A brief screening tool can help health care providers identify child sex trafficking
Studies have found many survivors seek medical attention but may not disclose that
they are being exploited due to shame or fear.
Researchers evaluated a brief tool that providers can use to identify these victims
in pediatric emergency departments (EDs), child advocacy centers and teen clinics.
The study included 810 adolescents visiting one of 16 sites. EDs patients were included
only if their chief complaint was acute sexual assault/abuse.
The teens completed a questionnaire regarding their sexual history, high-risk behaviors
and contact with police. Health care providers then asked follow-up questions.
Overall, 11% of the patients were identified as victims of child sex trafficking by
health care professionals based on survey responses and other information obtained
during the visit. About 16% of the clinic patients, 13% of ED patients and 6% of child
advocacy center patients in the study were classified as victims.
About 84% of trafficking victims screened positive, resulting in a sensitivity of
84% and specificity of 57.5%.
Sensitivity and specificity were 83% and 49%, respectively in EDs, 84% and 61%, respectively
in child advocacy centers and 85% and 55%, respectively in teen clinics.
When researchers removed a question about a history of broken bones or cuts needing
stitches, specificity increased.
The authors called the tool an “enormous improvement over the existing situation”
and said although it may incorrectly classify some adolescents as victims, doing so
isn’t necessarily problematic.
“The ‘intervention’ prompted by a positive screen may prevent an at-risk patient from
becoming a victim of trafficking,” they wrote. “Alternatively, failure to identify
a victim may lead to significant harm.”
They encouraged health care providers to be vigilant for victims and discuss concerns
with patients who exhibit risk factors.