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1.
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.  相似文献   

2.
Research on youth sexual exploitation in Africa has largely neglected the experiences of exploited boys. To date, much of the research in sub-Saharan Africa continues to consider boys mainly as exploiters but not as exploited. Using the only publicly available population-based surveys from the National Survey of Adolescents, conducted in four sub-Saharan African countries — Burkina Faso, Ghana, Malawi, and Uganda—we assessed factors associated with transactional sexual behaviour among never-married adolescent boys and girls. We also examined whether boys’ reported sexual exploitation was linked to similar risky sexual behaviours as has been noted among girls in sub-Saharan Africa. Results from our analyses indicated that even though adolescent girls have a somewhat higher likelihood of reporting sexual abuse and exploitation, the odds of trading sex were significantly elevated for previously traumatized boys (that is those with a history of sexual and physical abuse) but not for their female counterparts. Just like adolescent girls, transactional sexual behaviour was associated with the risk of having concurrent multiple sexual partners for boys. These findings support the reality of boys’ sexual exploitation within the African context, and further highlight the importance of including males in general and boys in particular in population-based studies on sexual health, risk, and protective factors in the sub-Saharan African region. Understanding the factors linked to sexual exploitation for both boys and girls will help in developing policies and programs that could improve the overall sexual and reproductive health outcomes among adolescents and youth in sub-Saharan Africa.  相似文献   

3.
Several states have recently enacted “Safe Harbor” laws to redirect child victims of commercial sexual exploitation and child sex trafficking from the criminal justice system and into the child welfare system. No comprehensive studies of Safe Harbor law implementation exist. The nine state Safe Harbor laws enacted by 2012 were analyzed to guide state legislators, health professionals, law enforcement agents, child welfare providers, and other responders to the commercial sexual exploitation of children on the development and implementation of state Safe Harbor laws. The authors conducted 32 semi-structured interviews with Safe Harbor experts in these states. Participants conveyed that Safe Harbor legislation signified a critical paradigm shift, treating commercially sexually exploited youth not as criminals but as vulnerable children in need of services. However, Safe Harbor legislation varied widely and significant gaps in laws exist. Such laws alone were considered insufficient without adequate funding for necessary services. As a result, many well-meaning providers were going around the Safe Harbor laws by continuing to incarcerate commercially sexually exploited youth in the juvenile justice system regardless of Safe Harbor laws in place. This was done, to act, in their view, in what was the best interest of the victimized children. With imperfect laws and implementation, these findings suggest an important role for local and state responders to act together to protect victims from unnecessary criminalization and potential further traumatization.  相似文献   

4.
Although there is evidence for specific risk factors leading to child sexual exploitation and prostitution, these influences overlap and have rarely been examined concurrently. The present study examined case files for 175 young persons who attended a voluntary organization in Leicester, United Kingdom, which supports people who are sexually exploited or at risk of sexual exploitation. Based on the case files, the presence or absence of known risk factors for becoming a sex worker was coded. Data were analyzed using t-test, logistic regression, and smallest space analysis. Users of the voluntary organization's services who had been sexually exploited exhibited a significantly greater number of risk factors than service users who had not been victims of sexual exploitation. The logistic regression produced a significant model fit. However, of the 14 potential predictors – many of which were associated with each other – only four variables significantly predicted actual sexual exploitation: running away, poverty, drug and/or alcohol use, and having friends or family members in prostitution. Surprisingly, running away was found to significantly decrease the odds of becoming involved in sexual exploitation. Smallest space analysis of the data revealed 5 clusters of risk factors. Two of the clusters, which reflected a desperation and need construct and immature or out-of-control lifestyles, were significantly associated with sexual exploitation. Our research suggests that some risk factors (e.g. physical and emotional abuse, early delinquency, and homelessness) for becoming involved in sexual exploitation are common but are part of the problematic milieu of the individuals affected and not directly associated with sex trading itself. Our results also indicate that it is important to engage with the families and associates of young persons at risk of becoming (or remaining) a sex worker if one wants to reduce the numbers of persons who engage in this activity.  相似文献   

5.
The current study sought to understand commercially sexually exploited (CSE) youths’ health care experiences, barriers to care, and recommendations for improving health care services. We conducted focus groups (N = 5) with 18 CSE youth from February 2015 through May 2016 at two group homes serving CSE youth in Southern California. We performed thematic content analysis to identify emergent themes about CSE youths’ perspectives on health care. Youth described facilitators to care, including availability of services such as screening for sexually transmitted infections, knowledge about sexual health, and a strong motivation to stay healthy. Barriers included feeling judged, concerns about confidentiality, fear, perceived low quality of services, and self-reliance. Overall, youth emphasized self-reliance and “street smarts” for survival and de-emphasized “victimhood,” which shaped their interactions with health care, and recommended that health providers develop increased understanding of CSE youth. Our findings suggest that providers and community agencies can play an essential role in raising awareness of the needs of CSE youth and meet their health needs through creating a non-judgmental environment in health care settings that validates the experiences of these youth.  相似文献   

