Family-Controlled Trafficking in the United States: Victim Characteristics, System Response, and Case Outcomes 

Emily E. Edwards, Jennifer S. Middleton & Jennifer Cole (2022): Family Controlled Trafficking in the United States: Victim Characteristics, System Response, and Case Outcomes, Journal of Human Trafficking, DOI: 10.1080/23322705.2022.2039866

Though limited research has explored trafficker relationships involving family  members as perpetrators, it is well documented that some victims of child  trafficking are exploited by a family member or by a non-relative facilitated  by a family member. This study utilized administrative data from the United  States’ Kentucky child welfare system to examine how victim characteristics,  case factors, system responses, and case outcomes are related to whether a child is trafficked by a family member perpetrator versus non-relative (only)  perpetrator. Analyses were based on 698 alleged victims of child trafficking  reported between 2013 and 2017. Findings suggest that victims of family controlled trafficking were more likely to have a higher number of perpetrators, live in rural communities, and be younger. Further, instances of  family-controlled trafficking were found to be more likely reported by anonymous, non-relative community members, and relative reporting parties  compared to reporting parties of professionals, law enforcement, courts, and juvenile justice, as reflected in previous literature. Important findings  revealed that having a family member involved as the perpetrator of trafficking predicted that the case would not be substantiated and/or founded,  compared to cases not involving a family member. Implications for future research regarding the dynamics of family-controlled trafficking cases are  discussed. Findings suggest opportunities for enhanced practices, training,  and capacity in rural communities. To make a significant impact on the  reduction of family-controlled trafficking, this study sheds light on the  need for enforced penalties for family members as traffickers.

Human trafficking is the fastest growing criminal industry in the world today (Office of Refugee  Resettlement. United States Department of Health and Human Services, 2012) generating $9.5 billion  yearly in the United States (United Nations News Story, 2007). Troublingly, 83% of all confirmed  human trafficking cases in the United States involve American born citizens and 98% of sex trafficking  victims are women and girls (Department of Justice/Office of Justice Programs Report, 2011).  According to the U.S. DOJ, children first fall victim to commercial sexual exploitation, on average,  between 12 and 14 years of age (Adams et al., 2010) and one in 11 youth receive an unwanted online  sexual solicitation or approach (K. Mitchell et al., 2014). Victims are becoming younger, largely because  exploiters are concerned about victims having HIV or AIDS (Franchino-Olsen, 2021; Hall, 2010). Many  victims tend to come from vulnerable populations with a serious history of previous abuse. Risk factors  that increase youths’ vulnerability to trafficking include sexual or physical abuse or maltreatment,  running away or being homeless, system-involvement, such as with the juvenile justice and child welfare systems, being LGBTQIA+, substance abuse, poverty, and early adverse childhood experiences  (Bryan, 2014; IOM (Institute of Medicine) and NRC (National Research Council), 2013). Children, in  particular, are at high risk for human trafficking and oftentimes trafficking by a family member. In the  United States, per federal law, states’ child welfare systems are tasked with the prevention, investigation,  and intervention of child trafficking. As a result, state child welfare systems collect substantial amounts  of data pertaining to the scope and characteristics of child trafficking. For the purposes of the current  study, child trafficking data were derived from a state child welfare agency and thus offer a unique, specific vantage point in better understanding human trafficking in the United States Child trafficking, which includes commercial sexual exploitation, domestic, sex trafficking, and  labor trafficking of minors (Ijadi-Maghsoodi et al., 2014) results in high rates of posttraumatic stress  disorder, depression, suicidal ideation, drug addiction, and a multitude of somatic symptoms among  the victims (Middleton et al., 2018; Zimmerman et al.,2008). Specifically, most victims experience  symptoms of complex trauma, resulting from events that include entrapment; relocation; exposure to  the abuse of others; and extended physical, sexual, psychological abuse (Courtois, 2008). Trafficked  youth are also at increased risk for suicide (DuBois & Felner, 2016; Frey et al., 2018), which is likely  exacerbated by the difficulty in accessing these youth in order to ensure accurate clinical assessment  and prompt follow-up care (Martinez, 2006). 

Some victims of child trafficking are exploited by a family member as the perpetrator or by a non relative along with a family member facilitating exploitation. Though few studies have examined this  type of child trafficking, family member involvement in child trafficking has been identified in the  literature (Kennedy & Pucci, 2007), with terms coined “familial trafficking” (Sprang & Cole, 2018) and  “family facilitated juvenile sex trafficking” (Reid et al., 2015). Frequently used in the Kentuckiana region is the term describing this experience as family-controlled trafficking (Arvizu, 2019) to encompass the wider range of experiences of human trafficking survivors whose families were involved in  their exploitation. The literature review below serves to unpack family-controlled trafficking and is  divided into four key sections: prevalence, risk factors, consequences, and the local community  landscape of family-controlled trafficking. 

Prevalence of Family-Controlled Trafficking in the United States 

In the United States, awareness regarding the phenomenon of family-controlled trafficking is increas ing, as substantiated cases involving family members and/or caregivers as perpetrators are becoming  more prevalent. Over 10 years ago, K. J. Mitchell et al. (2010) found that 12% of juvenile prostitution  cases involved personal relationships between the child victim and perpetrator, including caretakers  and family members who were paid for the child’s commercial sexual exploitation and sexual abuse.  Similarly, in a report by Polaris Project (2012), researchers identified a small but meaningful percen tage of child trafficking victims being recruited by caregivers and over 11% of child trafficking  recruitment occurring while the child is at home. Additionally, the National Human Trafficking  Resource Center (NHTRC; 2015) identified 314 child welfare-involved cases of child trafficking  from 2007 to 2012 in which the children were allegedly trafficked by a parent, legal guardian, and/  or foster parent. More recent literature focusing on the tactics of traffickers reveals that 14.4% of sex  traffickers were found to victimize their children, spouses, partners, siblings, and other family  members (Feehs & Richmond, 2018), and this percentage increased to 37.8% the following year  (Currier & Feehs, 2019). 

