A Research-Based Question and Answer Resource on Sex Trafficking for Youth-Supporting Professionals

Research BriefSexual & Reproductive HealthSep 29, 2022

Sex trafficking is of growing concern to professionals who support young people who experience the child welfare and/or justice systems, homelessness, and/or disconnection from school and work. Sex trafficking survivors (i.e., those who are currently being trafficked or who were trafficked in the past) may suffer a variety of short- and long-term physical and psychological consequences including sexually transmitted infections, unintended pregnancy, depression, post-traumatic stress disorder, substance abuse, malnutrition, and suicidality. These consequences can disrupt normative development and persist into adulthood.1, 2

This resource provides answers to common questions that youth-supporting professionals may have about sex trafficking. Some of these questions may be of interest to all youth-supporting professionals, regardless of the young people with whom they work. Other questions may be of particular interest to youth-supporting professionals who work with young people who experience the child welfare and/or justice systems, homelessness, and/or disconnection from school and work.

  • What is sex trafficking?
  • What are the signs a young person may be a sex trafficking survivor?
  • How can you start a conversation with a young person who may be a sex trafficking survivor?
  • What sex trafficking screening and assessment tools have been developed for use with young people involved with the child welfare and/or justice system, experiencing homelessness, and/or disconnected from work and school?
  • What resources related to sex trafficking are available to young people who are sex trafficking survivors or youth-supporting professionals?
  • How prevalent is sex trafficking among young people involved with the child welfare and/or justice system, experiencing homelessness, and/or disconnected from work and school?
  • What are the links between sex trafficking and child welfare system involvement, justice system involvement, and experiencing homelessness?
  • What evidence-based programs are available to help young people involved with the child welfare and/or justice system, experiencing homelessness, and/or disconnected from work and school who are at risk for or survivors of sex trafficking?

By providing research-based answers to these questions, this resource can help professionals appropriately respond to the needs of young people who experience with the child welfare and/or justice systems, homelessness, and/or disconnection from school and work who are at risk for or survivors of sex trafficking.

Intimate partner violence (IPV) and teen dating violence (TDV) are of growing concern to professionals who support young people who experience the child welfare and/or justice systems, homelessness, and/or disconnection from school and work. IPV/TDV have been linked to negative sexual and reproductive health outcomes among young people who experience the child welfare and/or justice systems and/or homelessness, including a lower likelihood of frequent condom use, unplanned pregnancy, and engaging in sex under the influence of alcohol and drugs. 1-3

This resource provides answers to common questions that youth-supporting professionals may have about IPV and TDV. Some of the questions may be of interest to all youth-supporting professionals, regardless of the young people with whom they work. Other questions may be of greater interest to youth-supporting professionals who work with young people who experience the child welfare and/or justice systems, homelessness, and/or disconnection from school and work.

  • What are IPV and TDV?
  • What are the signs that a young person may be experiencing IPV/TDV?
  • How can you start a conversation with a young person who may be experiencing IPV/TDV?
  • What supports are available to young people experiencing IPV/TDV?
  • What is the prevalence of IPV/TDV among young people involved with the child welfare and/or justice system, experiencing homelessness, and/or disconnected from work and school?
  • What evidence-based programs are available to help young people involved with the child welfare and/or justice system, experiencing homelessness, and/or disconnected from work and school who are at risk for or experiencing IPV/TDV?

By providing research-based answers to these questions, this resource can help professionals appropriately respond to the needs of young people who experience the child welfare and/or justice systems, homelessness, and/or disconnection from school and work who are experiencing or at risk for IPV/TDV.

Sex trafficking is the crime of using force, fraud, or coercion to induce another individual to do a commercial sex act as defined by the Trafficking Victims Protection Act of 2000 (TVPA).3 Common types include escort services, pornography, illicit massage businesses, brothels, and outdoor solicitation. Under TVPA, any commercial sexual activity with a young person under age 18, even without force, fraud, or coercion, is considered trafficking.4 Sex trafficking of a minor is also referred to as the commercial sexual exploitation of children.

A young person may be a sex trafficking survivor if they:5

  • Want to stop participating in commercial sex but feel scared or unable to.
  • Disclose that someone pressured them to engage in commercial sex.
  • Live where they work or are transported by guards between home and their workplace.
  • Live with or are dependent on a family member who is abusive or has a substance use problem.
  • Have a “pimp” or “manager” in the commercial sex industry.
  • Work in an industry where it may be common to be pressured into performing sex acts for money, such as a strip club, go-go bar, or an illicit cantina or massage business.
  • Have a controlling parent, guardian, romantic partner, or “sponsor” who will not allow them to meet or speak with anyone alone or who monitors their movements, spending, or communications.

