited law enforcement focus, and cultural perspectives. Most adolescent-focused prostitution and commercial sexual exploitation of children research participants in North America are drawn from jails/prisons, drug and alcohol treatment programs, homeless teen outreach programs, exiting programs, and known prostitutes. Globally, these services and the involvement of juveniles in sex work within them differ widely. Thus, the majority of the literature reviewed in this article is from North America where services provided, and legal considerations of sex work and cultural perspectives are similar.

Predictors of lifetime involvement in prostitution from the research literature focused on sex work in North America include studying individuals who have experienced childhood sexual abuse (El Bassel, Witte, Wada, Gilbert, & Wallace, 2001; James, 1979; McClanahan, McClellan, Abram, & Teplin, 1999; Silbert & Pines, 1981, 1982; Simons & Whitbeck, 1991; Wilson & Spatz-Widom, 2008), childhood physical abuse (El Bassel et al., 2001; James, 1979; Silbert & Pines, 1981, 1982), parental drug problems and substance use/abuse (Flowers, 1998; Inciardi, Lockwood, & Pottieger, 1993; Kramer & Berg, 2003; Potterat, Rothenberg, Muth, Darrow, & Phillips-Plummer, 1998), being a teenage runaway and resulting homelessness (McClanahan et al., 1999; Nadon, Koverola, & Schludermann, 1998; Seng, 1989; Simons & Whitbeck, 1991), and economic need (Hardman, 1997; Mallory, 2000). The commercial sexual exploitation of children or adult experiences of prostitution as a survival skill (i.e., “survival sex”) including exchanging sexual services for food, protection, a place to stay, drugs and money (Greene, Ennett, & Ringwalt, 1999), among juveniles has been extensively studied among minors who have experienced homelessness. This research shows that survival sex experiences were more often reported by study participants who had experience living on the street, had witnessed drug abuse in their families, reported a history of victimization, had participated in criminal behavior, and had a history of attempted suicide (Greene et al., 1999), family abuse, substance use, and friends who sold sex (Ennett, Bailey, & Federman, 1999; Tyler, Whitbeck, & Cauce, 2004).

It is clear from the literature that there is not one issue or problem that leads directly to prostitution for each individual. It has been suggested that perhaps it is the combination or junction among factors that creates risks that develop into a situation that leads to prostitution involvement (Chesney-Lind & Sheldon, 1992).

There is also some disagreement on the risk factors leading to vulnerability to commercial sexual exploitation of children. Experiences of childhood abuse and subsequent running away as an adolescent have long been considered primary risks for the commercial sexual exploitation of children (McClanahan et al., 1999; Nadon et al., 1998; Seng, 1989; Simons & Whitbeck, 1991), but Spatz Widom’s (1995) study on the long-term consequences of childhood maltreatment (sexual and physical abuse and neglect) found that few of the 908 individuals with substantiated abuse ran away as adolescents (5.8%) and none was arrested for prostitution.

Few studies have explored the relationship between childhood emotional abuse and prostitution involvement (Medrano, Hatch, Zule, & Desmond, 2003; Silbert & Pines, 1981; Stoltz et al., 2007), and even fewer have explored the influence of experiences of childhood maltreatment on age of entry into prostitution (Kramer & Berg, 2003; McClanahan et al., 1999). Childhood emotional abuse has been thought to reduce the coping skills and self-confidence that girls need to effectively deal with the high-risk situations that they encounter as they try to escape their abusive situations, thus increasing their dependence on survival strategies such as trading sex for a place to stay, for clothing, or for protection (Stoltz et al., 2007).

Suggested Pathways Into Prostitution

Silbert and Pines (1982) identified two distinct pathways into prostitution. The first pathway included white juveniles from families with above average incomes and reported experiences of physical, sexual, and emotional abuse at home, who ran away to escape molestation. They were then recruited by a pimp and were commercially sexually exploited as a means to survive on the streets. The second path was taken by minority women from low socioeconomic backgrounds where crime, drugs, and prostitution are prevalent in their communities. These women began prostituting due to economic pressures and deviant social networks.

Similarly, Simons and Whitbeck (1991) suggested two pathways specific to sexually abused girls and prostitution: (a) sexual abuse may increase the probability of participation in illegal activities and street culture (and deviant social groups); girls/women who have experienced sexual abuse are more likely to have social skill problems, drift into survival sex work, and become increasingly delinquent; and (b) sexual abuse leads a girl to runaway from her offender and her unsafe home; she then becomes involved in street life and associated social networks and develops criminal skills, including prostitution, to support herself.