Research explains that for some children and youth who are victims of trafficking, a family history  and culture of survival sex may be seen as a “family business” (Miccio-Fonseca, 2017, p. 567). This is  congruent with existing research, which has shown the prevalence of close relationships between sex  traffickers and their victims, including family members (Malm & Bichler, 2011; Malm et al., 2010;  McGloin, 2005; Natarajan, 2006). Researchers have postulated that working in small groups, cliques,  or subgroups with these types of intimate and biological relationships provides safety and protection  to sex traffickers (Malm & Bichler, 2011; Malm et al., 2010; Natarajan, 2006) and limits detection by law enforcement (Sabon et al., 2021). Though the research on family-controlled trafficking is growing  in recent years, there remains a gap in the literature regarding the complexities of family-controlled  trafficking and a lack of clarity or empirical support for predisposing factors related to this  phenomenon. 

There are several reasons for the small body of research addressing family-controlled trafficking.  Human trafficking alone is complex, and the dynamics of family-controlled trafficking add a layer of  complexity and enhance the barriers to rigorous examination and measurement. The human trafficking industry is underground and invisible (Franchino-Olsen, 2021) and many victims do not realize  they are being exploited (McClain & Garrity, 2011). Furthermore, for victims with family members as  traffickers, trafficking is embedded within the intimate relationships, characterizing intimidation,  violence, and control, as well as affection and dependency (Verhoeven et al., 2015). Thus, evidence  clearly suggests researchers are met with difficulties collecting data that reflects the volume, frequency,  and complexities of child trafficking (Franchino-Olsen, 2021), which arguably, points to more  inherent challenges when researching family-controlled trafficking nested within the field of child  trafficking. As a result, more research is needed to continue exploring and examining various  exploitation typologies, inclusive of those with family member involvement. 

Risk Factors Associated with Victims of Family-Controlled Trafficking 

Though an emerging area of research, very little exists in the literature on risk factors for the  involvement of family members as perpetrators in child trafficking. Generally, childhood trauma  has been found to be associated with child trafficking. For example, Middleton and Vavrousek (2016)  found that 48% of the youth reporting being sex-trafficked had Adverse Childhood Experiences  (ACEs) of seven or more. The ACEs predicting sex trafficking included experiencing emotional  abuse, sexual abuse, emotional neglect, physical neglect, and witnessing domestic abuse. Other risk  factors for child trafficking include the child’s history of running away and early alcohol/drug use  (J. A. Reid, 2011), as well as having a history of child maltreatment and a caregiver with alcohol/drug  use, mental health problems, domestic violence (J. Reid, 2012). 

While limited, the research regarding known risk factors for child trafficking facilitated by a family  member runs parallel to the risk factors for child trafficking. For example, Twis (2020) discovered that  child victims with a family member as the trafficking perpetrator were more likely to have a history of  child welfare involvement, whereas child victims with juvenile justice system involvement were more  likely to be trafficked by a stranger and/or third party trafficker. In addition, early findings calling for  more research on family-controlled trafficking revealed that child victims of family-controlled trafficking were mostly from suburban communities, were the least likely to have a known history of running  away (K. J. Mitchell et al., 2010) and had family members involved in sex work (Fedina et al., 2016).  More recent research on risk factors for family-controlled trafficking include living in rural or  micropolitan areas and children of young age (Sprang & Cole, 2018). 

Consequences of Family-Controlled Trafficking 

Child trafficking increases risk for many complex difficulties as children grow up and the consequences can be detrimental or even fatal. For example, Frey et al. () found that among a sample of  youth experiencing homelessness and sex trafficking, 53% reported experiencing suicidal ideation and  84.4% had attempted suicide in their lifetime. Importantly, the one consistent protective factor against  child trafficking and its severe consequences is that of supportive interpersonal relationships (Landers  et al., 2019; O’Brien, 2018). However, in cases of family-controlled trafficking, a relative, primary  caregiver, or guardian in a position of trust is an involved perpetrator causing harm to the child. This  type of context of perpetrator relationship is critical to consider because children who experience  abandonment, sexual abuse, and betrayal trauma from caregivers endure immense psychological and social consequences (Arata et al., 2007; Freyd, 2003; Norman et al., 2012; Stroebel et al., 2012). Thus,  children who experience trafficking facilitated by a family member are at-risk for similar, if not more  significant negative outcomes. 

When studying the characteristics and dynamics of 19 family-controlled trafficking cases, Reid et al.  (2015) found similar psychological and social consequences among victims such as anxiety, depression, interpersonal relationship difficulties, and problems with authority figures. Of the 19 victims,  90% were diagnosed with a mental health disorder (including posttraumatic stress disorder, bipolar  disorder, depression, conduct disorder, and attention-deficit hyperactivity disorder) and almost half  were diagnosed with more than one mental health disorder. Other consequences included suicidal  ideation, as well as self-harming behavior and psychiatric hospitalizations due to suicidal attempts.  While the above-mentioned consequences are parallel to the literature regarding consequences of  child trafficking in general, Reid et al. (2015) also found that social consequences of family-controlled  trafficking included low frustration tolerance and uncontrollable anger at the caregiver facilitating  trafficking and authority figures in general. 