Importantly, any commercial sexual activity with a young person under age 18, even without force, fraud, or coercion, is considered sex trafficking.

Before starting a conversation with a young person about sex trafficking, first ask yourself the following:

  • Does the young person appear to be in crisis (e.g., threatening to harm themselves or others, unable to control their emotions or behaviors, under the influence of alcohol or other drugs)?
  • Are you somewhere young people feel safe?
  • Can you maintain confidentiality?
  • Have you built enough rapport with the young person to ask sensitive questions?
  • Do you know enough information about the young person to ask questions that are sensitive to their history of trauma or other adverse experiences?
  • Do you believe you are the best person in your organization to have this conversation with the young person?

Following are some questions you can ask young people to determine if they are a sex trafficking survivor:6

  • Are your communications (e.g., calls, emails, texts, chats, conversations) ever restricted or monitored?
  • How do you get by day-to-day if you are living on the streets?
  • Has anyone offered you something like food or a place to sleep in exchange for sexual favors?

New York State’s Office of Children and Family Services has developed several child trafficking resources to facilitate conversations with young people about sex trafficking, including Do’s and Don’ts When Discussing Child Trafficking with survivors and Engaging in Conversations with Potential Survivors.

The following sex trafficking screening and assessment tools have been validated with young people involved with the child welfare system or experiencing homelessness.

The Human Trafficking Screening Tool for youth involved with the child welfare system, youth who have run away, and youth experiencing homelessness was developed and tested by the Urban Institute.26

New York’s Office of Child and Family Services (OCFS) requires the completion of a rapid indicator tool on behalf of all young people under age 18 who are under the care or supervision of a county Department of Social Services or OCFS to determine whether they are at risk for or a survivor of sex trafficking. A Spanish language version is also available.27

The Human Trafficking Interview and Assessment Measure (HTIAM-14) is a human trafficking screening tool validated for use with 18 to 22 year-olds experiencing homelessness.28 It can take up to 45 minutes to administer and requires an interviewer with human trafficking expertise.

The Quick Youth Indicators of Trafficking (QYIT) is a sensitive, brief, and user-friendly trafficking screening tool developed by Covenant House that is validated for use with homeless young adults.29

The Trafficking Victims Identification Tool (TVIT) is a 30-item validated screening tool for identifying human trafficking survivors developed by the Vera Institute.30,31

If you are working with a young person who you believe is a sex trafficking survivor, share the 24-hour National Human Trafficking Hotline that connects sex and labor trafficking survivors with services and supports.

The following organizations provide additional sex trafficking resources and trainings:

Estimates of the prevalence of sex trafficking among young people in the U.S. are not available.7 Although several studies have examined the prevalence of sex trafficking among samples of young people experiencing homelessness, these samples are typically small and not representative of the homeless youth population.

Between 15% and 40% of young people experiencing homelessness report being a survivor of sex trafficking.8-12

Many young people experiencing homelessness who have been sex trafficked were first sex trafficked when they were under age 18.  Depending on the study, between 36% and 86% of young people experiencing homelessness who were sex trafficked were under age 18 the first time they were trafficked.9,11 A study of young people seeking services for homelessness in 10 U.S. and Canadian cities found that 50% of those who identified as survivors of sex trafficking were under age 16 the first time they were trafficked.12

Sex traffickers strategically target young people in foster care because their trauma histories coupled with the child welfare system’s failure to provide a sense of belonging leave them vulnerable to exploitation.7,13-15, Sex traffickers also know where group homes are located and seek out young people in those placements, using cell phones first to entice them and then to control and track their whereabouts.

Young people in foster care, especially those in congregate care, often run away from their placements, which puts them at risk for sex trafficking. Some young people who run away end up on the street where they may be exploited by sex traffickers or recruited into sex trafficking by other young people who are being sex trafficked. They may also resort to “survival sex” to meet their basic needs.10,17

Sex trafficking can lead to justice system involvement among young people. Historically, minors involved in the sex trade were criminalized by the justice system for prostitution and related offenses such as running away. Despite efforts by child advocates to shift the response to sex trafficking from punitive to restorative, sex trafficking survivors continue to be detained and incarcerated for offenses related to their sexual exploitation.18

Young people experiencing homelessness are at heightened risk for commercial sexual exploitation and sex trafficking. Many young people who are homeless resort to “survival sex” to meet their basic needs for shelter, food, and other essentials. Additionally, homelessness among young people often is a result of other risk factors for commercial sexual exploitation and sex trafficking such as poverty, family dysfunction,19 and a history of neglect, abuse, or other trauma.

