Prevalence and characteristics of sex trafficking among youth experiencing homelessness: A cross-sectional study.

Abstract

Youth experiencing homelessness (YEH) face elevated risk for sex trafficking due to interconnecting structural, interpersonal, and psychological vulnerabilities. Despite growing recognition of this link, regional data from the southern United States remain limited. This study examines the proportion of YEH reporting experiences consistent with sex trafficking and describes associated characteristics among a sample of YEH in Houston, TX. Baseline data (September 2019-May 2023) from a randomized controlled trial of a nurse-led HIV prevention intervention were analyzed. Participants (N = 450; ages 16-25) completed self-administered surveys. Sex trafficking was defined as endorsing ≥1 of five Commercial Sexual Exploitation items from the Urban Institute Human Trafficking Screening Tool. Adjusted and unadjusted modified Poisson regression models with robust variance estimation were used to examine relationships between sex trafficking and age, gender, race/ethnicity, sexual orientation, foster care history, past-30-day drug use, and last permanent residence in Houston. Within this sample of YEH, 23.1% (104/450) reported experiences consistent with sex trafficking. In adjusted models, those who identified as female vs. male (aPR = 2.341, 95% CI: 1.530-3.582) were more likely to report being trafficked. Among YEH in Houston, study findings showed that trafficking disproportionately impacted those who identify as female. Findings suggest a need for routine, trauma-informed trafficking screening; service strategies to reach impacted youth; and longitudinal research to clarify causal pathways and guide tailored prevention and care for diverse youth populations. ClinicalTrials.gov NCT03910218.