Family-Controlled Trafficking in Kentucky 

Cole and Anderson (2013) conducted surveys of 323 professionals (i.e., court designated workers, DOJ  personnel, providers for at-risk youth and victim services) in Kentucky, with 49.8% having worked  with definite or alleged victims of child trafficking. They found that the most commonly reported  trafficker-victim relationship of the three most recent cases was a family member (62%) followed by  a third-party perpetrator (e.g., pimp, family friend, intimate partner, stranger). To better understand  the dynamics of family-controlled trafficking in Kentucky, Sprang and Cole (2018) examined 31  children in Kentucky’s child welfare system who were receiving mental health assessment and  treatment. Of these cases, the researchers explored characteristics of the victims (e.g., gender, resi dence, experiences), the trafficking situation, the case outcomes, and the relationships between the  victims and traffickers. All the cases examined involved a family member as the trafficker, including the mother (64.5%), father (32.3%), and other family members (3.2%). In almost half of cases, there  were also indications of third-party traffickers who were non-family members. In a vast majority of the  cases, parents were trafficking their children to receive illicit drugs as currency. Child victims were  trafficked for prostitution, pornography, and strip club involvement, and recruited by threats and  authority intimidation by caregivers. Of these cases, 64.5% resulted in a criminal charge against the  trafficker (e.g., child abuse), however, only a third resulted in criminal, human trafficking charges. It is  important to note that labeling family-controlled trafficking as child abuse without the commercial  element results in less severe charges (Smith et al., 2009). 

The United States’ Trafficking Victims Protection Act (TVPA) of 2000 established federal policies  and methods of prosecuting traffickers, preventing human trafficking, and protecting victims and  survivors of trafficking, including children. The act established human trafficking and related  offenses as federal crimes and helped to inform new state-level policies about the prevention and  intervention of trafficking of children throughout the United States. In June 2013, the Human  Trafficking Victims’ Rights Act, which is a safe harbor law, was enacted in Kentucky. One of the key  provisions of the law was to mandate the state child welfare agency, the Department of Community  Based Services (DCBS), to be responsible for investigating reports of human trafficking involving  a juvenile, handling cases of human trafficking like any other dependency, neglect, or abuse case,  and providing services to juvenile victims, regardless of the relationship of the trafficker to the  alleged victim (Human Trafficking Victims’ Rights Act, Kentucky Revised Ann. Statutes § 529.120).  Since Kentucky’s safe harbor law in 2013, child trafficking reports increased between the years 2014  and 2017 (Cole & Sprang, 2020). However, the substantiation rates for child trafficking (confirmed  by law enforcement) were lower than substantiation rates for child neglect (as reported in the Anne  E. Casey Foundation, 2019) and child sexual abuse (Cole & Sprang, 2020). The status of substantiation rates relates to the level of evidence available to the investigating party (Reid et al., 2017) and the literature suggests that more research is needed to uncover the child welfare and law enforce ment processes that occur after reports of suspected human trafficking to determine if there are  system break downs or challenges that prevent successful identification and investigation of human trafficking cases. (Cole & Sprang, 2020, p. 8) 

Cole and Sprang (2020) postulated that successful identification and investigation of complex  human trafficking cases might be prevented by system breakdowns and challenges related to investi gative techniques involving diverse types of sex trafficking scenarios (e.g., family-controlled  trafficking). 

During a similar time period, Middleton and Edwards (2020) examined child trafficking cases  through administrative data in Kentucky’s child welfare system between the years 2013 and 2017,  following the safe harbor law. Building on previous findings on child trafficking and family-controlled  trafficking (Cole & Anderson, 2013; Cole & Sprang, 2020; Sprang & Cole, 2018), Middleton and  Edwards (2020) found similar results in case characteristics and outcomes. Among 698 alleged victims  of child trafficking, 57.7% of trafficking victims were controlled by family members and 61.2% of the  alleged victims were at home when the allegations of child trafficking were received. Reflecting  previous literature, multiple perpetrators were more likely to be involved in cases involving young  children, drugs, and family-controlled trafficking. The current study utilizes the same administrative  data involving child trafficking cases to further examine how victim characteristics, case factors,  system responses, and case outcomes are related to whether a child is trafficked by a family member  perpetrator versus non-relative (only) perpetrator. Specifically, the current study aims to answer the  following research questions about child welfare cases: (1) What victim characteristics are associated with family-controlled trafficking cases? (2) What case factors are associated with family-controlled trafficking cases? (3) What system responses are associated with family-controlled trafficking cases? (4) What case outcomes are associated with family-controlled trafficking cases? 

Methods 

Participants 

The authors conducted a comprehensive case review of 698 alleged child trafficking cases reported to  the Kentucky Department of Community Based Services (DCBS) between 2013 and 2017. In  Kentucky, all residents are considered mandated reporters and any individual can file a report of  child abuse and neglect. Reports can be submitted using the hotline phone number if they are  considered emergent, or via an online portal if they are considered to be non-emergent. When child  abuse and neglect reports are received through the hotline, the DCBS asks one question about whether  child trafficking is suspected. The dataset included 29 questions answered by the reporting party. In  addition to specific questions asked when making reports, each case had an open-ended question for  additional comments and a brief description of the allegations reported. 

