Commercial Sexual Exploitation and Transactional Sex Among Ghanaian Adolescents: The Role Schools

Background/Purpose: Commercial sexual exploitation of children and adolescents (CSECA) refers to transactional sexual activities involving a minor. These transactions include sexual exchange for food, shelter, clothing, money, educational achievement, job opportunities, or other items or opportunities perceived as valuable (Williams, Bingawaho, & Betancourt, 2012). Despite difficulty estimating the prevalence of CSECA, there has been increasing attention focused on CSECA in sub-Saharan Africa. In particular, researchers, practitioners, and policy makers are interested in better understanding malleable risk factors associated with CSECA to inform prevention efforts. Based on theory and preliminary evidence, scholars have called for enhancing school-based prevention efforts. However, limited research has evaluated the relationship between school factors and CSECA. To address this knowledge gap, the current exploratory study examines factors associated with CSECA among Ghanaian adolescents ages 15–18 years, with a particular focus on the role of variables related to school access, engagement, and resources (e.g., health screenings). The study is guided by the following research question: What is the relationship between school-related variables and the likelihood of experiencing CSECA?

Methods: Cross-sectional data collected in 2014 were obtained from a subsample of sexually-experienced and school-going Ghanaian adolescents ages 15–18 years (N = 122). CSECA was a binary variable that measured whether the respondent ever had transactional sex. Independent variables included student demographic characteristics (e.g., gender), attitudes toward sex, and both individual-level (i.e., commitment to school, academic aspirations and expectations, distance to school) and school-level variables related to formal schooling (i.e., frequency of school-based health screenings). We used multilevel logistic regression to analyze our binary outcome and clustered data (youth within schools). We also conducted a series of moderation tests. The final multilevel model included an interaction between commitment to school and academic expectations.

Results: Forty-eight percent of the sample reported experiencing CSECA. Multivariate findings indicated significant association of CSECA with gender, attitudes toward sex, commitment to school, and school-based health screenings. Being an adolescent girl, having more receptive beliefs about sex, and being more committed to school was associated with higher likelihood of CSECA. Schools that provided frequent health screenings were associated with lower likelihood of CSECA among their students compared to schools that had less health screenings. Results also indicated that academic expectations moderated the association between commitment to school and CSECH. Students who expected going to college and were more committed to school were less likely to experience CSECA.

Conclusions/Implications: Almost half of the sample of sexually experienced Ghanaian adolescents had experienced CSECA.  Findings suggest that school factors are associated with CSECA among youth in Ghana. School-based health screenings was protective against CSECA. Further, being committed to school emerged as a risk factor for CSECA unless the youth expected receiving a college education. Implications for practice and policy include efforts to support and implement various health screenings in schools, and to increase access to college education. Future research is needed to replicate findings from this exploratory study with larger more representative samples.