Personal characteristics of adolescent prostitutes and rearing attitudes of their parents: a structural equation model

Toward a Global Definition and Understanding of Child Sexual Exploitation: The Development of a Conceptual Model

Child sexual exploitation (CSE) is a serious and persistent global issue affecting up to 5% of the child and youth population worldwide; yet there is no universally accepted definition. To develop a theoretically robust definition of CSE, this review systematically synthesized literature examining CSE definitions aiming to develop a conceptual model and typology. Electronic databases were searched to February 2021, yielding 384 nonduplicative records. Inclusion criteria were peer-reviewed and grey literature investigations of sexual exploitation, with a mean sample age of 18 years or younger, available in the English language. Literature review and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Sixty-six studies met final inclusion criteria. Two independent reviewers extracted relevant data and used an epistemological approach to thematically analyse meaning and patterns across CSE definitions. Key findings demonstrate that CSE nomenclature is widely inconsistent, and despite growing awareness of this severe form of abuse, language continues to perpetuate stigma and criminalisation, utilising terms such as 'adolescent or child prostitute'. Our findings propose a scientifically and trauma-informed definition and conceptualisation of CSE, based on the following four-dimensional components: (1) A child/young person; (2) sexual acts; (3) abuse; and (4) exploitation (abuse + exchange). In this systematic review, a unified definition and conceptual model aims to advance knowledge and understanding of CSE, contributing to the progression of social norms which embrace nuances of trauma-informed practice and support for the identification and recovery of children, young people and families affected by sexual exploitation.

Correlates of Exchanging Sex for Drugs or Money for Adolescent Males: A Hidden Population

Research from prostitution, sex trafficking, and commercial sexual exploitation (CSE) literature have found risk factors that can lead to both male and female youth becoming involved in this sex trade. These behaviors have been clearly defined and institutions have begun to address known risk factors. Youth who have reported involvement in trading/exchanging sex still remain hidden with limited information known about this group. The exchanging/trading sex literature has failed to explore correlates of involvement for adolescent males. This study explores factors found in prior research related to prostitution, sex tracking, and CSE to begin to understand adolescent males who exchanged sex for drugs or money. A secondary data analysis was used to examine the exchange of sex for male youth aged 12 to 18 in the United States. Results reveal that sexual activities were significant in predicting exchanging sex indicating a need for a more in-depth analysis of current and potential correlates for males.

Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis

IMPORTANCE

Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention.

OBJECTIVE

To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance.

DATA SOURCES

Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019.

STUDY SELECTION

Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger.

DATA EXTRACTION AND SYNTHESIS

Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020.

MAIN OUTCOMES AND MEASURES

Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors.

RESULTS

Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations.

CONCLUSIONS AND RELEVANCE

In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment.

Engaging adolescent girls in transactional sex through compensated dating

Transactional sex through so-called compensated dating in adolescent girls is a problem in need of public concern. Compensated dating typically involves the use of information communication technology to advertise, search, bargain, and eventually arrange for transactional sex. The technology enables the sexual partners to maintain privacy and secrecy in transactional sex. Such secrecy necessitates the girls' disclosure about their life experiences in order to address the concern. The disclosure is the focus of the present qualitative study of 27 girls practicing the dating in Hong Kong, China. Based on the disclosure, the study presents a grounded theory that epitomizes engagement in compensated dating by referential choice. Such a referential choice theory unravels that choice with reference to the family push and social norms sustains the engagement. Meanwhile, the choice rests on expectancy and reinforcement from experiential learning about compensated dating. The theory thus implies ways to undercut the engagement through diverting the referential choice of the dating.

A Longitudinal Study of Compensated Dating and Juvenile Prostitution Behaviors Among Adolescents in Hong Kong

STUDY OBJECTIVE

The purpose of this study was to examine longitudinal changes in compensated dating (CD) and juvenile prostitution (JP) behaviors and related psychosocial correlates among Hong Kong adolescents.

DESIGN, SETTING, AND PARTICIPANTS

In this study, adolescent CD and JP behaviors were examined in 3 waves (namely wave 2, 3, and 4) of a longitudinal study. At wave 2 (2010-2011), 3638 secondary 2 students (grade 8) from 28 schools participated in the study (mean age, 13.60 years; SD = 0.72). In the following 2 academic years (2011-2012 and 2012-2013), they were invited to respond to the same questionnaire. A total of 2921 students completed the questionnaire in 3 waves and their results were analyzed.

RESULTS

The number of CD cases was higher than JP cases. Although there was a decline in CD cases at wave 4, the number of JP cases increased at wave 4. Although there was some support for the influence of family intactness and positive youth development on CD and JP, the evidence was not strong. The effects of gender, economic disadvantage, and family functioning on CD and JP were not significant.

CONCLUSION

There was a decrease in CD but an increase in JP in the 3 waves of data. However, there was a fluctuation of CD over the years which made it difficult to identify a stable pattern. Some possible explanations for such a fluctuation and the related nonsignificant findings are proposed.

Rationalising predictors of child sexual exploitation and sex-trading

Although there is evidence for specific risk factors leading to child sexual exploitation and prostitution, these influences overlap and have rarely been examined concurrently. The present study examined case files for 175 young persons who attended a voluntary organization in Leicester, United Kingdom, which supports people who are sexually exploited or at risk of sexual exploitation. Based on the case files, the presence or absence of known risk factors for becoming a sex worker was coded. Data were analyzed using t-test, logistic regression, and smallest space analysis. Users of the voluntary organization's services who had been sexually exploited exhibited a significantly greater number of risk factors than service users who had not been victims of sexual exploitation. The logistic regression produced a significant model fit. However, of the 14 potential predictors--many of which were associated with each other--only four variables significantly predicted actual sexual exploitation: running away, poverty, drug and/or alcohol use, and having friends or family members in prostitution. Surprisingly, running away was found to significantly decrease the odds of becoming involved in sexual exploitation. Smallest space analysis of the data revealed 5 clusters of risk factors. Two of the clusters, which reflected a desperation and need construct and immature or out-of-control lifestyles, were significantly associated with sexual exploitation. Our research suggests that some risk factors (e.g. physical and emotional abuse, early delinquency, and homelessness) for becoming involved in sexual exploitation are common but are part of the problematic milieu of the individuals affected and not directly associated with sex trading itself. Our results also indicate that it is important to engage with the families and associates of young persons at risk of becoming (or remaining) a sex worker if one wants to reduce the numbers of persons who engage in this activity.

