{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:19:53Z","timestamp":1787768393918,"version":"build-2784847793"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["# R01NR020997"],"award-info":[{"award-number":["# R01NR020997"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015308","name":"Stephenson Cancer Center","doi-asserted-by":"publisher","award":["#P30CA225520"],"award-info":[{"award-number":["#P30CA225520"]}],"id":[{"id":"10.13039\/100015308","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100024521","name":"Oklahoma Tobacco Settlement Endowment Trust","doi-asserted-by":"publisher","award":["STCST00400_FY25"],"award-info":[{"award-number":["STCST00400_FY25"]}],"id":[{"id":"10.13039\/100024521","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Youth experiencing homelessness (YEH) face elevated risk for sex trafficking due to interconnecting structural, interpersonal, and psychological vulnerabilities. Despite growing recognition of this link, regional data from the southern United States remain limited. This study examines the proportion of YEH reporting experiences consistent with sex trafficking and describes associated characteristics among a sample of YEH in Houston, TX.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Baseline data (September 2019\u2013May 2023) from a randomized controlled trial of a nurse-led HIV prevention intervention were analyzed. Participants (N\u2009=\u2009450; ages 16\u201325) completed self-administered surveys. Sex trafficking was defined as endorsing \u22651 of five Commercial Sexual Exploitation items from the Urban Institute Human Trafficking Screening Tool. Adjusted and unadjusted modified Poisson regression models with robust variance estimation were used to examine relationships between sex trafficking and age, gender, race\/ethnicity, sexual orientation, foster care history, past-30-day drug use, and last permanent residence in Houston.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Within this sample of YEH, 23.1% (104\/450) reported experiences consistent with sex trafficking. In adjusted models, those who identified as female vs. male (aPR\u2009=\u20092.341, 95% CI: 1.530\u20133.582) were more likely to report being trafficked.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Among YEH in Houston, study findings showed that trafficking disproportionately impacted those who identify as female. Findings suggest a need for routine, trauma-informed trafficking screening; service strategies to reach impacted youth; and longitudinal research to clarify causal pathways and guide tailored prevention and care for diverse youth populations.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n \n ClinicalTrials.gov\n NCT03910218<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0357091","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:40:13Z","timestamp":1787766013000},"page":"e0357091","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and characteristics of sex trafficking among youth experiencing homelessness: A cross-sectional study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4992-7096","authenticated-orcid":true,"given":"Higinio","family":"Fern\u00e1ndez-S\u00e1nchez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9210-010X","authenticated-orcid":true,"given":"Jennifer","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Utsav","family":"Arandhara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Padhye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeline","family":"Nyamathi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerita","family":"Lightfoot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmeen","family":"Quadri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Businelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane Santa","family":"Maria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"pone.0357091.ref001","unstructured":"ILO WF a t IO f M. Global Estimates of Modern Slavery: Forced Labour and Forced Marriage. 2022. https:\/\/www.ilo.org\/sites\/default\/files\/wcmsp5\/groups\/public\/%40ed_norm\/%40ipec\/documents\/publication\/wcms_854795.pdf"},{"key":"pone.0357091.ref002","unstructured":"Trafficking Victims Protection Act of 2000. U.S.C.A. 2000. https:\/\/www.congress.gov\/106\/plaws\/publ386\/PLAW-106publ386.htm"},{"key":"pone.0357091.ref003","unstructured":"National Human Trafficking Hotline. National statistics. https:\/\/humantraffickinghotline.org\/en\/statistics. 2024."},{"key":"pone.0357091.ref004","author":"A Henderson","year":"2021"},{"key":"pone.0357091.ref005","author":"A Farrell","year":"2005"},{"key":"pone.0357091.ref006","unstructured":"Lane L, Gray A, Rodolph A. Federal human trafficking report 2023. 2024."