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Interviewing children who may have been sexually abused is a daunting task fraught with far-reaching consequences for the children, families, institutions, and professionals involved. With no room for error, forensic and clinical interviewers must navigate the complex and often contradictory evidence that informs their decision making. This book critically analyzes the research on assessing child sexual abuse. Noting that issues such as memory and suggestibility, questioning techniques, the use of media, and false allegations remain hotly contested, the chapters advise on applying available research to professional judgment while drawing also on best practice guidelines and conceptual, clinical, and consensus-based writings. The book covers the entire interview process, showing professionals how to structure, document, and follow up on children’s responses in interviews; work with children who are very young, have special needs, or come from diverse backgrounds; use standardized tests and measures; formulate conclusions about sexual abuse; and defend those decisions in a courtroom or clinical setting.

Objectives. To estimate the lifetime prevalence of official investigations for child maltreatment among children in the United States. Methods. We used the National Child Abuse and Neglect Data System Child Files (2003–2014) and Census data to develop synthetic cohort life tables to estimate the cumulative prevalence of reported childhood maltreatment. We extend previous work, which explored only confirmed rates of maltreatment, and we add new estimations of maltreatment by subtype, age, and ethnicity. Results. We estimate that 37.4% of all children experience a child protective services investigation by age 18 years. Consistent with previous literature, we found a higher rate for African American children (53.0%) and the lowest rate for Asians/Pacific Islanders (10.2%). Conclusions. Child maltreatment investigations are more common than is generally recognized when viewed across the lifespan. Building on other recent work, our data suggest a critical need for increased preventative and treatment resources in the area of child maltreatment.

PEPFAR (President's Emergency Plan for AIDS Relief), a landmark US foreign health policy, is recognised for saving 26 million lives from HIV. PEPFAR investments have also had life-saving impacts for children across sub-Saharan Africa through childhood HIV prevention, care, and treatment, ensuring 7·8 million babies were born HIV-free, supporting 13 million orphaned and vulnerable children, and protecting 10·3 million girls from sexual abuse. In this Health Policy, we review data from UNAIDS, UNICEF, World Bank, Violence Against Children Surveys, SPECTRUM model data, and Population-based HIV Impact Assessments; synthesise PEPFAR reports; conduct in-depth interviews; search PubMed for programme effectiveness evidence; and review economic reports. PEPFAR support is associated with substantial collateral benefits for the USA and Africa, including a four-fold increase in export of US goods to Africa, and US$71·6 billion in total goods trade between the USA and Africa in 2024. PEPFAR-supported countries in Africa are committed to ownership of HIV responses by 2030—overall, PEPFAR-supported countries in sub-Saharan Africa have progressively increased their co-financing of their health systems through domestic government and private expenditure from $13·7 billion per year in 2004 to $42·6 billion per year in 2021. The feasibility of a 5-year transition to country-led sustainability is supported by evidence of innovative cost-saving models of delivery, including through faith-based and community-based organisations, and high return-on-investment for PEPFAR programmes. There are also collateral benefits of PEPFAR for US and Africa national security and health security, for example, reducing forced migration and increasing capacity to control emerging transborder infectious disease threats. Risks in sub-Saharan Africa remain acute: one in five girls (younger than 18 years) experience rape or sexual assault; one in ten children (younger than 18 years) are orphaned; and a child (younger than 15 years) is estimated to die from AIDS every 7 min. Without continued PEPFAR programmes, models predict that by 2030, an additional 1 million children will become infected with HIV, 0·5 million additional children will die of AIDS, and 2·8 million children will additionally become orphaned by AIDS. There is now an opportunity for a transformational partnership between the USA and Africa, to accelerate domestic government co-financing, private-sector investments, and charitable foundations. A 5-year progressive runway of transition can occur through continued authorisation of PEPFAR programmes, which can lead to the end of AIDS for children and families, an historic achievement.

Objectives. We examined the relation between childhood sexual abuse and injection drug use initiation among young adult injection drug users. Methods. We used mixed effect linear models to compare age at first injection among 2143 young injection drug users by first sexual abuse age categories. Results. The participants were predominantly male (63.3%) and White (52.8%). Mean age and age at first injection were 23.7 and 19.6 years, respectively; 307 participants (14.3%) reported childhood sexual abuse. After adjustment for gender, race/ethnicity, noninjection drug use before first injection drug use, and recruitment site, childhood sexual abuse was independently associated with younger age at first injection. Conclusions. Childhood sexual abuse was associated with earlier initiation of injection drug use. These data emphasize the need to integrate substance abuse prevention with postvictimization services for children and adolescents.

Background Sexual and gender minority (SGM) persons experience substantial mental health disparities throughout the life course, including increased vulnerability to depression and suicide. Few existing studies, however, have explored how pervasive experiences of SGM-related stigma, discrimination, and trauma (i.e., minority stress) contribute to adverse mental health outcomes among diverse sub-populations of SGM adults living in rural areas of the United States. This paper describes the protocol for a prospective cohort study, “Rural Exploration and Approaches for LGBTQ + Mental Health (REALM),” that will explore minority stress in relation to mental health conditions and suicidal behaviors among rural SGM adults. Methods Online processes will be used to recruit and enroll a diverse sample of up to 2,500 SGM adults aged 18 + living in rural counties and small metropolitan areas in the United States to complete an online baseline survey. This will include: up to 1,000 cisgender sexual minority persons (up to n  = 500 each cisgender women and cisgender men); and up to 1,500 gender minority persons (up to n  = 500 persons who were assigned male at birth and identify as a woman, female, and/or transfeminine; up to n  = 500 persons who were assigned female at birth and identify as a man, male, and/or transmasculine; and up to n  = 500 persons who identify as some other gender, including non-binary, gender non-conforming, and/or agender regardless of sex assigned at birth). All enrolled participants will subsequently be followed over a 12-month period, with repeated surveys at three-month intervals. Included survey measures will focus on sociodemographic information, mental health, substance use, suicidal behaviors, minority stressors, psychological processes, and other related risk and protective factors. Discussion This study presents a critical opportunity to better understand how minority stress contributes to adverse mental health outcomes among populations that remain underrepresented in research and programs in 2024. Results will be used to create more targeted, acceptable, and impactful intervention content and strategies that mitigate stigma, promote mental health, and prevent suicidal behaviors among rural SGM adults.

