Experiences of online sexual exploitation among child survivors of sexual abuse.

BACKGROUND: Children's increasing use of digital platforms elevates their risk for online sexual exploitation (OSE), especially among those with sexual abuse histories. Despite known risk, data on prevalence and related characteristics remain limited. Digital safety screening (DSS) offers child abuse professionals a tool to assess risk or prior exploitation but is not standardized. OBJECTIVE: To examine age-related variation in OSE disclosure within a clinically relevant population and characterize how DSS is applied in this clinical setting. PARTICIPANTS AND SETTING: A retrospective chart review was conducted of 307 patients aged 10-18 years who received forensic interviews (FIs) for evaluation for suspected sexual abuse by a single social worker between 2022 and 2024 at a Child Advocacy Center in the Midwestern United States. METHODS: FI notes were analyzed through content analysis to characterize the utilization of DSS and patient disclosure or denial of OSE. Descriptive statistics revealed prevalence: logistic regression examined associations between patient age and OSE. RESULTS: Of 307 patients, 96.1% received DSS. Among 299 who discussed OSE, 41.5% reported at least one experience. Odds of reporting increased with age, beginning at 12.0% at age 10, 27.3% at 11, and increasing to 60.0% at age 16. CONCLUSIONS: OSE exposure likely increases with age and may vary by sex assigned at birth. Findings underscore the need for routine, standardized DSS validated across developmental stages and languages, as well as further research on prevalence and risk and prevention and response strategies.