Of the 698 alleged victims included in the reports of possible human trafficking to the state child  welfare agency from 2013 to 2017, the mean age of the alleged victims was 13.7, with nearly one-third  of alleged victims (32.1%) being 13 years old or younger, 30.2% were 14 and 15 years old, and the  remaining 37.6% of alleged victims were 16 and 17 years old. The majority of victims were female  (83.5%). The vast majority of victims (97.6%) were born in the U.S. Furthermore, most victims (89.0%)  had prior involvement with the child welfare agency. The majority of alleged victims (59.5%, n = 415)  had at least one perpetrator who was a family member, 40.5% (n = 283) of alleged victims had their  only perpetrator (or all of their perpetrators, if multiple) who were not family members. The numbers  of alleged victims reported to the child welfare agency as possible victims of human trafficking  increased over time as indicated in the report years: 2013 (n = 22), 2014 (n = 102), 2015 (n = 115),  2016 (n = 208), and 2017 (n = 251). 

Procedures 

The authors worked with the Department of Community Based Services (DCBS) to obtain a data  sharing agreement and design a data extraction tool to be used to collect pertinent information and  specific variables for the case file review. Research-based characteristics of child trafficking victims  informed the data elements to be included in the data extraction tool utilized to collect data from the  DCBS case worker intake assessment form (aka: ADT CPS Assessment for Abuse/Neglect form). 

Measures 

Operational Definitions 

In the data, if at least one perpetrator was a family member, then the case was classified as “family controlled trafficking.” Included in the report being made was a question, “Was the perpetrator  a caretaker?” Further, additional questions asked, “What was the caretaker’s relationship to the victim?”  and “What was the non-caretaker’s relationship to the victim?” The authors condensed this variable  into the question, “Was the perpetrator a family member?” which resulted in two outcomes:  Nonrelative, encompassing all relationships of perpetrators not related to the alleged child victim;  and Family Member, encompassing biological, legal, or adoptive relationships including aunt, uncle,  brother, sister, father, mother, stepmother, stepfather, adoptive mother, adoptive father, grandmother,  and grandfather. 

In the reports, case outcome (e.g., whether a case was substantiated and/or founded) was included  as an outcome variable and of interest to the authors due to the need to further examine the  substantiation process in Kentucky (Cole & Sprang, 2020). Ninety-five cases involving a family member as the perpetrator/trafficker resulted in being substantiated, 141 cases involving a non 

family member as the perpetrator/trafficker resulted in being founded; and 26 cases involving both  a family member and non-family member as perpetrators/traffickers resulted in being both substan tiated and founded. To account for the overlapping cases, specifically the 26 cases involving victims  trafficked by both a family member and non-family member, the authors subtracted 26 from the total  sample (n = 236), resulting in 210 cases. Thus, the authors created one variable that accounted for all  cases (n = 210) confirmed either by law enforcement investigation (founded) and/or by a DCBS  investigation (substantiated). 

Community type was classified as metropolitan or rural (non-metropolitan) based on United  Nations News Story, 2007) data. Included in the reports was a variable accounting for the child  victim’s county of residence. The authors differentiated metropolitan from rural/non-metropolitan by  separating the three highest-populated counties in Kentucky from the rest of the state: Jefferson  County (pop. 741,096), Fayette County (pop. 295,803), and Kenton County (pop. 159,720). 

Data Analysis Approach 

To not violate the assumption of independence in the statistical tests used in the bivariate and  multivariate analysis, the unit of analysis was at the case-level and not the victim-level. We randomly  selected one of the victims in cases involving multiple victims to include in the bivariate and multi variate statistical tests. Two variables had more than 5% of cases with missing values: drug involvement of victim (n = 79, 13.9%) and charges related to human trafficking (n = 50, 8.8%).  A third variable, Referral source, had two categories that could not be assigned to the dummy variable,  referral by the justice system (Yes/No), that was used in the logistic regression: anonymous (n = 93,  16.4%) and unknown (n = 9, 1.6%), thus, the dummy variable had 101 cases missing values. To reduce  bias, missing values analysis was conducted. Multiple imputation was conducted using all the variables  in the dataset to maximize information to impute values (Donders et al., 2006; Van der Heijden et al.,  2006). The missing patterns showed monotonicity. Missing values were assumed to be missing at  random and were imputed with the use of multivariate imputation by chained equations for variables  in SPSS 27.0. Five imputed datasets were generated and used for bivariate and multiple analyses involving the variables with the higher frequencies of missing values. In these cases, the results were  combined to estimate pooled regression parameters. For the other analyses involving variables with  lower frequencies of missing values, bivariate and multivariate analyses were conducted on the original  dataset. 

Bivariate associations of family-controlled trafficking with victim characteristics, case factors,  system responses, and case outcomes were assessed with chi-square tests of independence for  categorical variables and student’s t test for continuous variables. To examine the research  questions, two logistic regression models were conducted to investigate the association separately  of multiple (1) case factors (including victim characteristics), and system responses, and (2) case  outcomes with the dichotomous variable, family-controlled trafficking (vs. non-relative trafficking). With the exception of two variables (victim’s nationality and cases involving sex trafficking),  all the victim characteristic, case factors, and system factors examined in the bivariate tests were  included as predictor variables in the binary logistic regression model with the outcome variable,  family member perpetrator. The reason these two variables were not included in the logistic  regression is they had small variance; almost all victims had a U.S. nationality and almost all cases  involved allegations of sex trafficking. For all logistic regression models, the Nagelkerke R2 was  used to assess the variability accounted for on the dependent variable by the predictor variables.  The overall model significance for the logistic regression models was examined by the collective  effect of the independent variable, presented with a β coefficient. Individual predictors were  assessed by the Wald coefficient. Predicted probabilities of an event were determined by the odds ratio. 

