Study Objective To describe the clinical characteristics of patients referred for domestic minor sex trafficking (DMST) to improve identification and intervention. Design Retrospective cohort study. Setting The Lawrence A. Aubin, Sr Child Protection Center at Hasbro Children's Hospital where patients are evaluated by child abuse pediatricians in outpatient, emergency department, and inpatient settings. Participants A total of 41 patients younger than the age of 18 years referred for the evaluation of DMST involvement between August 1, 2013 and March 30, 2015. Interventions and Main Outcome Measures We collected demographic, social-environmental, medical, and psychiatric variables from the medical records of patients referred for evaluation who have self-disclosed, been reported with evidence, and/or have histories that place them at high risk for DMST involvement. Results Children had frequent contact with medical providers, with 81% seen in the year before referral for DMST. Childhood maltreatment and family dysfunction were identified (sexual abuse, 21/37 or 57%; parental substance abuse, 22/37 or 60%) in the 41 patients. Children had medical problems (eg, sexually transmitted infection, 13/41 or 32%), psychiatric needs (eg, acute suicidality, 8/41 or 20%; at least 1 previous psychiatric admission, 19/41 or 46%), and substance use (36/41 or 88%). Although 26/41 (63%) had runaway and 17/41 (42%) lived in a group home placement, 28/41 (68%) currently lived at home and 29/41 (71%) presented with a parent/guardian or relative. Conclusion Children referred for DMST present frequently to physicians and have complex medical and psychiatric needs. Medical providers’ increased awareness of this health issue would inform victim identification and intervention. © 2016 North American Society for Pediatric and Adolescent Gynecology

Domestic minor sex trafficking Victim Commercial sexual exploitation of children Patient Sexual abuse

medical record review Parents hospital admission Child Abuse, Sexual residential home clinical feature Hospitals, Pediatric human Rhode Island statistics and numerical data priority journal Substance-Related Disorders substance abuse pediatrics sexually transmitted disease sex trafficking family conflict health personnel attitude Attitude of Health Personnel school child Humans psychology Adolescent parent male female patient referral substance use Referral and Consultation clinical article automutilation child sexual abuse Health Knowledge, Attitudes, Practice human trafficking Article Retrospective Studies runaway behavior minor (person) domestic minor sex trafficking awareness hospital emergency service cohort analysis Emergency Service, Hospital hospital retrospective study homeless youth attitude to health health care need suicidal ideation Child