title: Screening for Child Sexual Exploitation in Online Sexual Health Services: An Exploratory Study of Expert Views.
abstract: Sexual health services routinely screen for child sexual exploitation (CSE). Although sexual health services are increasingly provided online, there has been no research on the translation of the safeguarding function to online services. We studied expert practitioner views on safeguarding in this context.
  
  
  
  The aim was to document expert practitioner views on safeguarding in the context of an online sexual health service.
  
  
  
  We conducted semistructured interviews with lead professionals purposively sampled from local, regional, or national organizations with a direct influence over CSE protocols, child protection policies, and sexual health services. Interviews were analyzed by three researchers using a matrix-based analytic method.
  
  
  
  Our respondents described two different approaches to safeguarding. The "information-providing" approach considers that young people experiencing CSE will ask for help when they are ready from someone they trust. The primary function of the service is to provide information, provoke reflection, generate trust, and respond reliably to disclosure. The approach values online services as an anonymous space to test out disclosure without commitment. The "information-gathering" approach considers that young people may withhold information about exploitation. Therefore, services should seek out information to assess risk and initiate disclosure. This approach values face-to-face opportunities for individualized questioning and immediate referral.
  
  
  
  The information-providing approach is associated with confidential telephone support lines and the information-gathering approach with clinical services. The approach adopted online will depend on ethos and the range of services provided. Effective transition from online to clinic services after disclosure is an essential element of this process and further research is needed to understand and support this transition.
authors.affiliation: King's College London, London, United Kingdom.
authors.forename: Victoria
authors.identifier: 0000-0001-9171-9667
authors.initials: V
authors.lastname: Spencer-Hughes
authors.affiliation: King's College London, London, United Kingdom.
authors.forename: Jonathan
authors.identifier: 0000-0002-4479-1604
authors.initials: J
authors.lastname: Syred
authors.affiliation: Independent Researcher, London, United Kingdom.
authors.forename: Alison
authors.identifier: 0000-0002-7459-1240
authors.initials: A
authors.lastname: Allison
authors.affiliation: Lambeth and Southwark Public Health Directorate, London, United Kingdom.
authors.forename: Gillian
authors.identifier: 0000-0001-7650-9717
authors.initials: G
authors.lastname: Holdsworth
authors.affiliation: King's College London, London, United Kingdom.|King's College Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Paula
authors.identifier: 0000-0002-3354-6494
authors.initials: P
authors.lastname: Baraitser
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008403:Mass Screening / Q000379:methods; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000523:psychology*
keywords: Internet; adolescent health services; child abuse, sexual; risk assessment; sexually transmitted diseases