Specifically created to complement the Third Edition of the APSAC Handbook on Child Maltreatment, this collection of 23 carefully selected articles on child abuse and neglect parallels the structure of the Handbook. It is also a great companion to other Sage books, such as Barnett’s Family Violence Across the Lifespan and Miller and Perrin’s Child Maltreatment.

Youths with a minority sexual orientation (i.e., gay, lesbian, bisexual, and mostly heterosexual) are at high risk for cigarette smoking. We examined sexual-orientation disparities in smoking during adolescence and emerging adulthood and investigated the role of age at first smoking in contributing to smoking disparities. We used data from the Growing Up Today Study, a large longitudinal cohort of adolescents followed from ages 12 to 24 years (N = 13,913). Self-administered questionnaires filled out annually or biennially assessed age at first smoking, current smoking, frequency of smoking, number of cigarettes smoked daily, and nicotine dependence. Proportional hazards survival analysis and repeated measures regression estimated sexual-orientation differences in smoking. Compared with completely heterosexuals, lesbian/gay, bisexual, and mostly heterosexual youths smoked their first cigarette at younger ages, were more likely to be current smokers, and had higher frequency of smoking. Among past-year smokers, sexual-minority females smoked more cigarettes daily and scored higher on nicotine dependence than completely heterosexual females. In some instances, gender and age modified relationships between sexual orientation and smoking, with relative risk accentuated in female sexual minorities and in sexual minorities during younger ages. Younger age of smoking onset contributed to elevated smoking in mostly heterosexuals and bisexuals, and to a lesser extent in lesbians, but not in gay males. Sexual-orientation minorities are at greater risk for smoking during adolescence and emerging adulthood than heterosexuals. Disparities are larger in females and evident in early adolescence. Prevention and cessation efforts should target this population, preferably beginning in early adolescence.

Objectives. This 11-city study sought to identify risk factors for femicide in abusive relationships. Methods. Proxies of 220 intimate partner femicide victims identified from police or medical examiner records were interviewed, along with 343 abused control women. Results. Preincident risk factors associated in multivariate analyses with increased risk of intimate partner femicide included perpetrator’s access to a gun and previous threat with a weapon, perpetrator’s stepchild in the home, and estrangement, especially from a controlling partner. Never living together and prior domestic violence arrest were associated with lowered risks. Significant incident factors included the victim having left for another partner and the perpetrator’s use of a gun. Other significant bivariate-level risks included stalking, forced sex, and abuse during pregnancy. Conclusions. There are identifiable risk factors for intimate partner femicides.

Each year, more than two million children around the world fall victim to commercial sexual and labor exploitation. Put simply, the growing epidemic of child exploitation demands a coordinated response. In addition to compliance concerns raised by the Foreign Corrupt Practices Act (FCPA), UK Bribery Act, and other more familiar transnational anti-corruption laws, today's companies must also respond to more novel legal requirements, such as those contained in the California Transparency in Supply Chains Act, Federal Acquisition Regulations on Trafficking in Persons in Federal Contracts, U.K. Modern Slavery Act of 2015, European Union's Directive on Transparency and its amendments, and the proposed federal Business Transparency in Trafficking and Slavery Act and other laws. This Second Edition of Child Exploitation and Trafficking: Examining Global Enforcement and Supply Chain Challenges and U.S. Responses brings fresh, practical thinking to this oft-misunderstood area of the law, helping erase some of its counterproductive mythology. The book not only provides the first comprehensive, practical introduction to the history and present-day reality of child exploitation and supply chain issues, but it also traces the interconnected web of domestic and transnational federal laws and law enforcement efforts launched in response thereto. The Second Edition not only is updated to reflect the latest trends and other development presented by two of the premier experts concerning this constantly-evolving field, but it also contains new chapters examining areas such as special issues in the fight against human trafficking and the raft of landmark anti-trafficking laws that herald a new compliance reality for the globe's business community. Written from the distinctive perspective of those who have spent their careers in the trenches investigating, prosecuting, and adjudicating these intricate, emotional cases, as well as those who are tasked with ensuring that products are free from the taint of child exploitation and force labor, the book is uniquely proscriptive, as well as descriptive, in the sense that it relies on real-world examples to serve up practical advice and reform proposals for those involved at all levels of this challenging area.

Does expert testimony on forensic interviews with children help adults distinguish between poorly conducted and well-conducted interviews? This study evaluates the effects of social framework expert testimony regarding child witnesses in a case involving allegations of child sexual abuse. A 2 (Expert Testimony: present or absent) × 3 (Child Forensic Interview Quality: poor, typical, or good) × 2 (Child's Age: 4- or 10-year-old) factorial design was used to examine whether expert testimony is prejudicial or beneficial to jurors (N = 463). The results revealed that, without expert testimony, mock jurors did not consider the forensic interview quality when reaching a verdict. However, with expert testimony, mock jurors were more likely to render guilty verdicts if the interview quality was good versus poor. Further expert testimony increased mock jurors' knowledge about child witnesses. These findings suggest that expert testimony related to the impact of interview techniques on the reliability of children's reports may assist fact-finders in evaluating child abuse cases.