6.
When compared to children from the general population, sexually abused children receive more medical services, both for physical and mental health problems. However, possible differences between sexually abused boys and girls remain unknown. The lack of control group in studies that find gender differences also prevents from determining if the differences are specific to sexual abuse or to gender. The objective of the study was to assess differences in physical and mental health between sexually abused boys and girls in comparison to those from the general population. Administrative databases were used to document physical and mental health problems of 222 males and 660 females with a substantiated report of sexual abuse between 2001 and 2010. A comparison group individually matched to those from the sexually abused group on gender, age and geographic area was also used to document gender differences in the general population. Yearly incidence rates of diagnoses resulting from medical consultations and hospitalizations of males and females were compared over five years after a first substantiated sexual abuse report using the mixed general linear model. Sexually abused girls were up to 2.2 times more likely to consult a physician than sexually abused boys for physical health problems. Similar findings are observed in the general population. Conversely, results revealed that sexually abused boys were up to 2.3 times more likely than females to consult a physician for mental health problems. This gender difference was not apparent in the general population group.  相似文献   

7.
8.
The evidence available at this time indicates that male children are more likely to be abused by nonfamily rather than family members. Residing in a neglectful home or a mother-headed household and having previous homosexual contact tend to heighten risk for sexual abuse by nonfamily members. Familial sexual abuse appears related to residence in a home where other siblings are being abused, where the father was a victim of sexual abuse as a child, and where parents suffer myriad personal and social adjustment difficulties. Effects of male child sexual abuse appear to be serious and long lasting. The scant writings available at this time imply that the sexually abused male child experiences a range of adjustment and self-esteem problems as an adult and may be at heightened risk to become a child sexual abuser.  相似文献   

9.
Book reviews     
Lifelong learning is recognized as an important tool to reduce social exclusion, but out of the many investigations into the provision of lifelong learning in Europe none has yet sought to examine the specific situation of mental health care service users. This study examines the provision of lifelong learning for this disadvantaged group; it identifies current policies and explores the access to, and nature of, lifelong learning practices for mental health care service users in eight European countries. Data have been collected through a literature and policy review and through questionnaires completed by mental health practitioners in the eight countries. The study found broad compliance amongst the eight countries with the Lisbon policy goals on lifelong learning, but evidence of specific lifelong learning provision for mental health care service users is patchy and sporadic. The study identified the main benefits of, and the barriers to, the participation in lifelong learning for mental health care service users from the viewpoint of mental health professionals and practitioners. The implications for practice were described, and suggestions for actions were made for improving the lifelong learning provision for the target group.  相似文献   

10.
The aim of this study was to present the dynamics of sexual violence against boys. Interviews were conducted with four male victims of sexual abuse between the ages of six and 10, as well as four psychologists employed in the health care system and involved in the treatment of sexually abused boys. Results were examined using thematic content analysis, based on six deductively identified themes corresponding to the following stages of sexual violence against children and adolescents: preparation, episodes, silencing, narratives, repression and overcoming. The results suggested that proximity between victims and offenders, who were mostly adolescent boys, was a facilitator of abuse. The interviews also revealed that victims faced significant levels of disbelief and discrimination. Lastly, the findings pointed to the importance of protective actions and of the system itself, though all practitioners perceived the latter as flawed and unprepared to handle cases involving sexually abused boys. These findings underscore the social invisibility of sexual violence against boys, due to the low number of referrals as well as the disbelief and discrimination, which permeates the management of these cases.  相似文献   

11.
OBJECTIVE: The purpose of this study was to explore how mothers' developmental history and current functioning affects their sexually abused children's functioning and recovery. METHOD: A sample of 67 African-American mothers and their sexually abused children participated in this study. Interviews and a range of adult and child measures were administered in order to assess maternal developmental history and current functioning, and child functioning. RESULTS: Mothers' past experiences as children were associated with their children's behavior and general functioning following the sexual abuse. Mothers who experienced more discontinuity of childhood care, who were sexually abused as children, and/or had more problems in their family of origin had children who showed poorer functioning and more behavioral symptomatology. In addition, mothers who currently were experiencing more trauma symptomatology, reported substance abuse, and/or were less able to provide support to their children, had children with more behavior problems and poorer functioning. CONCLUSIONS: The findings from this study point to the impact of mothers' developmental history and current functioning upon the symptomatology of their sexually abused children.  相似文献   

12.
A study of 200 juvenile and adult street prostitutes documented extremely high levels of sexual child abuse in their background. Sixty percent of the subjects were sexually exploited by an average of two people each, over an average period of 20 months. Two-thirds were sexually abused by father figures. The abuse had extremely negative emotional, physical, and attitudinal impacts. Seventy percent of the women reported that the sexual exploitation definitely affected their decision to become a prostitute. The others reflected the influence in their open-ended comments. Findings make a unique contribution to both the studies of the antecedents to prostitution, and the long-term impacts of sexual child abuse.  相似文献   