Previous Research

The extant research on prostitution has been based on multiple population groups, including individuals who have experienced drug addiction and who are in or out of treatment (Burnette, Schneider, Timko, & Ilgen, 2009; Medrano et al., 2003; Nuttbrock, Rosenblum, Magura, Villano, & Wallace, 2004), incarcerated women (McClanahan et al., 1999), minors who have been homeless and live on the street (Simons & Whitbeck, 1991; Stoltz et al., 2007), and women known to have experienced prostitution(Dalla, 2000; El Bassel et al., 2001; Kramer & Berg, 2003; Nadon et al., 1998; Nixon, Tutty, Downe, Gorkoff, & Ursal, 2002; Silbert & Pines, 1981). Within these varied populations, similar correlates of experiencing prostitution have been identified.

Race

Race appears to contribute to prostitution in unique ways and has received significant research attention in studies of the prostitution experiences of adult women. McClanahan et al. (1999), in their study of 1,142 incarcerated women, found that African American women entered prostitution, on average, at a younger age than White or Hispanic women. Medrano et al. (2003) found, in their study of trauma and prostitution in a sample of 676 heterosexual individuals who experienced drug addiction, that race was a significant predictor of involvement in prostitution. They report that Black women with histories of childhood trauma (emotional abuse, emotional neglect, and physical neglect) were more likely to be involved in prostitution than White or Hispanic women with similar levels of reported trauma.

Kramer and Berg (2003) in their exploration of timing of entry into prostitution in a sample of 309 women working in street-level prostitution concluded that Hispanic women entered prostitution approximately 2.5 years younger than White women. White participants reported higher levels of having experienced physical and sexual abuse by a family member and were more likely to report drug or alcohol use by a parent during their childhoods. In their final model, however, race was not influential regarding age of entry. Burnette et al. (2009) studied of 1,287 women in substance abuse treatment programs and found that Black women, less educated women, and women who experienced homelessness were more likely to have a history of involvement in prostitution.

Childhood Abuse

In a study of 113 street sex workers, El Bassel et al. (2001) found that a third reported having been abused before the age of 18. Twenty-two percent reported experiencing childhood physical abuse and 31% reported experiencing childhood sexual abuse. Nixon et al. (2002) studied adult women in Canada who had all reported involvement in commercial sexual exploitation prior to age 18. They found that most reported experiencing commercial sexual exploitation before they were age 15 and had high rates of experiencing sexual abuse (80.3%), out-of-home care (77%), and child welfare involvement as children (64%), but lower rates of experiencing physical abuse (6%) and severe neglect (6%).

Medrano et al. (2003) explored the interaction of childhood trauma and adult prostitution in a large group of individuals who have experienced drug addiction. They found that childhood emotional abuse was the most frequently reported type of abuse by both men and women. The impact of the childhood abuse appeared to differ by race, women’s marital status, and income. Stoltz et al. (2007), in a study of 261 high-risk street-involved youth, found that childhood sexual abuse and childhood emotional abuse were independently associated with involvement in commercial sexual exploitation after controlling for social and demographic variables. They did not control for other types of abuse, but looked at the associations with each type of abuse separately.

Age

The study of the age of entry into prostitution has proven to be a complicated task and current findings have limited applicability due to the sample from which they are drawn, i.e., if the sample is of young adults, the average age of entry will be younger; if the sample is of older women, there is the opportunity to enter at an older age. Thus, interpretation of the findings on age of entry into prostitution should consider these limitations.

Silbert and Pines (1981) interviewed 200 juvenile and young adults currently and formerly involved in street prostitution about their growing-up experiences and how those experiences may have influenced their pathways into prostitution. The vast majority of the participants reported an absent parent (67%), physical abuse (62%), sexual abuse (60%), emotional abuse (70%), extreme alcohol and drug use by a parent (89%-92%), and witnessing domestic violence (22%-51%). Juveniles and adults reported different reasons for entry into prostitution; juveniles more often identified the need for money and for a pimp, while adults often reported the desire for drugs and for glamour. Adults also identified entering prostitution for the money, but at a lower rate than juveniles. The adults entered prostitution at an average age of 18, while the juveniles reported entering at an average age of 13.