Results 

Frequencies of Variables by the Unit of Analysis of Victims 

A total of 567 cases involving 698 victims were reported as possible human trafficking to the child  agency in the report years 2013–2017. Among the 73 cases involving multiple victims, there were 204  alleged victims, with an average of 2.8 victims per case and a median of 2.0 victims. Among cases  involving multiple victims (n = 73), the majority (63.0%) involved 2 victims with an additional 21.9%  involving 3 victims, and the remaining 15.1% involving 4 − 10 alleged victims. 

Bivariate Associations with Family-Controlled Trafficking 

Two variables examined in the bivariate analyses had more than 5% of cases with missing values: drug involvement of victim (n = 79, 13.9%), and charges related to human trafficking (n = 50, 8.8%). The  chi-square tests with these two variables were conducted on the multiply imputed dataset. Table 1  presents the results of bivariate associations of victim characteristics and case factors with family  member perpetrator vs. non-relative perpetrator. The mean age of victims was significantly lower in  cases involving a family member perpetrator. Cases involving family member perpetrators had  a higher average number of perpetrators compared to cases with non-relative perpetrators.  A significantly higher percentage of cases with family member perpetrators were in rural (nonmetropolitan) communities than cases with non-relative perpetrators. A smaller percentage of cases  with family member perpetrators had notes in their file that indicated the victim was using, given, or  sold for drugs when compared to cases with non-relative perpetrators. Gender, victim’s original  nationality, prior involvement with child welfare, and allegations of sex trafficking (i.e., commercial  sex) did not differ significantly by type of perpetrator. 

Table 2 presents the results of bivariate associations of system responses and case outcomes with  type of perpetrator (i.e., family member perpetrator vs. non-relative perpetrator). First, referral source  was significantly associated with the type of perpetrator. Nearly half of cases with non-relative  perpetrators were referred by a professional (other than school, mental health, or criminal justice 

Note: The following variables had the following number of cases with missing values: age of alleged victim (n = 3), gender of alleged  victim (n = 2), number of perpetrators (n = 5), victim was using drugs, given drugs, or sold for drugs (n = 79). Because 13.9% of  cases had missing values for the variable, drug-involvement of victim, this chi square test was conducted on the multiply imputed  dataset. **p < .01, ***p < .001. 

professional) compared to only 24.1% of cases with family member perpetrators. Nearly one-fourth of  cases with family member perpetrators were reported to the child welfare agency by an anonymous  person compared to only 6.0% of cases with non-relative perpetrators. Compared to cases with family  member perpetrators, significantly more cases with non-relative perpetrators were reported to the  child welfare agency by law enforcement and the juvenile justice system or court system. Compared to  cases with non-relative perpetrators, significantly more cases with family member perpetrators were  reported to the child welfare agency by a non-relative community member and a relative. The  remaining referral categories did not differ by perpetrator type. Significantly more cases with non relative perpetrators had notes in their records that criminal charges related to human trafficking were  filed compared to cases with relative perpetrators. In significantly more cases with family member  perpetrators, children were removed from the home because of the reported incident when compared  to non-relative perpetrator cases. 

Type of perpetrator was significantly associated with both outcome variables (charges of human  trafficking were filed and a finding of substantiation or founding). Significantly more cases with non relative perpetrators had notes in their records that criminal charges related to human trafficking were  filed compared to cases with relative perpetrators. Significantly more cases with non-relative perpe trators had a case outcome of substantiation or founding when compared to cases with family member  perpetrators. Law enforcement involvement and whether an interview was conducted at a child  advocacy center were not associated with type of perpetrator.

Multivariate Analysis 

A binary logistic regression was performed to ascertain the association of the having a family member  as an alleged perpetrator of human trafficking and the following victim characteristics, case factors,  and system response factors as predictor variables: time (defined as report year), victims’ age, gender,  type of community in which the victim resided (urban vs. rural), prior involvement with the child  welfare agency, drug involvement, number of perpetrators, referral by the justice system, involvement  of law enforcement in the case, interview was conducted at a Child Advocacy Center, and the child was  removed as a result of the incident (see, Table 3). Because two of the included predictor variables had  a high percent of missingness (e.g., Referral by the justice system and drug involvement), this logistic  regression was conducted on the multiply imputed dataset. The β coefficients were pooled. Naïve  pooling was used for the Hosmer-Lemeshow statistic. 

The logistic regression model was statistically significant, Χ2 (11) = 185.329, p < .001. The model  explained 37.5% (Nagelkerke R2 = .375) of the variance in family-controlled trafficking among the  cases reported to the state child welfare agency and correctly classified 76.5% of cases. Five of the 11  predictor variables were significantly associated with an alleged perpetrator being a family member,  while controlling for the other variables. Specifically, with each year’s report, the odds of an alleged  perpetrator being a family member decreased. Reported cases involving younger victims had greater  odds of having an alleged perpetrator being a family member. Alleged victims living in rural counties  (OR = 2.988) had greater odds of having a family member perpetrator. The number of alleged  perpetrators was significantly, positively associated with having a family member perpetrator.  Among the victim characteristics and case factors, gender of the alleged victim and having prior  involvement with the child welfare agency were not significantly associated with family-controlled trafficking.

