A brief screener to identify youth at risk for commercial sexual exploitation: Development and validation among sexual and gender minority youth

Background Self-report tools to identify adolescents exposed to commercial sexual exploitation are scarce, particularly for sexual and gender minority youth at elevated risk. Many existing screeners hinge on a single direct item and focus on behavior over coercion, which can inadvertently imply victim responsibility. Objective To develop and validate the Adolescent and Young Adult Commercial Sexual Exploitation screener and evaluate scoring rules for identifying youth at risk for commercial sexual exploitation. Participants and Setting The sample consist of 612 sexual and gender minority adolescents and young adults (ages 13–22) recruited through social media in the United States. Methods Seven trauma-informed, behaviorally anchored items were evaluated using Exploratory Graph Analysis, Item Response Theory, and Classical Test Theory. Convergent (risk behaviors) and discriminant (social connectedness) validity were examined. Cutoffs were optimized across simple-sum, network-weighted, and Item Response Theory-weighted scores against a criterion of 51 youths endorsing direct commercial sexual exploitation items (8.3%). Findings Analyses supported a unidimensional, nonredundant scale. Sexual assault and being offered something for sex were most central. The screener showed acceptable internal consistency (α = .74), precise measurement at moderate–high risk, moderate correlations with risk behaviors, and near-zero associations with social connectedness. A network-weighted score (0–13) with a ≥5.5 cutoff balanced sensitivity (76.5%) and specificity (83.1%) and reduced false positives compared with simple-sum scoring. Conclusion The Adolescent and Young Adult Commercial Sexual Exploitation screener is a brief, trauma-informed screener that can support early identification of youth at risk for commercial sexual exploitation by focusing on experiences of coercion and vulnerability rather than self-identified “trading sex.” It offers a practice tool for use in youth-serving settings, with particular relevance for sexual and gender minority youth.