The average age of first experience of commercial sexual exploitation as a child or prostitution as an adult varies appreciably between studies. Among the 43 women who had experienced street prostitution whom Dalla (2000) interviewed, the average age of entry into prostitution was 19.4 years (range 11-31 years). Potterat et al. (1998) surveyed 237 adults who had experienced prostitution and 407 adults in a comparison group about sex and drug-related experiences. They found that the average age of entry into prostitution in their sample was 20.5 years old.

Nadon et al. (1998) interviewed adolescents from teen work training programs, an adolescent training program, an adolescent residential treatment program, and two detention centers. Among the 45 adolescents who reported being commercially sexually exploited the average age of entry into commercial sexual exploitation was 14.1 years (range 10-18). Eighty-nine percent were 16 or younger when they were first commercially sexually exploited. McClanahan et al.’s (1999) study of incarcerated women found the average age of entry into prostitution was 20.9 years. They found that women with a history of childhood sexual abuse had higher rates of prostitution involvement and entered prostitution slightly younger than those without a history of sexual abuse. Substance use or a substance use disorder did not appear to affect age of entry into prostitution in their sample. A history of running away, though, was associated with entering prostitution at a younger age, but only affected entry into prostitution for those who were commercially sexually exploited in their early adolescence. McClanahan et al. (1999) estimated that due to increased vulnerability, running away increased risk for involvement in commercial sexual exploitation by more than 40 times.

One of the challenges of studying high-risk populations is the possibility that many of the risk factors are strongly correlated and separating them out statistically can be complex. This is especially true with the commercial sexual exploitation of children. The suggested risk factors—running away during adolescence, parental substance use, childhood sexual and physical abuse, being homeless, using drugs—are usually intercorrelated. This correlation may be due to the fact that many homes with one risk factor, such as sexual abuse, will often have other risk factors present (Dube et al., 2003).

The purpose of this study is to assess the nature and extent of childhood emotional abuse, as well as develop a better understanding of the impact of childhood emotional abuse on timing of entry into prostitution or commercial sexual exploitation for those under age 18, among adult women in a prostitution-exiting program. This study builds on previous research, particularly the work of Kramer and Berg (2003) who explored the cumulative hazard rate of abuse histories on timing of entry into prostitution, but did not include emotional abuse. The present study takes a further step, exploring the impact of race, childhood sexual and physical abuse, and the impact of childhood emotional abuse on age of entry into prostitution. First, we examined the different individual, family, drug use, mental health and child maltreatment experiences of women who reported being commercially sexually exploited (under age 18) compared to those who experienced prostitution at age 18 or older. Then we created a model that assessed the unique influence of race, sexual and physical abuse, and emotional abuse on age of entry into prostitution.

Our research questions are

Research Question 1: Are there differences between females who have experienced prostitution who were commercially sexually exploited before the age of 18 and those who entered prostitution after age 18?

Research Question 2: When controlling for childhood sexual abuse and physical abuse, does emotional abuse add to the prediction of timing (age) of entry into prostitution?

Our hypotheses are

Hypothesis 1: Relative to those who entered prostitution at age 18 or older, those who were commercially sexually exploited before the age of 18 will report higher rates of emotional abuse, running away, and parental drug use problems.

Hypothesis 2: Relative to those who entered prostitution at age 18 or older, those who were commercially sexually exploited before the age of 18 will report more serious mental health problems.

Hypothesis 3: Childhood emotional abuse will contribute uniquely towards predicting younger entry into prostitution after controlling for other variables related to age of entry.

Method

Participants

The study participants were female residents at a prostitution-exiting program in Phoenix, Arizona. The program provides housing, case management, counseling, and access to substance abuse and support group services. Men and transgendered persons were not included in the study as the agency only provided services to females. All of the women had been in the sex industry as street-prostitutes as adults and answered affirmatively to the question “Have you ever consented to perform a sexual act, including sexual intercourse, oral or anal contact, for money?” Some women had also been sexually trafficked by adults when they were children and teenagers and identified those experiences as the age at which they first “were prostituted” or “commercially sexually exploited.” Women were recruited to the residential program through street and prison outreach, diversion programming, and community education conducted by staff from the program.

Recruitment for this study occurred between January 2006 and January 2009 and all women participating in the program were approached by the researcher. Ten women during that time declined to participate in the study and did not complete the surveys. A total of 71 women completed the survey. The majority (69%, n = 49) of the sample was White, followed by Hispanic (15.5%, n = 11), African American (12.7%, n = 9), American Indian (1.4%, n = 1), and other (1.4%, n = 1). The age of the participants ranged from 18 to 53 years (M = 34.9, SD = 9.84) and age of first experience of commercial sexual exploitation or prostitution ranged from 5 to 46 (M = 22, SD = 8.46). Duration of prostitution ranged from less than a year to 46 years (M = 12.9, SD = 10.5).