Associations of system responses to reports of human trafficking of children with family controlled trafficking were examined with a logistic regression model (see, Table 4). One of the  categories included in the referral source variable (i.e., anonymous) could not be recoded into the  dichotomous variable, referral by law enforcement, the court, or the juvenile justice system. Thus,  for the dichotomous variable 101 (17.5%) cases had a missing value. This logistic regression was  conducted on the multiply imputed dataset. The β coefficients were pooled. Naïve pooling was used  for the Hosmer-Lemeshow statistic. The logistic regression model was statistically significant, Χ2  (4) = 13.893, p < .01. The model explained a small amount of the variance, 3.3% (Nagelkerke  R2 = .033), in family-controlled trafficking among the cases reported to the state child welfare agency  and correctly classified 58.6% of cases. Two of the four predictor variables were significantly  associated with an alleged perpetrator being a family member. Specifically, cases referred by law  enforcement, the court, or the juvenile justice system had lower odds of an alleged perpetrator being  a family member. Second, the alleged victim being removed from the household because of the  report/investigation was greater for cases with family member perpetrators. There was no associa tion of law enforcement involvement and having an interview conducted in the child advocacy  center and having a family member perpetrator. 

A logistic regression model examined multivariate associations of family-controlled trafficking  cases, community type, and time (i.e., report year) as predictor variables with the case outcome of  substantiation or a finding as the dependent variable (see, Table 5). The logistic regression model was  statistically significant, Χ2(3) = 27.723, p < .001. The model explained 6.1% (Nagelkerke R2 = .061) of  the variance in family-controlled trafficking among the cases reported to the state child welfare agency  and correctly classified 71.3% of cases. One of the three predictor variables was significantly associated  with an outcome of substantiation or finding. Specifically, cases involving family member perpetrators  

Discussion 

Emerging research demonstrates that individuals are more likely to be trafficked within their own  communities and sex trafficking networks in particular, are often family based (Denton, 2016;  Mancuso, 2014; Sabon et al., 2021). The key findings of this study expound upon the existing literature  and serve to increase awareness of the issue of family-controlled child trafficking and inform future  directions regarding research, practice, and policy. In regard to the researchers’ first question, “What  victim characteristics are associated with family-controlled trafficking cases,” the results indicate that  victims of family-controlled trafficking were more likely to have a higher number of perpetrators, live  in rural communities, and be younger. The association of family-controlled trafficking with higher  numbers of perpetrators is a novel finding not previously explored in the literature, and the role of  rurality is still not fully understood as it has only been explored and addressed in one other study  (Sprang & Cole, 2018). The finding regarding age as a significant factor associated with family controlled trafficking runs parallel to the existing literature on human trafficking in general  (Clawson et al., 2009; Hardy et al., 2013. However, this finding is noteworthy in that it suggests that  family members as traffickers may have access to younger children as compared to third-party  traffickers. Investigation of research question number two, pertaining to case factors associated with  family-controlled trafficking cases, revealed that family-controlled trafficking cases were less likely to  involve drugs (e.g., victim was using, given, or sold for drugs) when compared to cases with non relative perpetrators. While this is also a novel finding and has not been found to be the case in previous literature regarding family-controlled trafficking (e.g., Sprang & Cole, 2018, found the  opposite to be true), it may point to other risk factors such as economic vulnerability or material  need, which have been found to be associated with child sex trafficking in general (Cole & Sprang,  2015). In regard to the third research question regarding system responses associated with family-controlled  trafficking cases, results indicate that issues of family-controlled trafficking were found to be more likely  reported by anonymous, non-relative community members, and relative reporting parties compared to  reporting parties of professionals, law enforcement, courts, and juvenile justice, as reflected in previous  literature. More specifically, this finding may reinforce the notion proposed by Twis (2020) that the  presence or absence of systems in children’s lives can predict who might exploit them. In addition,  results indicate that cases involving family members as perpetrators were less likely to have human  trafficking related criminal charges filed and less likely to involve the removal of the child or children.  This finding, while concerning from a practice and policy standpoint, is also congruent with the existing  child trafficking literature. For example, a recent study found that approximately two-thirds of the  family-controlled traffickers were criminally charged, but only approximately one-third of these were  charged with a crime associated with human trafficking (Sprang & Cole, 2018). This may indicate a lack  of understanding regarding the dynamics and implications of family-controlled trafficking by the  systems that respond to and investigate child trafficking (Cole & Sprang, 2015). 

Importantly, in regard to the fourth research question pertaining to case outcomes associated with  family-controlled trafficking cases, findings revealed that having a family member involved as the  perpetrator of trafficking predicted that the case would not be substantiated and/or founded, com pared to cases not involving a family member. While this finding follows the adjacent trend regarding  criminal charges mentioned above, it is novel in that no other studies to date have explored or  confirmed the predictive relationship between family-controlled trafficking and diminished substantiations and confirmed cases. 

Implications 

In light of the novel findings of this study, the researchers purport a number of implications for  research, practice, and policy in the following section. Before the implications are delineated, it is  important to note that some of the research implications presented regarding data will first require  administrative changes orchestrated by the government agencies (e.g., public child welfare systems). It  is important that government agencies work closely with researchers to align administrative data  collection processes with the current and emerging research in order to increase their capacity to  evaluate their efforts and to account for and better understand the complexities associated with family controlled trafficking. In addition, when considering the potential for significant policy changes, it is  noteworthy to acknowledge that states and governments are still exploring how to best address this  issue of child trafficking, never mind the specific issue of family-controlled trafficking nested within  the child trafficking field of study. However, in examining the broader issue of child trafficking from  a multilevel, multisystem, socio-ecological perspective (Bronfenbrenner, 1994; Ogbu, 1990), it seems  that macro-level interventions must consider addressing the large range of circumstances that make  minors vulnerable to abuse and neglect, such as poverty, structural violence, and inequality (Duger,  2015; Rafferty, 2016). By the same token, micro-level interventions should include policy changes to  better protect individual children via government agencies, including social services, law enforcement,  and child protection teams (Rafferty). 

