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Majority of Medicaid Managed Care Plans Cover Opioid Overdose Reversal Drug Naloxone

Attendees of SPH and MAPC's heat health symposium view a poster on identifying and engaging heat-vulnerable communities.
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Examining Mixed-Gender Shelter for Child Survivors of Sex Exploitation in Italy.

April 19, 2017
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Rome-aerial-Italy-mixgender-sheltersLike other child survivors of sexual exploitation, the 17-year-old girl from Romania suffered from PTSD, panic attacks, and anxiety when she landed in a mixed-gender shelter for exploited children in the Veneto region of Italy.

After interventions by the program staff, the girl learned to form non-sexual, respectful relationships with peers in the facility, went back to school, overcame her panic attacks, and now leads a productive life.

This is one “striking example” of the success of a unique mixed-gender shelter program for commercially sexually exploited children (CSEC) that researchers from the School of Public Health and Associazione Mimosa in Italy say warrants further exploration.

In a recent paper in the Journal of Social Service Research, the research group, which includes Emily Rothman, associate professor of community health sciences, cited the shelter as an innovative model of services for CSEC victims that relies on “a flexible, loose approach to regulating youth,” and found that the majority of youths “respond well to that type of flexibility.”

“Youth are not heavily monitored by program staff, and friendly, mutually respectful relationships between program volunteers, staff, and youth clients are established,” the review says. “There have been several youths who have graduated from this organization and moved on to become employed, married with stability, and self-reliant. There have been other youth who were unable to be ‘rescued’ by this program.

Associazione-Mimosa-mixed-gender-shelter
Photo courtesy of Associazione Mimosa

“Identifying and providing ideal aftercare services to CSEC survivors remains a work in progress, and program evaluation is urgently needed,” the review urges.

The study focused on a mixed-caseload shelter that houses CSEC victims, along with foreign unaccompanied minors and Italian and foreign-born juveniles convicted of petty crimes, such as pickpocketing. Shelter residents typically go to school and attend the shelter-based program, which consists of twice-weekly group meetings, activities and lessons on topics including health, finding employment, making friends, and being in healthy relationships. All programming is coeducational, so that participants are forced to “confront their biases and consider others’ point of view, which the staff believes enhances interpersonal skills and fosters open-mindedness.”

The shelter has housed youths as young as 11 years old and up to 17 years old. When youths turn 18, they can no longer remain in the shelter and are expected to find jobs and live independently.

Associazione-Mimosa-mixed-gender-shelter-kitchen
Photo courtesy of Associazione Mimosa

Prior studies have found that the consequences of being trafficked for sex are severe and often long-lasting. They include an increased risk for physical injury, sexual violence, mental health consequences, HIV exposure, other STI infections, and substance use disorders.

The authors said the idea of putting male juvenile delinquents in the same house as female sex trafficking victims drew some criticism from other human services professionals at first. But while a segregated, single-sex system allowed for CSEC victims to “decompress and recover in safety inside the shelter,” it also deprived victims of the opportunity to learn how to interact in a healthy way with opposite-gender peers. When the facility began bringing males and females together in 2013, many of the youths appeared to benefit from the mixed-gender living environment, the authors said.

Rothman and colleagues recommend “rigorous process and outcome evaluation . . .  to understand whether the mixed-gender, mixed-service population model is having an impact on CSEC victims in particular, and whether it is having any more or less impact than single-sex or single-population CSEC service models.” They caution against making the assumption that the model would work in all settings, but add that “the flexibility and unregimented style of the shelter may be an element of its apparent success.”

CSEC, they said, is an urgent public health problem, and practitioners have little guidance on best practices.

“Human trafficking remains a persistent threat to public health and safety, and effective models of prevention (including tertiary prevention, or aftercare for victims) are critically important,” they conclude. “Evaluation research of CSEC and other trafficking survivor programs should be prioritized in Europe and elsewhere.”

Co-authors on the study, from Associazione Mimosa, were Barbara Maculan and Eleonara Lozzi.

—Lisa Chedekel

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  • exploited children
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  • sexual exploitation
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