Procedures and Measures

The Arizona State University Institutional Review Board approved this study. The participants voluntarily completed surveys during their first week of attending a 2-hour a week ongoing trauma psycho-education group from January 2006 until January 2009. Three instruments were used: a life experience survey called the Esuba Survey, the modified Parental Psychological Maltreatment Scale (Briere & Runtz, 1990), and the Trauma Symptom Inventory (Briere, 1995). All instruments collected self-report data.

The Esuba Survey was created by Roe-Sepowitz, Pate, and Bedard (2007) to obtain information regarding childhood abuse and maltreatment (e.g., have you ever been molested), family issues (e.g., parental drug use problems, observing domestic violence), risk taking behaviors (e.g., drinking alcohol excessively, having sex with strangers, prostitution), and criminal behaviors (e.g., have you ever driven a car drunk). It is a self-administered questionnaire with primarily dichotomous answer options. Questions are categorized into six sections: demographics, family history, health, substance use, behavior, and justice system contact. Sexual abuse was determined by answers of yes to either of the two questions asking about molestation (“Before age 18, did anyone ever sexually molest you, touch your body in a sexual way, or make you touch their body parts?”) or rape prior to age 18 (“Did anyone rape you, force you to have oral, anal or vaginal intercourse, or insert a finger or object in your anus or vagina?”). Physical abuse was determined by a yes to any of the three questions about whether a caregiver had ever made them bruise, bleed, or had broken a bone. There has been no exploration of reliability or validity on the Esuba Survey.

The seven-item modified Parental Psychological Maltreatment Scale (PYS; Briere & Runtz, 1990) was used to assess childhood emotional abuse. The PYS stem asks, “Prior to age 15, how often did the following occur during an ‘average’ year” followed by questions asking

how often a parent, stepparent, foster parent, or adult in charge of you “yelled at you,” “insulted you,” “criticized you,” “tried to make you feel guilty,” “ridiculed or humiliated you,” “embarrassed you in front of others,” and “made you feel like you were a bad person.” (Briere & Runtz, 1990)

Each item was scored on a 6-point scale ranging from 0 = never to 6 = more than 20 times per year. The PYS was modified by this author to increase the time span of “childhood” to include all years prior to age 18, and to minimize the requirement to recollect specific incident frequencies. Thus, the response format was changed to a 5-point scale (never, rarely, sometimes, often, and always). The scores were then dichotomized such that responses of “often” or “always” on all seven-items were categorized as childhood emotional abuse. This was done to minimize reporting errors as participants may not recall events or, if they do recall them they may remember without specificity (Leonard-Barton, 1990). Previous studies have shown that the original format had reasonably good alpha reliability (Briere & Runtz, 1988, 1990) and Briere (1992) reported that the successful use of the PYS in various studies suggests predictive and construct validity. Using the data from this study with the modified PSY scoring, Cronbach’s alpha coefficient was .97, supporting strong internal consistency.

The Trauma Symptom Inventory (TSI) was created by Briere (1995) to assess the traumatic stress symptoms that many trauma victims experience. The TSI measures symptoms including dissociation, posttraumatic stress, and related psychological symptoms (Briere, 1995). The full 100-item measure was used. The TSI asks respondents about how often specific experiences had occurred during the past 6 months. The TSI scale has been shown to have coefficient alpha reliability coefficients ranging from .77 to .89 and exhibit reasonable convergent, discriminant, and predictive validity in normative and clinical samples (Briere, 1995). The TSI subscales’ reliability estimates were calculated with data from the present study and each has adequate reliability. Cronbach’s alpha reliability estimates are anxious arousal (.85), depression (.94), anger/irritability (.93), dissociation (.89), sexual concerns (.84), impaired self-reference (.88), and tension reduction behavior (.85), and moderate scores for defensive avoidance (.76), dysfunctional sexual behavior (.75), and intrusive experiences (.69). The clinical scales of anxiety, depression, anger, intrusive experiences, defensive avoidance, dissociation, sexual concerns, dysfunctional sexual behavior, impaired self-reference, and tension reduction behaviors reflect symptoms in each of these areas. Two cases were removed from analysis of the TSI subscales due to having higher than acceptable scores (75 or above) on the Inconsistent Response Scale, which indicates inconsistent responses that may reflect random endorsement, language issues, or concentration problems (Briere, 1995).

