An Examination of Trauma Symptoms Among Children and Adolescents From Two Red-Light Areas in Mumbai, India

Background and Purpose:Children of women in low-income prostitution in India experience extraordinary violence in their everyday lives including, exposure to sexual exploitation of their parent; exposure to alcoholism, familial and community violence, vulnerability to sexual harassment/abuse and HIV and risk of trafficking. An initial step to understanding their mental health needs would be to examine the traumatic impact of their life experiences on their mental and emotional wellbeing. This study measures and conducts a cross-group examination of trauma symptoms among 133 children and adolescents from Falkland Road and Kamatipura red-light areas in Mumbai.

Methods:In-person survey interviews were conducted with: i) 64 shelter-based children (aged 13-17 years) whose mothers are currently prostituting or have ever prostituted; ii) 47 community- based children(aged 13-17years) whose mothers are currently prostituting or have ever prostituted; and iii) 22 community-based children(aged 13-17years) whose mothers have never prostituted. Purposive sampling was used to recruit participants for this study. A vernacular language version of the Trauma Symptoms Checklist for Children (TSCC) was administered verbally by the Principal Investigator as part of a larger data collection package assessing exposure to violence and presence of factor promoting resilience among the participants. For the purpose of analysis, cross-tabulations, analysis of co-variance and logistic regression were conducted.  

Results: Analysis of co-variance with under-reporting as the covariate suggested that community based children of ever prostituted women reported more clinical/subclinical symptoms than community-based children of women who had never prostituted. Shelter and community based children of ever prostituted women did not differ in their endorsement of clinical/subclinical vs. nonclinical trauma symptoms. However, the shelter based group had more children who reported clinical significance on at least one sub-dimension. Analysis of co-variance of the group t-scores with under-reporting as the covariate confirmed that community- based children of ever-prostituted women reported significantly higher mean scores on Anxiety and Depression scales than community- based children of non-prostituting women. The TSCC contains 8 critical items pertaining to self-harm, expectation of sexual maltreatment, suicidality, fears (of men women and being killed) and anger. These critical items were endorsed in highest frequency by community based children of ever prostituted women followed by shelter-based children.

Conclusion and implications: A linear process is apparent with community-based children of ever prostituted women faring the worst, shelter-based children faring marginally better than the former but worse than community- based children of never prostituted women. These findings indicate that community-based children of ever prostituted women are at higher risk for negative mental health outcomes than community- based children of never prostituted women. Shelter-based children are experiencing some benefits from decreased exposure to violence in the community/family and/or services being provided at the shelters. Services that work at individual level to assess identify and address mental health needs of children of ever prostituted women are urgently needed. Programs aimed at building peer and community level support systems for promoting mental and emotional wellbeing may be helpful.