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Sexual health nurses (SHNs) are in a powerful position to pinpoint child sexual exploitation. Ann Marie Songster, Dr Maureen Crowley and Amanda McGrandles set up a study in Scotland to explore SHNs' perceptions of their role.
Child sexual exploitation (CSE) is a form of child trafficking that is growing rapidly across the world. Unicef (2011) estimates that more than 1.2 million children worldwide are trafficked annually. Described as 'a form of modern-day slavery' (Scottish Government, 2013), trafficking in children takes many forms, the most common of which in the UK is sexual exploitation (NSPCC, 2013).
CSE can occur in person and/or online and can involve physical or non-contact sexual activities. This can be perpetrated by individuals, an informal or organised group of abusers, or by peer exploitation (Scottish Government, 2014). Any child under 18 years can be affected, but the average age at which CSE is identified is between 12 and 15 years (Beckett and Walker, 2016). Although it is advocated that girls are more at risk than boys, it has been argued that prevalence among boys is greatly underestimated (Barnardo's, 2014).
The extent of CSE in Scotland and the rest of the UK is statistically undetermined due to its hidden nature (HM Government, 2017; Scottish Government, 2016). Complicating this further, the four devolved UK countries all define CSE differently (NSPCC, 2018; Kelly and Karsna, 2017). Nevertheless, health professionals have a duty to act and protect children and young people from sexual exploitation (Scottish Government, 2014).
Misidentification of trafficking can contribute to inaccurate statistics, and health professionals have sometimes failed to identify children and young people at risk of CSE (Jay, 2014; Scotland's Commissioner for Children and Young People, 2011).
CSE has a significant health impact, and the need to identify those affected is great. In a study of 207 women and adolescents who had been trafficked, Zimmerman et al (2006) found nearly every bodily system - neurological, gastrointestinal, musculoskeletal and so on - was affected. Sexual health problems were reported by 60% of victims and 17% reported having at least one induced abortion. Likewise, Lederer and Wetzel (2014) identified similar widespread health complications in a study of 107 trafficked women: some subjects reported being sexually exploited as much as 30 to...