Results

Data Analysis

Overall group characteristics were explored and then data analyses proceeded in two steps. First, a comparison was conducted between the juvenile entry group (first experiencing commercial sexual exploitation before the age of 18) and the adult entry group (first experiencing prostitution at age 18 or older) with age of entry being a dichotomous variable. This comparison was conducted using t tests and chi-square analyses. Second, age of entry (a continuous variable) was predicted using the race, childhood sexual, physical and emotional abuse using hierarchical linear regression.

Fifty-five percent (n = 39) of the participants reported experiencing physical abuse in childhood, 45% (n = 32) reported experiencing childhood emotional abuse, and 79% (n = 56) reported experiencing childhood sexual abuse. Forty-five percent (n = 32) reported that social services were involved with their families during their childhood and 71.8% (n = 56) reported a parent or caregiver in their home had a drug or alcohol problem during their childhood. Two thirds of the participants (n = 48) reported a history of running away from home.

Comparisons between the juvenile entry group (n = 26, 36.6%) and the adult entry group (n = 45, 63.4%) are displayed in Tables 1 and 2. The two groups were not different on race. At the time they completed the survey, the juvenile entry group was significantly younger (M = 31.4, SD = 10.6) than the adult entry group (M = 36.9, SD = 8.9), t(69) = −2.35, p < .05. The juvenile entry group reported entering prostitution from the ages of 5 to 17 (M = 14.3, SD = 2.7) and the adult entry group reported entering prostitution from ages 18 to 46 (M = 26.5, SD = 7.3). The two groups also differed on duration of experiencing prostitution with the juvenile entry group being commercially sexually exploited longer (M = 17.1, SD = 11.7) than the adult entry group (M = 10.5, SD = 8.4), t(69) = 2.75, p < .01. All of the participants reported that they had exchanged sex for money, but regarding the other reasons (for drugs, jewelry, a place to stay, other items and protection), the two groups differed only for protection with the juvenile entry group reporting exchanging sex for protection more often than the adult entry group, χ²(1, N = 71) = 5.03, p < .05.

Table 1.

Differences Between Women Who Had Entered Prostitution Prior to Age 18 (as a Juvenile) Compared to Those Entering at 18 or After (as an Adult)

	Juvenile entry		Adult entry
	(n = 26)		(n = 45)
	(%) n		(%) n
Race
White	73.1	19	66.7	30
African American	7.7	2	16.3	7
Hispanic	15.4	4	16.3	7
American Indian	3.8	1		0
Other			2.3	1
Childhood physical abuse	65.4	17	48.9	22
Childhood sexual abuse	84.6	22	75.6	34
Childhood emotional abuse*	61.5	16	35.6	16
Parent problem with drugs/alcohol
Parent domestic violence	53.8	14	40	18
Runaway during childhood**	92.3	24	53.3	24
Addiction to drugs/alcohol*	76.9	20	93.3	42
Reason for prostitution
Money	100	26	100	26
Drugs	69.2	18	77.8	35
Clothing	30.8	8	26.7	12
Place to stay	65.4	17	75.6	34
Protection**	65.4	17	37.8	17
Other items (jewelry etc.)	53.8	14	48.9	22

p < .05. **p < .01.

Table 2.

Differences Between Juvenile Entry Group and Adult Entry Group

	Juvenile entry		Adult entry
	(n = 26)		(n = 45)
	M	SD	M	SD
Age*	31.4	10.6	36.9	8.9
Duration of prostitution behavior**	17.1	11.7	10.5	8.4
TSI Subscales
Anxiety/arousal	66.9^	8.6	62.2	12.3
Depression	63.4	12	61.2	12.3
Anger/irritability	63.6	11	59.4	13.2
Intrusive experiences	68.2^	11.4	64.7	11
Defensive avoidance	67.9^	5.7	64.7	9.4
Dissociation**	74^	12.6	63.8	14.6
Sexual concern	68.9^	15	65.8^	12.3
Dysfunctional sexual behavior	81.7^	19.5	77.4^	20.5
Impaired self-reference	68.6^	10	64.2	12.3
Tension reduction behavior	75.2^	17.3	69.8^	19

^ = clinically significant. *p < .05. **p < .01.