The Runaway Intervention Program (RIP) is an intensive home visiting and case management program that promotes the healthy development of 12 to 15 year-old girls who have run away, and have been sexually assaulted or exploited. After an initial assessment, advanced practice nurses provide case management, healthcare, and health education at home and in school. Studies have found that RIP reduces risk behaviors, increases self-esteem, and helps runaway youth who identified as females reconnect to school and family.20-22  For more information visit: https://cdc.thehcn.net/promisepractice/index/view?pid=3600

Peer Education and Connection through Empowerment (P.E.A.C.E.) is a three-month, group-based, trauma-informed and peer-supported psychosocial intervention for 16 to 24 year-old girls who have experienced homelessness and sex-based violence, including sexual exploitation or trafficking. Group activities focus on health promotion and include psychoeducational sessions facilitated by a health promotion coordinator and two peer mentors. Evaluations of PEACE have found improvements in quality of life and reductions in experiences of victimization among participants 12 months post-enrollment,23 as well as satisfaction with the intervention.24 For more information visit:
http://kh-cdc.ca/en/project-profiles/peace.html

  1. Chung, R., & English, A. (2015). Commercial sexual exploitation and sex trafficking of adolescents. Current Opinion in Pediatrics, 26, 427-433 doi: 10.1097/MOP.0000000000000242
  2. Chaffee, T., & English, A. (2015). Sex trafficking of adolescents and young adults in the United States. Current Opinion in Obstetrics and Gynecology, 27, 339-344 doi: 10.1097/GCO.0000000000000198
  3. Trafficking Victims Protection Act of 2000, 22 S.C. §7102 et seq. (2013).
  4. Greenbaum, J. (2014). Commercial sexual exploitation and sex trafficking of children in the United States. Current Problems in Pediatric and Adolescent Health Care, 44(9), 245-269.
  5. National Human Trafficking Hotline (n.d.). Recognizing the Retrieved June. 17, 2022 from https://humantraffickinghotline.org/human-trafficking/recognizing- signs.
  6. Family and Youth Services Bureau (2022). Integrating effective practices to identify youth victims of human trafficking, National Clearinghouse on Homeless Youth & Families.
  7. Franchino-Olsen, (2021). Vulnerabilities relevant for commercial sexual exploitation of children/domestic minor sex trafficking: A systematic review of risk factors. Trauma, Violence, & Abuse, 22(1), 99-111.
  8. Middleton, J. , Gattis, M. N., Frey, L. M., & Roe-Sepowitz, (2018). Youth experiences survey (YES): Exploring the scope and complexity of sex trafficking in a sample of youth experiencing homelessness. Journal of Social Service Research, 44(2), 141-157.
  9. Roe-Sepowitz, D., Brockie, , Bracy, K., & Hogan, K. (2016). Youth experiences survey: Exploring the sex trafficking experiences of homeless young adults in Arizona, Year 3. Office of Sex Trafficking Intervention Research. Arizona State University.
  10. Hogan, K. & Roe-Sepowitz, D. (2020). LGBTQ+ homeless young adults and sex trafficking vulnerability. Journal of Human Trafficking, 1-16.
  11. Schilling Wolfe, D. Greeson, J., Wasch, S., & Treglia, D. (2018). Human trafficking prevalence and child welfare risk factors among homeless youth: A Multi-City Study. The Field Center for Children’s Policy, Practice & Research, University of Pennsylvania.
  12. Murphy, L. T. (2016). Labor and sex trafficking among homeless youth. Loyola University Modern Slavery Research Project.
  13. National Research (2013). Confronting commercial sexual exploitation and sex trafficking of minors in the United States. National Academies Press.
  14. Walker, K., & Quraishi, F. (2014). From abused and neglected to abused and exploited: the intersection of the child welfare system with the commercial sexual exploitation of children. National Center for Youth Law.
  15. Reid, J. A., Baglivio, M. T., Piquero, A. R., Greenwald, M. A., & Epps, N. (2017). Human trafficking of minors and childhood adversity in Florida. American Journal of Public Health, 107(2), 306-311.
  16. Landers, M., McGrath, K., Johnson, M. H., Armstrong, M. I., & Dollard, N. (2017). Baseline characteristics of dependent youth who have been commercially sexually exploited: Findings from a specialized treatment program. Journal of Child Sexual Abuse, 26, 692–709.
  17. Pullmann, D., Roberts, N., Parker, E. M., Mangiaracina, K. J., Briner, L., Silverman, M., & Becker, J. R. (2020). Residential instability, running away, and juvenile detention characterizes commercially sexually exploited youth involved in Washington State’s child welfare system. Child Abuse & Neglect, 102, 104423.
  18. Cook, M., Talbert, R., & Thomas, B. (2021). A longitudinal study of justice characteristics among girls participating in a sex trafficking court program. Health Justice, 9, 1.
  19. Institute of Medicine and National Research (2013). Confronting commercial sexual exploitation and sex trafficking of minors in the United States. The National Academies Press.
  20. Redacted.
  21. Edinburgh, D., & Saewyc, E. M. (2009). A novel, intensive home-visiting intervention for runaway, sexually exploited girls. Journal for specialists in pediatric nursing, 14(1), 41-48.
  22. Saewyc, M., & Edinburgh, L. D. (2010). Restoring healthy developmental trajectories for sexually exploited young runaway girls: Fostering protective factors and reducing risk behaviors. Journal of Adolescent Health, 46(2), 180-188.
  23. Bounds, T., Edinburgh, L. D., Fogg, L. F., & Saeywc, E. M. (2019). A nurse practitioner-led intervention for runaway adolescents who have been sexually assaulted or sexually exploited: Effects on trauma symptoms, suicidality, and self- injury. Child Abuse & Neglect, 90, 99-107.
  24. Bani-Fatemi, A., Malta, M., Noble, A., Wang, W.,  Rajakulendran, T., Kahan, D., & Stergiopoulos, V. (2020). Supporting female survivors of gender-based violence experiencing homelessness: outcomes of a health promotion psychoeducation group intervention. Frontiers in Psychiatry, 11, 601540.
  25. Kahan, D., Lamanna, D., Rajakulendran, T., Noble, A., & Stergiopoulos, V. (2020). Implementing a trauma-informed intervention for homeless female survivors of gender-based violence: Lessons learned in a large Canadian urban centre. Health & Social Care in the Community, 28(3), 823-832.
  26. Dank, L., Yahner, J., Yu, L., Vasquez-Noriega, C., Gelatt, J., Pergamit, M. R., & Center, J. P. (2017). Pretesting a human trafficking screening tool in the child welfare and runaway and homeless youth systems. Urban Institute.
  27. New York State Office of Children and Family Services, Division of Youth Development and Partnerships for Success (n.d.). Human Trafficking--Resources for Professionals.
  28. Bigelsen, J., & Vuotto, (2013). Homelessness, survival sex, and human trafficking: As experienced by the Youth of Covenant House New York. Covenant House.
  29. Chisolm-Straker, M., Sze, J., Einbond, J., White, J., & Stoklosa, H. (2019). Screening for human trafficking among homeless young adults. Children and Youth Services Review, 98, 72-79.
  30. Vera Institute of (2014). Screening for human trafficking: Guidelines for administering the Trafficking Victim Identification Tool (TVIT). Vera Institute of Justice.
  31. Simich, L., Goyen, L., Powell, A., & Mallozzi, K. (2014). Improving human trafficking victim identification: Validation and dissemination of a screening tool. Vera Institute of Justice.

