Transactional sex involvement: exploring risk and promotive factors among substance-using youth in an urban emergency department

Initial Validity Evidence for a Measure of Transactional Sex in a U.S. College Student Sample

The current study provides initial validity evidence for a measure of Transactional Sex (TS). Participants (N = 269) were recruited from a Northeastern University in the United States and consisted of undergraduate and graduate students. Participants completed an online survey through QuestionPro that contained the Transactional Sex Measure (TSM) as well as measures of depression, anxiety, and stress, condom use negotiation self-efficacy and sexual risk, alcohol and drug use, and materialism. Construct and criterion validity were examined. Findings revealed that the TSM provided good criterion validity evidence but the construct validity evidence was minimal. Further studies on the conceptualization of TS and distribution of the TSM across a variety of diverse samples can provide more validity evidence.

Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas

Exchange sex is associated with sexual risk behaviors and poor outcomes and different types may incur different levels of risk. We assessed risk profiles of different types of exchange sex among non-injecting cisgender men and women who participated in the 2019 National HIV Behavioral Surveillance project at six sites. Six percent of men and 19% of women reported exchange sex in the past year; most engaged in non-commercial exchange sex for drugs/money with smaller percentages reporting formal sex work or non-commercial exchange sex for goods or services other than drugs/money. Exchange sex was associated with sexual risk and prevention behaviors and psychosocial and sexual health outcomes and associations varied by type of exchange sex. Efforts to improve access to STI/HIV testing and PrEP may benefit from tailoring based on type of exchange sex. Findings indicate value in a broader definition of exchange sex with follow-up assessment of exchange sex typology.

The Impact of Childhood Abuse on the Commercial Sexual Exploitation of Youth: A Systematic Review and Meta-Analysis

Scholars and practitioners have drawn attention to the issue of commercial sexual exploitation (CSE) of minors, yet we continue to lack a clear understanding of which factors increase a minor's risk to this type of victimization. The current article reviews the literature about the impact of sexual, physical, or emotional abuse on the risk of CSE. The study utilizes quantitative meta-analytical techniques to estimate an overall impact of prior abuse. Nineteen studies were selected after a comprehensive search of electronic databases covering the fields of social science, criminology, psychology, or related fields. To be included in the analyses, all articles had to measure the direct impact of sexual, physical, and/or emotional abuse on minor's risk to CSE, utilizing multivariate techniques and presenting statistical metrics to assess the impact of prior abuse. Key findings demonstrate that sexual abuse considerably increases the risk of exploitation, especially among female youth in the United States. Physical and emotional abuse show negligible or no significant independent impacts, even though a few studies have begun to suggest that experiencing multiple types of childhood abuse may aggravate a risk of sexual exploitation. Our findings can guide further research on the impact of prior victimizations and inform screening instruments that are being developed to identify youth at risk of CSE.

Testing Differential Item Functioning in Small Samples

Differential item functioning (DIF) is a pernicious statistical issue that can mask true group differences on a target latent construct. A considerable amount of research has focused on evaluating methods for testing DIF, such as using likelihood ratio tests in item response theory (IRT). Most of this research has focused on the asymptotic properties of DIF testing, in part because many latent variable methods require large samples to obtain stable parameter estimates. Much less research has evaluated these methods in small sample sizes despite the fact that many social and behavioral scientists frequently encounter small samples in practice. In this article, we examine the extent to which model complexity-the number of model parameters estimated simultaneously-affects the recovery of DIF in small samples. We compare three models that vary in complexity: logistic regression with sum scores, the 1-parameter logistic IRT model, and the 2-parameter logistic IRT model. We expected that logistic regression with sum scores and the 1-parameter logistic IRT model would more accurately estimate DIF because these models yielded more stable estimates despite being misspecified. Indeed, a simulation study and empirical example of adolescent substance use show that, even when data are generated from / assumed to be a 2-parameter logistic IRT, using parsimonious models in small samples leads to more powerful tests of DIF while adequately controlling for Type I error. We also provide evidence for minimum sample sizes needed to detect DIF, and we evaluate whether applying corrections for multiple testing is advisable. Finally, we provide recommendations for applied researchers who conduct DIF analyses in small samples.

Exchange of Sex for Drugs or Money in Adolescents and Young Adults: An Examination of Sociodemographic Factors, HIV-Related Risk, and Community Context

The goal of this research was to examine associations among sociodemographic factors, HIV risk, and community context (e.g., economic insecurity, job training, housing instability, crime victimization, and perceived community norms) in adolescents and young adults who ever exchanged sex for drugs or money. Anonymous survey data were collected using ACASIs at community venues where adolescents and young adults congregate in resource-challenged, STI prevalent, urban, US neighborhoods. Conventional descriptive statistics, Fisher's exact tests, and generalized estimating equations approaches were used to examine associations. Participants (1818, 95.5 % of those screened eligible) were, on average, aged 21.0 years; 42.2 % were males, and 4.6 % were transgender. Almost one-third (32.1 %) identified as gay or lesbian, 18.1 % identified as bisexual; 66.2 % were Black and 21.0 % were Hispanic; 1.3 % was 'living on the street'. A sizeable proportion reported HIV-related risk: 16.3 % exchanged sex, 12.6 % had sex with someone they knew to be HIV-infected, 7.8 % had sex with someone who injected drugs, and 1.3 % injected drugs. Multivariate comparisons identified a number of variables (e.g., being male or transgender, homelessness, sex with a partner who has HIV, STI history, unemployment, job training access, housing instability, crime victimization, perceived community norms) that were significantly associated with exchange of sex (p < 0.05). This research contributes to the knowledge-base regarding exchange of sex among adolescents and young adults, particularly as it relates to community context. Longitudinal studies to describe the trajectory of social, health, and physical risks and consequences are needed for development of effective evidence-based prevention strategies.

Rethinking research on sexual exploitation of boys: Methodological challenges and recommendations to optimize future knowledge generation

Research and policies on child and adolescent sexual exploitation frequently focus on the sexual exploitation of girls and fail to recognize the experiences of sexually exploited boys, including their potentially unique health care and social support needs. This oversight limits the ability of health care and social service providers to offer both targeted and evidence informed care to sexually exploited boys. As a first step in a larger grant to understand the experiences of sexually exploited boys and to develop interventions for this specific population, we conducted a systematic review to address the question, "What is the state of the research on sexually exploited boys internationally?" As we undertook this review, we faced a number of significant challenges that made the process more difficult than anticipated. In this paper we discuss four key methodological challenges we encountered: lack of a consistent definition of child and adolescent sexual exploitation, difficulties in differentiating sexual exploitation as a specific concept within child sexual abuse, failure to disaggregate data usefully across multiple variables, and limited epidemiological studies to inform prevalence. We reflect on how these challenges limited our ability to systematically analyze, synthesize, and interpret the available research. We conclude by making recommendations to improve the state of the research regarding sexually exploited boys with the aim of better informing future policy and practice.