Social Network Exposure to Commercial Sexual Exploitation and Risk of Harm to Youths.

Abstract

Importance: Commercial sexual exploitation (CSE) of young people (aged 6-26 years) poses a considerable public health and social challenge. Understanding how social network exposure to CSE influences CSE risk may inform targeted prevention strategies for at-risk youths.

Objective: To examine the association between social network exposure to CSE and personal risk of experiencing CSE among youths, with a focus on how exposure interacts with childhood adversities.

Design, setting, and participants: This cross-sectional study used data collected between January 1, 2015, and December 31, 2022, from a CSE program at a children's advocacy center in the northeastern US. Eligibility criteria included referral for suspected or confirmed CSE risk. Social relationships with offenders, peers, and others sharing residential placements were examined as potential sources of exposure. The final analyses were completed on March 20, 2025.

Exposure: Social network exposure to CSE among youths.

Main outcomes and measures: Experiencing CSE was the main outcome. Logistic regression was used to assess associations between youth network exposure to CSE and the risk of experiencing CSE, and social network analyses were conducted to identify patterns in the connections between youths with and without CSE experiences.

Results: A total of 997 youth were included in the study (mean [SD] age, 14.7 [2.1] years; 903 female [90.6%]). Youths exposed to CSE through their social networks were significantly more likely to experience CSE (adjusted odds ratio, 2.92; 95% CI, 1.91-4.47). A significant interaction between social exposure and childhood adversities revealed that social network exposure was associated with higher CSE risk among youth with fewer adversities (adjusted odds ratio, 1.45; 95% CI, 1.22-1.74). Network analyses revealed that youth experiencing CSE were more likely to be connected to one another (β [SE], 0.32 [0.14]), highlighting the clustering of CSE within social networks.

Conclusions and relevance: These findings suggest that prevention strategies should aim to reduce unmitigated exposure to individuals experiencing CSE and focus on fostering supportive and healthy relationships. This study underscores the potential for social network modeling to identify at-risk youth and inform prevention efforts.