Commercial sexual exploitation (CSE) of a child refers to an individual under the age of 18 years who is used for the purpose of exploitation through prostitution. Extreme socio-economic and structural inequalities: including poverty, gender inequality and racism, are direct contributors to heightened rates of CSE. Until recently, many viewed CSE of children as a ‘third world’ problem, but CSE has now become a major social and public health problem in the United States. Studies have revealed that CSE plagues the US and its children. It takes many forms, all destructive to society and the children affected.1 Although the scope of the issue has been difficult to quantify accurately, it is estimated that at least 100,000 children in the US are commercially sexually exploited, with an average age of entry of 12 years old.2 In general, those at greatest risk for involvement in CSEC are youth who are already marginalized: youth from communities of color, those in poverty, and those who have experienced major familial or social disruptions including prior abuse.1 In 2003, the Federal Bureau of Investigation identified the San Francisco Bay Area as one of 13 “High Intensity Child Prostitution Areas,” municipal regions with a particularly high incidence of child prostitution.3 Given the high level of engagement with the juvenile justice system by CSEC, much of the existing data on CSEC have been collected solely from juvenile offenders.1,2,4-6 However, according to a survey conducted from 2006 to 2008 by MISSSEY (Motivating, Inspiring, Supporting, and Serving Sexually Exploited Youth), a local agency working with CSEC in Oakland, CA, only 58% of the 204 surveyed service-recipients had previously been arrested for solicitation.7 Thus, relying primarily on data collected through the juvenile justice system has resulted in a large portion of this vulnerable population remaining essentially invisible to researchers, and consequently to policy-makers as well. MISSSEY’s report also provides some limited information on basic demographics and a few health-related practices among surveyed service-recipients. Surveyed clients were more likely to be African American than the general population in Oakland (68% vs. 13%), and a relatively high proportion of respondents had children (16%) or were pregnant (3%) at the time of the survey. The survey did not include questions regarding sexually transmitted infections, or regarding use of condoms and other contraceptive methods; therefore, its results, while generally informative, are not sufficient to guide public health interventions or clinical care.7 MISSSEY’s report is one of only two studies that capture self-reported reproductive health outcomes among CSEC. In the other, a 2008 grey literature report from New York City, 20.7% of 241 CSEC reported a known history of any STI;8 these findings suggest elevated levels of reproductive health risk among CSEC.
References
1. Walker K, California Welfare Council. Ending the commercial sexual exploitation of children: a call for multi-system collaboration in California. http://www.youthlaw.org/fileadmin/ncyl/youthlaw/publications/Ending-CSEC-A-Call-for-Multi-System_Collaboration-in-CA.pdf. Published 2013. Accessed January 30, 2014.
2. Estes RJ, Weiner NA. The commercial sexual exploitation of children in the U.S., Canada and Mexico. http://www.sp2.upenn.edu/restes/CSEC_Files/Complete_CSEC_020220.pdf. Published September 18, 2001. Updated February 20, 2002. Accessed January 30, 2014.
3. Office of the Inspector General. The Federal Bureau of Investigation’s efforts to combat crimes against children. Audit Report 09-08. http://www.justice.gov/oig/reports/FBI/a0908/chapter4.htm. Published January 2009. Accessed January 30, 2014.
4. Finkelhor D, Ormrod R. Prostitution of juveniles: patterns from NIBRS. https://www.ncjrs.gov/pdffiles1/ojjdp/203946.pdf. Published June 2004. Accessed January 30, 2014.
5. Mitchell KJ, Finkelhor D, Wolak J. Conceptualizing juvenile prostitution as child maltreatment: findings from the national juvenile prostitution study. Child Maltreat. 2010;15(1):18-36.
6. H.E.A.T. Watch, Office of the District Attorney, Alameda County. Children at risk: a snapshot. http://toolkit.heat-watch.org/community/files/DATA_SEM_Demographics_Snapshot_Dec_2013.pdf. Published December 2013. Accessed January 30, 2014.
7. Motivating, Inspiring, Supporting, and Serving Sexually Exploited Youth (MISSSEY). MISSSEY data report. http://www.misssey.org/documents/data_report_final.pdf. Published December 2009. Accessed January 30, 2014.
8. Curtis R, Terry K, Dank M, Dombrowski K, Khan B. Commercial sexual exploitation of children in New York City, volume one: the CSEC population of New York City: size, characteristics, and needs.