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Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis

IMPORTANCE: Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. OBJECTIVE: To provide a...

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Autores principales: Laird, Jessica J., Klettke, Bianca, Hall, Kate, Clancy, Elizabeth, Hallford, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509625/
https://www.ncbi.nlm.nih.gov/pubmed/32960280
http://dx.doi.org/10.1001/jamanetworkopen.2020.17682
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author Laird, Jessica J.
Klettke, Bianca
Hall, Kate
Clancy, Elizabeth
Hallford, David
author_facet Laird, Jessica J.
Klettke, Bianca
Hall, Kate
Clancy, Elizabeth
Hallford, David
author_sort Laird, Jessica J.
collection PubMed
description IMPORTANCE: Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. OBJECTIVE: To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance. DATA SOURCES: Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019. STUDY SELECTION: Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger. DATA EXTRACTION AND SYNTHESIS: Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020. MAIN OUTCOMES AND MEASURES: Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors. RESULTS: Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations. CONCLUSIONS AND RELEVANCE: In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment.
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spelling pubmed-75096252020-09-25 Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis Laird, Jessica J. Klettke, Bianca Hall, Kate Clancy, Elizabeth Hallford, David JAMA Netw Open Original Investigation IMPORTANCE: Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. OBJECTIVE: To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance. DATA SOURCES: Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019. STUDY SELECTION: Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger. DATA EXTRACTION AND SYNTHESIS: Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020. MAIN OUTCOMES AND MEASURES: Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors. RESULTS: Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations. CONCLUSIONS AND RELEVANCE: In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment. American Medical Association 2020-09-22 /pmc/articles/PMC7509625/ /pubmed/32960280 http://dx.doi.org/10.1001/jamanetworkopen.2020.17682 Text en Copyright 2020 Laird JJ et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Laird, Jessica J.
Klettke, Bianca
Hall, Kate
Clancy, Elizabeth
Hallford, David
Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis
title Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis
title_full Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis
title_fullStr Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis
title_full_unstemmed Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis
title_short Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis
title_sort demographic and psychosocial factors associated with child sexual exploitation: a systematic review and meta-analysis
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509625/
https://www.ncbi.nlm.nih.gov/pubmed/32960280
http://dx.doi.org/10.1001/jamanetworkopen.2020.17682
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