Parental bonding in males with adjustment disorder and hyperventilation syndrome

BACKGROUND

The purpose of the study was to identify the style of parental bonding and the personality characteristics that might increase the risk of hyperventilation and adjustment disorder.

METHODS

A total of 917 males were recruited, 156 with adjustment disorder and hyperventilation syndrome (AD + HY), 273 with adjustment disorder without hyperventilation syndrome (AD-HY), and 488 healthy controls. All participants completed the Parental Bonding Instrument, Eysenck Personality Questionnaire, and Chinese Health Questionnaire.

RESULTS

Analysis using structural equation models identified a pathway relationship in which parental bonding affected personality characteristics, personality characteristics affected mental health condition, and mental health condition affected the development of hyperventilation or adjustment disorder. Males with AD-HY perceived less paternal care, and those with AD + HY perceived more maternal protection than those with adjustment disorder and those in the control group. Participants with AD-HY were more neurotic and less extroverted than those with AD + HY. Both groups showed poorer mental health than the controls.

CONCLUSIONS

Although some patients with hyperventilation syndrome demonstrated symptoms of adjustment disorder, there were different predisposing factors between the two groups in terms of parental bonding and personality characteristics. This finding is important for the early intervention and prevention of hyperventilation and adjustment disorder.

Perceived parental attachment, personality characteristics, and cognition in male incest

The aim of this study was to investigate the multiple pathways of perceived child-rearing practices, cognitive-executive functions, and personality characteristics in incest and other sexual offenders. The participants consisted of 217 male sexual offenders who were in custody in southern Taiwan. Participants were divided into two groups of 25 incest and 192 nonincest sexual offenders. The incest offenders tended to be less extraverted and worse in abstract reasoning ability, and to have more perseverative thinking, and perceived less parental care than other sexual offenders. Moreover, the structural equation model showed that the effect of parental care on the type of sexual offense is mediated by cognitive-executive functions and personality traits. This finding suggests that the personality traits, cognitive function, and parental attachment of incest offenders differ from other sexual offenders. This result can be a helpful reference in sexual-offender intervention programs for relapse prevention.

Does biology underlie the oldest profession? Prostitution and sex disparities in john behavior

This study considers a biosocial explanation of why johns, the purchasers of commercial sex exchanges, are almost exclusively male. Trivers's theory of parental investment and sexual selection predicts that differential parental investment by biological sex will lead to divergent sex-based reproductive instincts. The sex bearing the larger parental investment will tend to be choosier whereas the sex bearing the lesser investment will tend to be relatively indiscriminate and competitive for access to sexual resources. We hypothesized that men are more likely than women to offer objects of value in exchange for access to sexual resources. Using self-reports of sex-purchasing from Add Health data (N = 14,544), we found that maleness was a robust predictor of john behavior even after controlling for well-known criminogenic risk factors.

Buying and selling sex in Québec adolescents: a study of risk and protective factors

This study examined the exchange of sexual services for compensation (e.g., money, drugs, alcohol) in high school students. The sale of sex in young people from nonclinical samples has been the subject of recent studies, but buying such services has received far less attention. This study described these two phenomena and associated factors within a nonclinical sample of 815 high school students (M = 15.86 years) from Québec. According to our results, 3% of these youth reported having bought and 4% reported having sold such services in their lifetime. More girls were involved in selling sexual services and more boys were involved in buying them. Young people generally disapproved of prostitution. Logistic regressions revealed that attitudes in support of prostitution, history of sexual abuse, casual sex, and the number of stressful life events were related to the sale of sex. Furthermore, observing sexualized social activities and exhibiting approving attitudes towards prostitution were associated with buying sexual services.

Alcohol use among female sex workers and male clients: an integrative review of global literature

AIMS

To review the patterns, contexts and impacts of alcohol use associated with commercial sex reported in the global literature.

METHODS

We identified peer-reviewed English-language articles from 1980 to 2008 reporting alcohol consumption among female sex workers (FSWs) or male clients. We retrieved 70 articles describing 76 studies, in which 64 were quantitative (52 for FSWs, 12 for male clients) and 12 qualitative.

RESULTS

Studies increased over the past three decades, with geographic concentration of the research in Asia and North America. Alcohol use was prevalent among FSWs and clients. Integrating quantitative and qualitative studies, multilevel contexts of alcohol use in the sex work environment were identified, including workplace and occupation-related use, the use of alcohol to facilitate the transition into and practice of commercial sex among both FSWs and male clients, and self-medication among FSWs. Alcohol use was associated with adverse physical health, illicit drug use, mental health problems, and victimization of sexual violence, although its associations with HIV/sexually transmitted infections and unprotected sex among FSWs were inconclusive.

CONCLUSIONS

Alcohol use in the context of commercial sex is prevalent, harmful among FSWs and male clients, but under-researched. Research in this area in more diverse settings and with standardized measures is required. The review underscores the importance of integrated intervention for alcohol use and related problems in multilevel contexts and with multiple components in order to effectively reduce alcohol use and its harmful effects among FSWs and their clients.