The two groups differed significantly on only two childhood experiences, having run away and experiencing childhood emotional abuse. The juvenile entry group more often reported a history of running away than the adult entry group, χ²(1, N = 71) = 11.43, p < .001. The juvenile entry group also more often reported experiencing childhood emotional abuse than the adult entry group, χ²(1, N = 71) = 4.49, p < .05. Although the findings were not significantly different between the groups, the juvenile entry group reported higher rates of experiencing childhood physical and sexual abuse.

The groups differed significantly on two adult experiences, adult drug addiction and clinical levels of dissociation. The adult entry group reported experiencing a drug addiction more often than the juvenile entry group, χ²(1, N = 70) = 5.54, p < .05. The juvenile entry group more often scored higher on the dissociation subscale (M = 74, SD = 12.6) than the adult entry group (M = 63.8, SD = 14.6), t(67) = 2.94, p < .01.

Predicting Age of Entry Into Prostitution

A three-step hierarchical regression was conducted to determine whether childhood emotional abuse predicts age of entry into prostitution net other factors. On the first step, race was entered. On the second step, childhood sexual abuse and physical abuse were entered together into the equation. On the final step, childhood emotional abuse was entered.

Regression results are displayed in Table 3. Race, childhood physical abuse, childhood sexual abuse, and childhood emotional abuse explained 13% of the variance in age of entry into prostitution with significant beta weights only for childhood emotional abuse. In the first step, entry of race did not account for a significant amount of the variance in age at entry, R² = .02, F(1, 69) = 1.64, p < .21. In the second step, childhood sexual abuse and childhood physical abuse were not found to explain a significant additional change in variance of age of entry after controlling for the variance accounted for by race, R² = .08, R² Change = .05, F(2, 67) = 1.95, p < .15. In the third and final step, childhood emotional abuse was found to explain a significant additional amount of variance of age of entry into prostitution after controlling for the variance accounted for by race and childhood sexual and physical abuse, R² = .13, R² Change = .05, F(1, 66) = 3.813, p < .05.

Table 3.

Hierarchical Regression Predicting Age of Entry into Prostitution

Predictor variables	Unstandardized B	SE	R ²	R² change	F value
Step 1			.023
Constant	21.47	1.08
Race	2.77	2.16
Step 2			.077	.054	1.947
Constant	25.17	2.29
Race	2.99	2.16
Childhood sexual abuse	−2.93	2.49
Childhood physical abuse	−2.6	2.06
Step 3			.127	.05	3.813
Constant	25.94	2.28
Race	2.63	2.12
Childhood sexual abuse	−2.95	2.44
Childhood physical abuse	−.14	2.38
Childhood emotional abuse	−4.51*	2.31

p < .05. *The author did not include running away in the regression model as the research question focused on childhood abuse experiences.

This model explains that the age of entry into prostitution if the individual had experienced childhood emotional abuse, controlling for race and childhood physical and sexual abuse, would decrease by approximately 4.5 years. Thus, the influence of emotional abuse on age of entry changed from a constant of 25.94 to 21.43 if childhood abuse was reported, holding constant race, and childhood physical and sexual abuse. The model results found race, and childhood sexual and physical abuse to not significantly add to the explanation of variance on age of entry. Sexual abuse appears to have an impact on age of entry with a decrease in age if sexual abuse experiences were reported, but the impact was not found to be significant in the model.

Discussion

The present study examined the differences between women who were commercially sexually exploited before the age of 18 and women who experienced prostitution as adults. The study also examined whether childhood emotional abuse—a factor about which there is little research—adds to the prediction of age of entry into prostitution over and above that of race and childhood sexual and physical abuse. Overall, the participants, all women exiting prostitution, reported high rates of childhood abuse and family problems.

The findings in the study on childhood abuse were higher than those found by El Bassel et al. (2001) in their study of street sex workers and were very similar to those found by Nixon et al. (2002) and Silbert and Pines (1982). These findings paint a picture of the abusive and drug-involved childhood homes that many of the women attempted to leave by running away.

Childhood sexual abuse was reported by almost 80% of the participants, more than any of the other childhood abuse categories. The relationship between commercial sexual exploitation in children and adult experiences of prostitution with childhood sexual abuse is undeniable, but in this study did not influence the age of entry into prostitution.

Regarding Research Question 1, findings indicated that there were significant differences between those who entered prostitution as juveniles compared to those who entered as adults.

