Child sex trafficking and commercial sexual exploitation of children (CSEC) are major public health problems in the United States and throughout the world. Despite large numbers of American and foreign youth affected and a plethora of serious physical and mental health problems associated with CSEC, there is limited information available to pediatricians regarding the nature and scope of human trafficking and how pediatricians and other health care providers may help protect children. Knowledge of risk factors, recruitment practices, possible indicators of CSEC, and common medical and behavioral health problems experienced by victims will help pediatricians recognize potential victims and respond appropriately. As health care providers, educators, and leaders in child advocacy, pediatricians play an essential role in addressing the public health issues faced by child victims of CSEC. Their roles can include working to increase recognition of CSEC, providing direct care and anticipatory guidance related to CSEC, engaging in collaborative efforts with medical and nonmedical colleagues to provide for the complex needs of youth, and educating child-serving professionals and the public.

Platelet endothelial cell adhesion molecule (PECAM)-1 has been implicated in angiogenesis, but a number of issues remain unsettled, including the independent involvement of human PECAM-1 (huPECAM-1) in tumor angiogenesis and the mechanisms of its participation in vessel formation. We report for tumors grown in human skin transplanted on severe combined immunodeficiency mice that antibodies against huPECAM-1 (without simultaneous treatment with anti-VE-cadherin antibody) decreased the density of human, but not murine, vessels associated with the tumors. Anti-huPECAM-1 antibody also inhibited tube formation by human umbilical vein endothelial cells (HUVEC) and the migration of HUVEC through Matrigel-coated filters or during the repair of wounded cell monolayers. The involvement of huPECAM-1 in these processes was confirmed by the finding that expression of huPECAM-1 in cellular transfectants induced tube formation and enhanced cell motility. These data provide evidence of a role for PECAM-1 in human tumor angiogenesis (independent of VE-cadherin) and suggest that during angiogenesis PECAM-1 participates in adhesive and/or signaling phenomena required for the motility of endothelial cells and/or their subsequent organization into vascular tubes.

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Overview A growing body of research addresses the issue of “commercial sexual exploitation of children” (CSEC) and “child sex trafficking.” These overlapping terms describe crimes of a sexual nature committed against children and adolescents that involve exploitation for financial or other gain. Existing literature demonstrates that commercially sexually exploited youth typically experience significant and ongoing trauma. The literature teaches that these youths have a unique set of health risks, including violence-related injuries, sexually transmitted infections, unwanted pregnancy, and a variety of mental health problems. Though federal law defines these youth as victims of human trafficking, in many states, commercially sexually exploited children and adolescents are incarcerated for crimes related to their exploitation. Fear of incarceration can prevent victims from seeking available services. While health care providers may play a critical role in connecting commercially sexually exploited youth with community resources, most providers lack the knowledge of human trafficking necessary to fulfill this role effectively. Published research about this vulnerable pediatric population, although rapidly growing, is still extremely limited. Further research into the prevention, identification, intervention, and multidisciplinary management of CSEC and sex trafficking of children and adolescents is needed.

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