Research Implications 

Given the rising awareness of issues of family-controlled trafficking, there is a significant gap in the  existing literature regarding the subject. To further understand this issue, future research should  include more details on the cases of child trafficking, such as safety and risk assessments, record of contact (ROC) notes, and Child and Adolescent Needs and Strengths (CANS) data from child welfare  systems. This supplemental data can help to give context in order to better understand the complex ities surrounding family members as perpetrators of child trafficking. 

The findings from this study revealed that cases with a family member as the perpetrator compared  to a non-relative perpetrator predicted lower odds of the case being confirmed by DCBS or law  enforcement. Future research on family-controlled trafficking must address this discrepancy. Possible  explanations for the differences in case outcomes based on family-controlled trafficking include the  potential for barriers to conducting assessments on families or a lack of expertise among child welfare  workers on the dynamics of this issue to effectively identify and intervene in family-controlled  trafficking. Other possible explanations exist in the investigation process, including the complexities  of receiving a child’s testimony. Instances of the family member perpetrator threatening the child with  the possibility of family disruption, being separated from siblings, or the child’s fear of the ramifications for the perpetrator would create murky waters for confirming an allegation of family-controlled  trafficking. 

The case determination process (e.g., substantiated/founded determination) is unclear and must be  examined to better understand, address, and ultimately reduce the problems of family-controlled  trafficking. Potential ways forward in researching this process are to randomly select cases that are  substantiated and/or founded and cases not substantiated nor founded and interview child welfare workers on the details of the process for confirming or not confirming the allegations. Another  potential research avenue includes partnering with law enforcement to review case studies of family controlled trafficking, child welfare workers, and prosecutors regarding the process of confirming  allegations. 

Practice Implications 

Family-controlled trafficking accounts for over 40% of five years of alleged child trafficking cases in  Kentucky. The one consistent protective factor against child trafficking and its severe consequences is  supportive interpersonal relationships (Landers et al., 2019; O’Brien, 2018). However, in cases of  family-controlled trafficking, a parent, relative, or primary caregiver is responsible for the abuse. Thus,  children who experience trafficking facilitated by family members are at greater risk for more  significant negative outcomes. Therefore, early identification is key. 

Tip sheets (see, Appendix A), screening tools and assessments used to identify victims of child  trafficking, including family-controlled trafficking, should be informed by current research. These  resources for professionals and community members screening for and identifying victims should  include the research on the known risk factors such as the four Adverse Childhood Experiences  (ACEs): sexual abuse, domestic violence, emotional abuse, and physical neglect (Middleton et al.,  2018). These resources should also include awareness of the cluster of factors associated with family 

controlled trafficking such as previous involvement with child welfare (Twis, 2020), children of  younger ages (Sprang & Cole, 2018), children in rural communities (Sprang & Cole, 2018), and  children with multiple perpetrators (Middleton & Edwards, 2020). This cluster of associated factors  should also be included in the design and implementation of prevention and early intervention  programs. 

There is a significant lack of training on the issue of child trafficking and even less training on how  to identify and effectively intervene in cases of child trafficking including family members as perpetrators. The findings of this study draw attention to the role that systems such as child welfare, law  enforcement, and juvenile justice need to play in the issue of family-controlled trafficking. Specifically,  this study as well as previous literature (Twis, 2020) revealed that there is a significantly smaller  proportion of professionals in these systems identifying victims of family-controlled trafficking  compared to child trafficking victims with a non-relative perpetrator. Thus, findings highlight the  importance for systems to receive thorough and regular training regarding the complex dynamics of  child trafficking. 

To maximize training efforts for identifying and responding to child trafficking among the systems  of child welfare, law enforcement, and juvenile justice, the authors recommend that each state  institutes a full-time human trafficking investigator position to be housed within the statewide child  welfare system (e.g., the Kentucky Department for Community Based Services). In the U.S., child  welfare systems are required to respond to cases of child trafficking and lead most of the child  trafficking investigations at this time. Thus, hiring a full-time human trafficking investigator in the  child welfare system creates the opportunity for a ripple effect on other systems (e.g., law enforcement,  juvenile justice). This ripple effect would help build capacity for co-training with other systems and  provide much-needed education for child welfare workers in other jurisdictions to better identify,  respond to and understand cases of child trafficking. More awareness of and multidisciplinary  approaches to child trafficking would create more options for case outcomes, services for victims,  and ultimately prevention efforts toward reducing instances of this heinous crime. 

Taking a multidisciplinary approach to ending family-controlled trafficking should also include  a more expansive range of professionals and community members in addition to the systems of child  welfare, law enforcement, and juvenile justice. Victims of family-controlled trafficking are more likely  to be younger than victims with a non-relative perpetrator. Professionals and community members  who work and interact with children, particularly young children, and their families must be trained  and provided with research-informed resources for identifying family-controlled trafficking. These  professionals and community members include but are not limited to pediatricians, daycare workers,  school personnel, and parent visitors in home visitation programs for any new or expectant parents  (e.g., the Kentucky Health Access Nurturing Development Services) are perhaps the most likely  community members to identify risk factors and indicators of family-controlled trafficking. 