13.
While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.  相似文献   

14.
The authors review the current literature on the sexual victimization of adolescent males with attention given to victim characteristics and victim selection factors and strategies. Following this review, a letter written by a middle-aged man to entice a teenage boy into sexual activity is presented and analyzed. The strategy used by the letter-writer is to refute the usual reservations a teenage boy might have about engaging in sexual activity with a man. The approach used in the letter and the ensuing analysis are generalizable to teenage boys experiencing similar encounters and highlight the sophisticated seduction and grooming strategies used to sexually victimize adolescent males.  相似文献   

15.
ABSTRACT

As increased attention and proposed funding are being directed toward community colleges, it is important to consider the sexual and reproductive health care needs of this growing population. Existing data suggest there are significant sexual health needs among this population and often insufficient provision of services. Some community college students are more likely than students at 4-year colleges to test positive for sexually transmitted diseases (STDs). Given resource constraints, creative solutions are required. These may include campus-wide policies addressing STD/HIV (human immunodeficiency virus) prevention, referral systems to connect students to care in the community, and partnerships with local health departments, Federally Qualified Health Centers, or community-based organizations to assist with the provision of services. Colleges have the unique opportunity to provide students with valuable information about sexual health and services. Community colleges, in particular, are uniquely positioned to reach at-risk community members for STD testing and sexual health care who might otherwise be lost to care. More research is needed on the sexual health needs of community college students, especially on factors such as geographic location, how embedded the school is into the community, social norms around sexual health on college campuses, and health services offered. New and innovative ways to promote linkage to care for testing and counseling could offer potential health benefits to this growing at-risk population.  相似文献   

16.
17.
The placement of children in foster or residential care does not ensure that children will be safe from abuse or neglect. The incidence of out-of-home maltreatment, especially sexual exploitation and abuse, has given rise to new community expectations and legislation which has placed the protection of children in alternate care squarely in the hands of the child protective system. These investigations differ in purpose and scope from familial investigations, and the current protective system is without adequate preparation, policy, and procedures to perform them. This paper discusses the differences in familial and out-of-home care investigations in relation to identification and reporting, assessing risk factors in the initial report, evidence gathering, essential components of the investigation, levels of culpability and corrective action approaches. The authors suggest that specialized investigation units may be more suited to these investigations than traditional child protective services.  相似文献   

18.
BackgroundChildren in out-of-home care are consistently found to have poor mental health compared to children in the general population. However, UK research has so far failed to disentangle the impact of the care system on children’s mental health outcomes from the effects of the adverse circumstances that led to their admission to care.ObjectiveThis research investigated the association between care placement and the presence of child mental health problems after controlling for children’s pre-care experiences. It also identified factors associated with mental health problems among children in care.Participants and SettingThe sample comprised three groups of children involved with child welfare services due to maltreatment, including children in out-of-home care (n = 122), reunified children (n = 82) and those who had never been in care (n = 159).MethodsThe mental health of the children in the three groups was compared, using information collected from their parents/foster carers and social workers.ResultsThe odds of a child in out-of-home care having a mental health problem were not significantly higher than those of a child who had never been in care (AOR = 1.24; p = 0.462). However, the odds of a child in out-of-home care having reactive attachment disorder (RAD) were significantly higher than those of a child who had never been in care (AOR=1.92; p = 0.032).ConclusionsThese findings make an important contribution to international debates about whether placing children in care is beneficial or detrimental to their wellbeing, and highlight a range of inter-linking factors associated with the mental health of children in out-of-home care.  相似文献   

19.
In Australia, paediatricians and Child Protection Specialists provide the medical and forensic examinations of child victims of sexual assault. There are workforce challenges in the recruitment and retention of doctors to undertake child sexual assault (CSA) work particularly in remote and rural areas. Pediatric Sexual Assault Nurse Examiner (PSANE) programs have existed in the USA and the UK for many years. Using Rapid Evidence Assessment (REA) methodology, a systematic search of the literature was performed to ascertain what is known about SANE programs, to evaluate the evidence for their effectiveness across a number of domains (accessibility, health and legal outcomes and cost effectiveness) and to inform policy on models of care and elements of best practice which may be appropriate for local implementation in Australia. This review showed that despite the limited evidence available and significant gaps in the evidence, SANEs provide a high standard of medical care and are not detrimental to the legal process. By providing recommendations regarding the potential value, effectiveness and feasibility of establishing a PSANE program in Australia, this article may be of interest to other high income countries facing similar workforce challenges in meeting the needs of children with alleged sexual assault.  相似文献   

20.
Adolescent reproductive health program promotion in Asia and Oceania has been hindered by a lack of appreciation on the part of parents, educators, policy makers, and development planners of the benefits of sex education. Concerns persist that sex education encourages adolescent promiscuity. However, a World Health Organization review of 1050 studies on sex education failed to provide any support for this position. In fact, the research shows that sex education can actually help to delay first intercourse among teens who are not already sexually active and promotes consistent contraceptive use among those who are sexually active. A comprehensive literature review commissioned by the US Agency for International Development as well as a US Centers for Disease Control study corroborated this finding. Cross-national comparisons have indicated adolescent pregnancy rates are lower in countries with liberal policies in terms of sex education programs and the provision of adolescent sexual health services.  相似文献   

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