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Commercial Sexual Exploitation of Children

An Update for the Forensic Nurse

Hornor, Gail, DNP, CPNP, AFN-BC1; Quinones, Saribel Garcia, DNP, PNP-BC2; Bretl, Deborah, MSN, RN, PPCNP-BC3; Courtney, Audrey B., MSN, CPNP-PC, APRN4; Herendeen, Pamela Ann, DNP, PPCNP-BC5,6; Lewin, Linda, PhD, PMHCNS-BC7; Loyke, Julie A., RN, MSN, APRN-CNP8; Morris, Kristen, DNP, CPNP, AFN-BC9; Schapiro, Naomi A., RN, PhD, CPNP-BC10; Williams, Sheona, CPNP, SANE-P11

doi: 10.1097/JFN.0000000000000243
Original Articles

ABSTRACT Commercial sexual exploitation of children (CSEC) is the sexual abuse of children through buying, selling, or trading their sexual services. This may involve engaging a child under the age of 18 years in prostitution, pornography, stripping, exotic dancing, escort services, or other sexual services. CSEC is a problem of epidemic proportions throughout the world including the United States; however, the actual number of CSEC victims in the United States is unknown. Studies indicate that most child victims are seen by a healthcare provider while being trafficked and that many victims receive care at a pediatric hospital within 1 year of their identification as a victim. CSEC is a significant pediatric healthcare problem. It is vital that forensic nurses possess a thorough understanding of the problem and be poised to better identify, intervene, and prevent CSEC. In this article, we focus on risk factors commonly experienced by victims, recruitment strategies used by traffickers, indicators to identify child victims, and intervention and educational strategies of relevance to forensic nurses.

Author Affiliations:1Center for Family Safety and Healing, Nationwide Children's Hospital;

2New York University;

3Children's Hospital of Wisconsin;

4Connecticut Children's Medical Center;

5Bivona Child Advocacy Center;

6Golisano Children's Hospital, University of Rochester;

7Wayne State University;

8University Hospitals Rainbow Babies and Children's Hospital;

9Peyton Manning Children's Hospital at St. Vincent;

10University of California San Francisco; and

11Child Advocacy Center at UPMC Children's Hospital of Pittsburgh.

The authors declare no conflict of interest.

Correspondence: Gail Hornor, DNP, CPNP, AFN-BC, Center for Family Safety and Healing, Nationwide Children's Hospital, 655 East Livingston Ave., Columbus, OH 43205. E-mail:

Received January 15, 2019; Accepted March 25, 2019

© 2019 by the International Association of Forensic Nurses. All rights reserved.
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