Longitudinal Outcomes Related to Commercial Sexual Exploitation of Minors in a Community Sample of Youth

Background and Purpose: The commercial sexual exploitation of children (CSEC)—otherwise known as child sex trafficking or domestic minor sex trafficking—is the exchange of sex or sexual acts by an individual under the age of 18 for goods, services, drugs, or money. Researchers have suggested that victims of CSEC have deleterious long-term outcomes; however, the longitudinal trajectories of youth who experience CSEC are underexplored. The objective of the current study was to employ propensity score matching techniques to examine the longitudinal trajectories of youth who experienced CSEC victimization, and contrast those trajectories with youth who did not experience CSEC. Within the purview of this broad aim, we sought to explore whether individuals who experienced CSEC differ in their psychological, behavioral, physical, and interpersonal well-being when compared to individuals who did not experience CSEC. In addition, we aimed to explore how well-being for individuals who experienced CSEC changed over time compared to individuals who did not experience CSEC.

Methods: A total of 20,745 adolescents in Grades 7–12 comprised the Wave I sample of nationally representative respondents from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Information from in-home youth interviews at Waves I and II (1996; n = 14,738; grades 8-12) was used to identity youth who had exchanged sex prior to age 18 and were therefore child victims of CSEC. Propensity score greedy matching (1-to-1 nearest neighbor within a caliper, without replacement) was then used to locate optimal matches between youth who experienced CSEC (n=430) and youth who did not experience CSEC but possessed similar levels of risk as indicated by their propensity scores (n=430), and those of low risk (n=782). Additional information from Waves II, III (2001-2002; ages 18-26), IV (2008-2009; ages 24-32), and V (2016-2018; ages 33-43) was used to examine longitudinal outcome trajectories.

Results: Youth who had experienced CSEC had higher levels of injection drug use, more police stops, more emergency room visits, and lower relationship satisfaction than their non-exploited peers. Other measures of well-being for individuals who experienced CSEC changed over time, but changes were comparable to the changes experienced by individuals of similar risk who did not experience CSEC. Importantly, all measures of well-being (e.g., psychological, behavioral, physical, and interpersonal) differed significantly between high risk and low risk groups, indicating that youth with high-risk profiles have significantly lower holistic well-being compared to their low-risk peers, regardless of CSEC victimization.

Conclusions and Implications: Youth experiencing issues related to drug use, delinquency, interpersonal relationships, and/or with urgent health care needs may benefit from CSEC screening, however all high-risk youth stand to benefit from holistic care to address disparities in psychological, behavioral, physical, and interpersonal well-being that persist across the lifespan. Implications for research and practice, including screening and CSEC prevention materials, will be discussed.