Adverse childhood experiences and propensity to participate in the commercialized sex market

Child Abuse Negl. 2020 Jun:104:104468. doi: 10.1016/j.chiabu.2020.104468. Epub 2020 Apr 2.


Background: Previous research has tied adverse childhood experiences (ACEs) to a variety of deleterious mental health, physical, and behavioral outcomes. There has been some examination of the relationship between ACEs and selling sexual services, but not on the relation of ACEs to purchasing.

Objective: We hypothesize a cumulative impact of ACEs on the propensity to purchase and buy and sell sex. We further hypothesize that childhood sexual abuse will have unique impacts on buying and selling.

Participants & setting: We recruited participants who had ever/never exchanged money or things of values for sex through Amazon MTurk (n = 930).

Methods: Using logistic regression, we examined how cumulative ACEs and each separate ACE increased propensity to buy or sell sex. We controlled for sex, age, race, employment status, and sexuality.

Results: Utilizing the analysis from cumulative ACEs found that the propensity to buy (odds ratio 1.11***) and sell sex (odds ratio 1.094**) increased as cumulative ACE score increased. Bisexuals had high propensity of both buying (odds ratio 2.12) and selling sex (odds ratio 2.74). Women (odds ratio 0.53) and people of color (odds ratio 0.65) where more likely to sell than others. For odds of buying sex, childhood sexual abuse (odds ratio 1.57) had the most impact. For selling sex, childhood sexual abuse (odds ratio 1.96) and household physical violence (odds ratio 2.73) increased propensity while household mental abuse (odds ratio 0.57) decreased propensity.

Conclusions: Understanding the impact of ACEs is important to understand participation as a buyer and seller in the commercialized sex market.

Keywords: ACEs; Adverse childhood experiences; Child sexual abuse; Commercial sex work; Prostitution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Adult Survivors of Child Adverse Events / psychology*
  • Adverse Childhood Experiences / psychology*
  • Aged
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Sex Work / statistics & numerical data*
  • Sex Workers / statistics & numerical data*
  • Young Adult