Policy Implications 

Important to note in the findings of this study is the greater likelihood of a victim of family-controlled  trafficking residing in a rural community, compared to child trafficking victims with a non-relative  perpetrator. The lack of resources in rural communities is a potential risk factor or predictor of family controlled trafficking, making it imperative to build capacity in rural communities for specialized  training and coordinated investigations among multidisciplinary teams. The authors recommend  creating a systematic process for coordinating investigations of child trafficking in rural communities.  This process would be made possible by having a regional consultant specializing in child trafficking,  including family-controlled trafficking, to be a primary contact for identifying and providing services  for victims and potential victims at risk for child trafficking. 

Findings from an earlier study (Middleton & Edwards, 2020) showed increased likelihood of child  trafficking cases being confirmed if a forensic interview was conducted at a child advocacy center.  Thus, the authors recommend the regional consultants be partnered and perhaps housed with regional  child advocacy centers. Having this type of team available to respond to child welfare workers in rural  communities and address issues of child trafficking and family-controlled trafficking would develop  expertise regarding this issue among these regions. 

Finally, the authors urge policymakers and lawmakers to hold family member perpetrators  accountable for family-controlled trafficking. This study revealed that significantly more cases with  non-relative perpetrators (39.6%) had a case outcome of substantiation or founding when compared to  cases with family member perpetrators (21.1%). Furthermore, focus group participants in an earlier  child trafficking study (Middleton & Edwards, 2020) reported concerns about family members as  traffickers being less likely to be charged, or receiving a reduced charge or finding. Labeling family controlled trafficking of minors as child sexual abuse without acknowledging the commercial element  may allow perpetrators to be charged with offenses that carry less severe penalties (Smith et al., 2009).  Moreover, identification of the commercial aspect of the sexual exploitation can allow law enforce ment to broaden the scope of the investigation to potentially include buyers of commercial sex. Until  more buyers of commercial sex are arrested and charged with criminal offenses, the demand forcommercial sex with children will continue unabated. In addition, appropriate charges can help to  strengthen crime victim services in general and law enforcement’s victim identification practices at all  levels, including state and local anti-trafficking task forces. 

Limitations 

The data analyzed in this study were collected over a five-year period and focused only on cases of  alleged child trafficking reported to the Kentucky Department of Community Based Services (DCBS)  through the child abuse hotline. Further details on the data obtained by DCBS and/or law enforce ment, including final case outcomes, were not included in the data provided to the authors. Additional  data from investigators’ notes, interviews, and observations could provide more context on the  processing of cases, such as the process for substantiating allegations of family-controlled trafficking. 

Conclusion 

When examining family-controlled trafficking in the literature, the authors discovered a cluster of  associated factors including having a higher number of perpetrators, living in rural communities, and  being younger. Reporting parties of family-controlled trafficking were more likely to be anonymous,  non-relative community members, and relatives compared to reporting parties of child trafficking by  a non-relative which were more likely to be professionals, law enforcement personnel, court officials,  and juvenile justice professionals. This finding reinforces the notion proposed by Twis (2020) that the  presence or absence of systems in children’s lives can predict who might exploit them. Further,  important findings in this study draw attention to the likelihood that family-controlled trafficking  cases, when compared to cases with non-relative traffickers, would not be substantiated and/or  founded. 

These findings first highlight the need for more research regarding the dynamics of family controlled trafficking. More specifically, the authors call for future research to hone in on the case  outcomes of family-controlled trafficking such as the dynamics that predict family-controlled trafficking cases to be unsubstantiated and unfounded. To build capacity among systems and specifically in  rural communities, there is a need for research-informed tip sheets and screening tools for child  welfare workers, as well as enhanced training across disciplines for a multidisciplinary approach to  ending family-controlled trafficking. 

To enhance resources in rural communities, the research highlights the need for partnerships  between child advocacy centers and consultants specializing in family-controlled trafficking to be  stationed in each region. With the reallocation of funding and restructuring of systems such as child  welfare, law enforcement, and juvenile justice, creating multidisciplinary teams with specializations in  family-controlled trafficking is a feasible step toward building capacity and much-needed resources in  rural communities. Finally, to significantly impact the issue of family-controlled trafficking, anti 

trafficking proponents emphasize the need to enforce the penalties for family members as traffickers of  children. The accurate labeling of this offense could potentially enhance services for child victims of  family-controlled trafficking, identification processes for systems addressing this issue, and ultimately  move in the direction of reducing the instance of family-controlled trafficking. 

Notes on contributor 

Emily E. Edwards, M.Ed., Research Associate, School of Public Health and Information Sciences, University of  Louisville; Jennifer Middleton, Ph.D., M.S.W., Associate Professor, Kent School of Social Work, University of  Louisville; Jennifer Cole, Ph.D., Associate Professor, Center on Drug & Alcohol Research, University of Kentucky. 

Data for this study was collected with funding from a two-year grant from the Kentucky Children’s Justice Act Task  Force, in partnership with the Kentucky Department of Community Based Services and the Kentucky Office of the  Attorney General. 

ORCID 

Emily E. Edwards http://orcid.org/0000-0001-8985-2418 

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Appendix A. Tip Sheet for Child Welfare Workers 

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Familial Sex Trafficking of Minors: Trafficking Conditions, Clinical  Presentation, and System Involvement