Outreach to commercially sexually exploited children (CSEC): A community health center (CHC) model

The commercial sexual exploitation of children in the United States is a hidden problem estimated to affect approximately 300,000 children at any time. By federal definition, commercially sexually exploited children (CSECs) are considered to be victims of human trafficking. Children are affected in all 50 states, are located in urban, rural, and suburban communities, and come from all racial and ethnic groups, and socioeconomic classes. The public and individual health effects on these children are significant: victims suffer from an undue burden of violence, substance abuse, mental illness, sexually transmitted diseases, pregnancy and lack of primary health care. The barriers to care are many: lack of insurance, poverty, health illiteracy, language and cultural barriers, minor consent laws, criminalization, and transportation. Asian Health Services, a federally qualified community health center in Oakland, California, and Banteay Srei, a unique community outreach and youth development program for Southeast Asian adolescents at high risk for sexual exploitation, have worked together to: 1) develop a screening tool of high-risk clinical indicators to assist in identifying victims in a clinical setting before they become engaged in the juvenile justice system, 2) provide culturally competent clinical services to address the health issues of these victims, and 3) craft a county level policy/advocacy strategy to address the barriers to care faced by CSECs. This comprehensive approach has been integral to addressing the systematic and institutional inequalities CSECs face and serves as an innovative culturally competent model towards achieving social justice for this unique population.