A high prevalence of abuse was found, with rates ranging from These rates are similar to a recent, methodologically comparable study of adult drug users Medrano et al. Further, two types of childhood maltreatment, sexual abuse and emotional abuse, were found to be independently associated with sex work after controlling for socio-demographic variables. Because we were not able to assess the additive burden of abuse due to collinearity of variables, we restricted the analysis to the relationship between each of the separate types of abuse and sex trade involvement.
In terms of the separate associations between sexual abuse and sex work, and emotional abuse and sex work, a number of points can be made. First, a possible explanation for the association between childhood sexual abuse and later sex work involvement may be that children who are sexually victimized develop psychologically and emotionally in ways that make them vulnerable to continuing sexual predation.
The connection between childhood emotional abuse and later sex work involvement may involve similar factors. A review by Spertus, Yehuda, Wong, Halligan, and Seremitis lists a number of emotional and psychological effects of emotional abuse, including depression, anxiety, suicidality, low self-esteem, personality disorders, poor body image, sexual dysfunction, and compromised physical health. These psychological effects may combine to create a vicious circle for many youth, wherein poor coping skills and resources are not adequate for the high-risk situations in which they find themselves, thereby increasing their dependence on strategies such as trading sex for survival.
This in turn would compound risks for which they are poorly equipped, perpetuating a downward spiral from which it is difficult to break free without external intervention. The finding that trauma associated with emotional abuse was independently associated with sex work among street-involved youth was unexpected. Although severe emotional abuse in childhood using the Childhood Trauma Questionnaire was recently found to interact with Black ethnicity in independently predicting involvement in sex work among an adult female drug-using population Medrano et al.
The finding has important implications for intervention programs that address high risk behaviors such as sex work among youth. Not only do interventions need to address childhood sexual abuse as a risk factor—for which there has been evidence for some time—but attention also needs to be paid to experiences of emotional abuse as a potential determinant of high risk behavior.
