Exploring the Link among adverse childhood experiences and commercial sexual exploitation

Abstract

Background: Youth with involvement in commercial sexual exploitation (CSE) frequently have extensive adverse childhood experiences (ACEs), affecting their mental health outcomes. Expanding ACE research reveals the complex situations of marginalized youth, particularly those in CSE. Objective: To examine ACEs’ frequency and severity in youth with and without CSE involvement, enhancing ACEs understanding. Participants and Setting: Marginalized youth (n = 200) referred for trauma/psychological evaluations by the Department of Child Services or juvenile probation were divided into CSE-involved (n = 153) and non-CSE-involved (n = 47) groups. CSE-involved youth were subcategorized according to CSE duration: less than two months (n = 56) or two months or more (n = 97). Method: Trauma/psychological evaluations were used to code ACEs, evaluating their prevalence, diversity, and impact. Two evaluators coded the ACEs, with a third resolving any discrepancies. Differences in the occurrence and frequency of ACEs were compared based on the presence and duration of CSE involvement. Findings: Participants encountered a broad spectrum of ACEs. Those involved in CSE had higher ACE frequencies, notably in family violence (IRR = 1.28, p = 0.02), sexual abuse (IRR = 1.251, p = 0.04), community violence (IRR = 1.469, p = 0.007), and personal ACEs (IRR = 1.224, p = 0.04). Findings revealed a heavier trauma load in CSE-involved youth, intensifying with longer involvement. Conclusion: These findings highlight the extent and diversity of ACEs among youth involved in CSE. Future research is needed to explore possible pathways through which ACEs might contribute to CSE involvement and the ways in which detailed assessment of youths’ histories can inform therapeutic programming.

Keywords

• Adverse childhood experience (ACE)
• Commercial sexual exploitation (CSE)
• Community violence
• Complex trauma
• Chronic stress
• Family violence