Children's Pathways into Commercial Sexual Exploitation in the United States: A Systematic Review

This study examined current evidence on children's pathways into commercial sexual exploitation (CSE) in the United States to determine if characteristics, vulnerabilities, and social contexts were distinguishable by age, gender, race/ethnicity, and location. Using Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, peer-reviewed studies and grey literature were included if they were focused on CSE pathways prior to age 18, available in English, U.S. based, and published in or after 2013. In total, 1,989 articles were screened and 306 were eligible for full-text review. In total, 22 studies were analyzed. Nine studies focused on cis girls or women. No studies exclusively focused on CSE among cis boys, gender diverse children, children identifying as LGBTQ+, or children initiated from infancy through preadolescence. Findings indicate that boys and girls at different life stages were initiated into CSE by five pathways, including: (a) family members and caregivers' paramours; (b) romantic partners; (c) peers, friends, and acquaintances; (d) strangers; and (e) circumstantial need. Girls and boys in infancy, toddlerhood, and preadolescence and across rural-urban classifications were exploited by family members, parent's romantic partners, and acquaintances known to their family. Adolescent girls, including those with intellectual disabilities, were trafficked by boyfriends, strangers, and out of circumstantial needs. This is the first review to provide a contemporary overview of dynamics that marked children's CSE pathways from infancy through adolescence. Findings revealed need for future research on CSE-impacted boys, gender diverse and LGBTQ+ children, and intellectually challenged children across early life stages and geographic areas.