1. Which comes first: Sexual exploitation or other risk exposures among street-involved youth? Dr. Elizabeth Saewyc UBC School of Nursing Vancouver Dr. Elizabeth Saewyc UBC School of Nursing Vancouver

2. Co-authors and Funding Acknowledgments  Dr. Laura MacKay  Dr. Angela Henderson  Dr. Maya Peled  Melissa Northcott  Funded by CIHR’s  Institute for Population & Public Health  Institute of Gender & Health  Office of Ethics

3. Street-involvement  Creates health challenges for youth  Risk-laden environments  Unstable housing  Alcohol and drugs  Violence  Infectious disease  Erratic access to basic necessities  Sexual exploitation / survival sex

4. What is sexual exploitation?  In BC, occurs when youth under age 19 trade sexual activities with adults in exchange for resources such as money, drugs, food, shelter, gifts, transportation or other material considerations  Illegal to exploit, regardless of presumed or explicit consent

5. But what comes first?  Sexual exploitation due to risk exposures once on the street? or  Sexual exploitation leads to other risks afterwards?

6. Purpose  Timing of patterns of risk behaviours among sexually exploited youth in British Columbia  Suggestions for points of intervention to prevent exploitation

7. Methods  3 surveys of street-involved youth in cities across BC (all regions)  SY 2000: 12-19 y.o., n=523  SY 2001: 18-25 y.o. Vancouver only, n=180  SY 2006: 12-18 y.o., n=762  Participatory epidemiology approach

8. Methods  Pencil and paper surveys, read aloud  Questions assessed various life experiences, risk behaviours  Included age of first experience, i.e., age first tried marijuana

9. Analyses  Timing of exploitation calculated as:  Prior to other risk behaviour  Same year as other risk  After other risk  Analyses separately by gender with cross-tabulations with  2 to test gender differences

10. Results

11.  In all surveys, both risk exposures and sexual exploitation occur at young ages:  Exploitation, 14 to 15 years on average  Alcohol & marijuana use, 12 to 13 years  Running away and being kicked out, 13 years  Majority experienced other risks first  10-30% other risks, exploited same year  Few gender differences

12. Leaving home: Kicked out (SY 2006 data Only)

13. Leaving home: Running away

14. Street involvement SY 2001SY 2006 malesfemalesmalesfemales Street involved first 41%52%71%62% Both same year 22% 28% Exploited first 37%26%7%10%

15. Alcohol use

16. Marijuana use

17. What does this tell us?  For most youth, sexual exploitation occurs  once street-involved  after leaving home, and  after exposure to alcohol and drugs  All of these exposures happened very early for most youth

18. What can we do?  Intervening early in the cycle of leaving home, working with families  Services for younger teens with patterns of running away, those newly on the street

19. Thank you! For pdf copy of report: saewyc@interchange.ubc.ca