More of the juvenile entry group reported a history of running away and using the exchange of sex for money or survival to gain protection on the streets and reported experiencing commercial sexual exploitation as a child and experiences of prostitution as an adult for longer than the adult entry group. As adults, the juvenile entry group reported more symptoms of dissociation, which included symptoms of depersonalization, out of body experiences, de-realization, and psychic numbing (Briere, 1995). The adult entry group members reported more serious problems with drugs and alcohol than did those in the juvenile entry group. Hypothesis 1 was partially supported. Relative to those who entered prostitution as adults, participants who entered prostitution before the age of 18 reported significantly higher rates of emotional abuse and running away, but did not report significantly different rates of parental drug use problems.

Regarding Hypothesis 2, the juvenile entry group reported more clinical mental health problems than the adult entry group on only one trauma subscale, dissociation. On all other TSI subscales, the mean scores were not significantly different between juvenile and adult entry.

Regarding Research Question 2, childhood emotional abuse produced a significant unique contribution to timing of entry into prostitution, controlling for childhood sexual and physical abuse, as predicted. The decrease in age of entry by 4.5 years was found if the subject had reported childhood emotional abuse confirming Hypothesis 3, childhood emotional abuse contributed uniquely toward predicting younger entry into prostitution.

Childhood emotional abuse was found to have a significant association with the age of entry into prostitution. Childhood emotional abuse transmits to child negative beliefs about themselves and their abilities as well as a pervasive lack of self worth (Spertus, Yehuda, Wong, Halligan, & Sermetis, 2003). Often childhood emotional abuse is hidden or more difficult to detect than physical or sexual abuse due to the lack of physical evidence. It is also far more difficult to measure in assessments than other types of abuse as there is not one common definition of emotional abuse. Most researchers have focused on sexual and physical abuse as they are thought of as the “most severe and overt forms of abuse” (Spertus et al., 2003, p. 1256). The long-term impact of childhood emotional abuse has received limited attention, but is thought to have implications for psychological and physical symptoms in adult women (Spertus et al., 2003). In the first study to explore emotional abuse and juvenile involvement in prostitution, Stoltz et al. (2007) suggested that childhood emotional abuse leads to psychological effects that result in the adolescent victims not having adequate coping strategies or resources to deal with the high-risk situations they encounter, increasing their use and dependency on strategies such as trading sex for survival. The findings of this study suggest that childhood emotional abuse may increase a girl’s vulnerability to prostitution and appears to have greater influence on younger age of entry than either childhood physical or sexual abuse experiences.

The differences found between the juvenile entry and adult entry into prostitution groups were histories of running away, childhood emotional abuse, exchanging sex for protection, and current clinically significant levels of dissociation. The profile that emerges is a vulnerable girl with low self-worth and poor self-efficacy who ran away and had little confidence and ability to respond to the stresses of the street, who then found herself exchanging sex simply to feel and be safe in the street life. The adult entry group reported significantly higher experiences of addiction to drugs or alcohol. Perhaps this is due to having more opportunity to be involved in drugs. Although not significantly different, the reported age of starting drug use was younger for the juvenile entry group (M = 13.9, SD = 4.4) when compared to the adult entry group (M = 15.6, SD = 5.72). The sequence of drug use, whether prior, during or after prostitution entry, has been difficult to assess with widely differing findings (Brawn & Roe-Sepowitz, 2008).

Many women enter and leave prostitution without the assistance or support of an exiting program. An important strength of this study was that the participants were not homogeneous on age and we could separate out the younger starters (before age 18) and compare them to the older starters. This is unique in the extant research and provides a unique opportunity to explore the differing pathways into prostitution. This study also has a number of limitations that should be considered when interpreting the findings. The sample is small and has limited generalizability to any other group than from that which it was drawn. This sample only represents women who chose to attend an exiting program in Phoenix, Arizona from 2006 to 2009. The data used in this study were based on retrospection and self-report. Participants may have answered in a way that is socially desirable. This was addressed by having the participants complete the questionnaire after they attended one group and spent two hours with the researchers with the intention that participants would be more comfortable giving truthful answers to people with whom they were familiar. Also, confidentiality of the questionnaires was extensively discussed. Male and transgendered individuals have been found to enter sex work as juveniles as found in the survival sex literature, but this study excluded them to focus exclusively on women. Further research should include male and transgendered participants.

Implications

Despite the limitations, this study extends previous research and contributes to the development of knowledge regarding the influence of different experiences upon age of entry into prostitution. Childhood emotional abuse, running away, and exchanging sex for protection were significantly different for the juvenile entry group. Childhood emotional abuse was found to be associated with younger age of entry into prostitution.