Suggested Citation: Schlecht, C., Griffin, A.M., & Kull, M. (2022). A research-based question and answer resource on sex trafficking for youth-supporting professionals. Child Trends. https://activatecenter.org/resource/a-research-based-question-and-answer-resource-on-sex-trafficking-for-youth-supporting-professionals

Author Attribution: This document was developed as part of a partnership between Child Trends and Chapin Hall. Authors of this resource from Chapin Hall include Colleen Schlecht, MPP, Amanda Griffin, Ph.D., and Melissa Kull, PhD.

Acknowledgements: The authors would like to thank the many contributors to this resource. Experts who informed the resource include:

  • Heidi Beaubriand, Oregon Department of Human Services
  • Cathy Benn, Second Story for Teens in Crisis
  • Soraya Borja, Second Story in the Community
  • JaQuay Butler, Sacramento County (CA) Public Health
  • Lauren Luberda, Second Story for Teens in Crisis
  • Kimberlyn Pena, Second Story in the Community
  • Rachel Roberts, Children’s Aid Society of Alabama
  • Lindsay White, Youth Villages

Thank you also to the several youth-supporting professionals, young people, and other experts who contributed but are not named here. We also thank other Activate project team members who assisted in the development of this resource including Mindy Scott, PI and Jan DeCoursey, Project Director. We are grateful for the contributions of other Child Trends, Chapin Hall, and Healthy Teen Network staff who contributed to this resource including:

  • Jenita Parekh, Child Trends
  • Julie Blechman, Child Trends
  • Nicholas Sufrinko, Healthy Teen Network
  • Milagros Garrido, Healthy Teen Network
  • Jennifer Farmer, Healthy Teen Network

Finally, a special thank you to the Child Trends communications staff, especially Kelley Bennett, Olga Morales, Catherine Nichols, Brent Franklin, and Stephen Russ.

This page was last updated in February 2025.