},{"key":"pone.0357091.ref007","unstructured":"U.S. Department of Housing and Urban Development. 2024 Annual Homelessness Assessment Report: Part 1: Point-in-Time Estimates of Homelessness in the United States. 2024."},{"key":"pone.0357091.ref008","unstructured":"The McKinner-Vento Homeless Assistance Act. 2026. https:\/\/nche.ed.gov\/legislation\/mckinney-vento\/"},{"key":"pone.0357091.ref009","unstructured":"Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009. 2009. https:\/\/www.congress.gov\/bill\/111th-congress\/house-bill\/1877"},{"key":"pone.0357091.ref010","unstructured":"Bigelsen J, Vuotto S. Homelessness, survival sex, and human trafficking: As experienced by the youth of Covenant House New York. 2013."},{"key":"pone.0357091.ref011","unstructured":"Murphy LT. Labor and sex trafficking among homeless youth. 2016."},{"issue":"2","key":"pone.0357091.ref012","doi-asserted-by":"crossref","first-page":"178","DOI":"10.5172\/conu.2012.42.2.178","article-title":"Comparisons of substance abuse, high-risk sexual behavior and depressive symptoms among homeless youth with and without a history of foster care placement","volume":"42","author":"AL Hudson","year":"2012","journal-title":"Contemp Nurse"},{"issue":"3","key":"pone.0357091.ref013","doi-asserted-by":"crossref","first-page":"363","DOI":"10.3390\/ijerph16030363","article-title":"Identifying Sexual and Labor Exploitation among Sheltered Youth Experiencing Homelessness: A Comparison of Screening Methods","volume":"16","author":"S Mostajabian","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0357091.ref014","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/23322705.2021.2020061","article-title":"Adverse Childhood Experiences (ACEs) and Homelessness: A Critical Examination of the Association between Specific ACEs and Sex Trafficking among Homeless Youth in Kentuckiana","volume":"10","author":"J Middleton","year":"2022","journal-title":"J Human Trafficking"},{"issue":"2","key":"pone.0357091.ref015","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3390\/socsci10020032","article-title":"The Prevalence and Correlates of Labor and Sex Trafficking in a Community Sample of Youth Experiencing Homelessness in Metro-Atlanta","volume":"10","author":"ER Wright","year":"2021","journal-title":"Social Sciences"},{"key":"pone.0357091.ref016","article-title":"Pretesting a human trafficking screening tool in the child welfare and runaway and homeless youth systems","author":"M Dank","year":"2017","journal-title":"Urban Institute"},{"key":"pone.0357091.ref017","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.childyouth.2018.12.014","article-title":"Screening for human trafficking among homeless young adults","volume":"98","author":"M Chisolm-Straker","year":"2019","journal-title":"Children and Youth Services Review"},{"key":"pone.0357091.ref018","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.childyouth.2018.12.022","article-title":"Human trafficking victimization among youth who run away from foster care","volume":"98","author":"NE Latzman","year":"2019","journal-title":"Children and Youth Services Review"},{"key":"pone.0357091.ref019","doi-asserted-by":"crossref","first-page":"119472","DOI":"10.1016\/j.socscimed.2026.119472","article-title":"International migration and sex trafficking: A scoping review","volume":"405","author":"H Fern\u00e1ndez-S\u00e1nchez","year":"2026","journal-title":"Soc Sci Med"},{"key":"pone.0357091.ref020","doi-asserted-by":"crossref","unstructured":"Dank M, et al. Estimating the size and structure of the underground commercial sex economy in eight major US cities. 2014.","DOI":"10.1037\/e508162014-001"},{"issue":"5","key":"pone.0357091.ref021","doi-asserted-by":"crossref","DOI":"10.2196\/26716","article-title":"A nurse case management HIV prevention intervention (Come as you are) for youth experiencing homelessness: Protocol for a randomized wait-list controlled trial","volume":"10","author":"D Santa Maria","year":"2021","journal-title":"JMIR Res Protoc"},{"issue":"2","key":"pone.0357091.ref022","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s10461-024-04544-3","article-title":"Results of a Randomized Wait-List Controlled Trial of CAYA: A Nurse Case Management HIV Prevention Intervention for Youth Experiencing Homelessness","volume":"29","author":"DS Maria","year":"2025","journal-title":"AIDS Behav"},{"issue":"3","key":"pone.0357091.ref023","article-title":"mice: Multivariate Imputation by Chained Equations inR","volume":"45","author":"van Buuren S","year":"2011","journal-title":"J Stat Soft"},{"issue":"1","key":"pone.0357091.ref024","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1177\/1524838020933873","article-title":"The Prevalence of Sex Trafficking of Children and Adolescents in the United States: A Scoping Review","volume":"23","author":"H Franchino-Olsen","year":"2022","journal-title":"Trauma Violence Abuse"},{"key":"pone.0357091.ref025","unstructured":"Wolfe DS, Greeson JKP, Wasch S, Treglia D. Human Trafficking Prevalence and Child Welfare Risk Factors Among Homeless Youth A Multi-City Study. 