The treatment of youth involved in commercial sexual exploitation has varied by state between prosecution as an offender and support services and assistance as a victim. Important new legislation has recently been enacted in a number of states, including New York (the New York Safe Harbor for Exploited Children) specifying that American children are victims of sexual exploitation and the crimes are against them, not committed by them. This act allows the minor to avoid criminal charges and be considered “a person in need of supervision” (Polaris Project, 2010). Illinois’s governor signed the Illinois Safe Children Act into law in August 2010, which is intended to protect the children of Illinois from being sexually exploited as well as giving law enforcement additional methods and tools to prosecute the exploiters. The impetus for this new legislation is the emerging understanding that children are sexually exploited by others (most often adults) and have extensive histories of childhood abuse (psychological, physical, and sexual abuse), and treating them as criminals will not serve their needs for supervision, crisis intervention, shelter, and counseling (Girls Educational & Mentoring Services [GEMS], 2010). This study confirms that women reporting involvement in commercial sexual exploitation before the age of 18 were found to have higher rates of emotional abuse, a history of running away, and survival sex for protection than women first experiencing prostitution over the age of 18.

Another important shift in national attention on the commercial sexual exploitation of children is the increasing prosecution of pimps. United States Attorneys began prosecuting pimps under the Federal Racketeer Influenced and Corrupt Organizations Act about 10 years ago, primarily due to limited local and state laws regarding the prosecution of pimps. In 2003, the Innocence Lost National Initiative integrated the efforts of 38 tasks forces around the country working to combat the domestic commercial sexual exploitation of children (Dahl, 2010). States are becoming increasingly harsh with their sentences for pimps, including Washington State, and other states and cities are working to eliminate the barriers of “proof” of coercion, force, or fraud in the prosecution of pimps (Dahl, 2010).

There has been limited research on the differing role of pimps on recruitment into sex work for juveniles compared with adults. The role of pimps with young adults (ages 16-25) has been described by Kennedy, Klein, Bristowe, Cooper, and Yuille (2007), but did not explore if the experiences of those under 18 were different from those over 18 years old. Williamson and Cluse-Tolar (2002) extensively interviewed six prostituted women who all had pimps. They identified the primary method used by a pimp to recruit or “turn a woman out” was providing them with love, attention and protection. The participants often identified their pimp as their boyfriend who had given them a sense of belonging and had told them they were beautiful. The juvenile participants in our study may be vulnerable to these recruitment techniques due to their vulnerability resulting from their childhood abuse experiences of emotional abuse and in many cases running away.

Future research on the association between childhood emotional abuse and age of first experiences of commercial sexual exploitation of children and adult involvement in prostitution may benefit from some clarity of concepts and improvement in standardization of measurement. It is critically important to develop a common definition and method for evaluating childhood emotional abuse and level of severity. With this, future research can better assess the long-term impact of childhood emotional abuse and how it effects decision making in high-risk juveniles and adults. Further research on the role of pimps related to entry into commercial sexual exploitation or adult experiences of prostitution may assist with prevention programming for at-risk youth.

Specific focus for the adult entry group should concentrate on drug and alcohol treatment and trauma symptom reduction. Although the adult entry group did not score as high as the juvenile entry group on the trauma symptom subscales, many of the trauma symptoms reported could greatly impact their successful exiting from prostitution. For juveniles, the effects of childhood emotional abuse on the decision to runaway appear also to influence the need to have sex in exchange for protection from the streets. Providing safe locations and residential centers for juveniles to run to if they run away from home is the first line of defense to prevent recruitment into prostitution. While receiving prevention or treatment services, interventions focused on the ramifications of childhood emotional abuse, weak self-worth, limited or no confidence in one’s own efficacy and feelings of worthlessness, may help prevent girls from being preyed upon by pimps or other sex workers

The treatment of childhood sexual abuse in at-risk juveniles has been well supported and these two foci could be combined in individual and group interventions. The long-term results of the experiences of the juvenile entry group resulted in higher clinical scores on all trauma symptom subscales, suggesting the longer the involvement in prostitution the greater the likelihood of serious mental health problems.

Footnotes

Declaration of Conflicting Interests

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

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

Bio

Dominique E. Roe-Sepowitz is an associate professor at Arizona State University School of Social Work. Dominique is a founding member of the National Research Consortium of Commercial Sexual Exploitation. Dominique is a practicing clinical social worker with victims of sexual exploitation and has conducted extensive researched in the areas of mental health and childhood maltreatment of victims of prostitution and sex trafficking.

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