2018."},{"key":"pone.0357091.ref026","doi-asserted-by":"crossref","first-page":"100073","DOI":"10.1016\/j.jmh.2021.100073","article-title":"Human trafficking and violence: Findings from the largest global dataset of trafficking survivors","volume":"4","author":"H St\u00f6ckl","year":"2021","journal-title":"J Migr Health"},{"key":"pone.0357091.ref027","unstructured":"UNODC. Global report on trafficking in persons 2024. United Nations. 2024."},{"issue":"11","key":"pone.0357091.ref028","doi-asserted-by":"crossref","first-page":"567","DOI":"10.3390\/socsci13110567","article-title":"Human Trafficking of Boys and Young Men: A Systematic Literature Review of Impacts on Mental Health and Implications for Services in Post-Trafficking Settings","volume":"13","author":"M Nodzenski","year":"2024","journal-title":"Social Sciences"},{"key":"pone.0357091.ref029","article-title":"Survey of youth currently and formerly in foster care at risk for human trafficking: Findings report","author":"MM Dolan","year":"2022","journal-title":"OPRE"},{"issue":"2","key":"pone.0357091.ref030","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2024-067965","article-title":"Youth homelessness in Denver, Colorado: 2017\u20132021","volume":"155","author":"MY Westfall","year":"2025","journal-title":"Pediatrics"},{"issue":"1","key":"pone.0357091.ref031","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1080\/23322705.2020.1841985","article-title":"LGBTQ Homeless Young Adults and Sex Trafficking Vulnerability","volume":"9","author":"KA Hogan","year":"2023","journal-title":"Journal of Human Trafficking"},{"key":"pone.0357091.ref032","doi-asserted-by":"crossref","first-page":"106691","DOI":"10.1016\/j.chiabu.2024.106691","article-title":"Unveiling the shadows: Exploring the reality of commercial sexual exploitation among LGBTQ+ youth in out-of-home care","volume":"149","author":"N Mazursky","year":"2024","journal-title":"Child Abuse Negl"},{"issue":"4","key":"pone.0357091.ref033","article-title":"Sex trafficking of LGBT individuals: A call for service provision, research, and action","volume":"42","author":"O Martinez","year":"2013","journal-title":"Int Law News"},{"issue":"12","key":"pone.0357091.ref034","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1007\/s10964-011-9646-6","article-title":"Increased substance use and risky sexual behavior among migratory homeless youth: exploring the role of social network composition","volume":"40","author":"SC Martino","year":"2011","journal-title":"J Youth Adolesc"},{"issue":"5","key":"pone.0357091.ref035","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s10488-022-01207-0","article-title":"Addressing Mental Health and Trauma-Related Needs of Sheltered Children and Families with Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)","volume":"49","author":"JA Spiegel","year":"2022","journal-title":"Adm Policy Ment Health"},{"issue":"1","key":"pone.0357091.ref036","article-title":"Young Adults\u2019 Use of Different Social Media Platforms for Health Information: Insights From Web-Based Conversations","volume":"24","author":"MSC Lim","year":"2022","journal-title":"J Med Internet Res"},{"key":"pone.0357091.ref037","unstructured":"National Human Trafficking Hotline. Statistics. https:\/\/humantraffickinghotline.org\/en\/statistics. 2024."},{"issue":"1","key":"pone.0357091.ref038","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s41256-023-00332-z","article-title":"Human trafficking risk factors, health impacts, and opportunities for intervention in Uganda: a qualitative analysis","volume":"8","author":"RE Klabbers","year":"2023","journal-title":"Glob Health Res Policy"},{"issue":"6","key":"pone.0357091.ref039","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0324795","article-title":"A scoping review of racism and anti-racist solutions in the health care of people who have experienced trafficking","volume":"20","author":"B Bernardin","year":"2025","journal-title":"PLoS One"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0357091","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:40:18Z","timestamp":1787766018000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0357091"}},"subtitle":[],"editor":[{"given":"Kimberly","family":"Page","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":39,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0357091","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]}}}