Table 5.

Findings from the qualitative studies (n = 15)

Author (Year)	Country	Setting	Study population	Type of sexual exploitation or trafficking	Thematic findings on risk factors	Thematic findings on abduction	Thematic findings on perpetrators	Thematic findings on adverse consequences/outcomes	Quality score
Bartels [26]	Lebanon	Refugee camps	Syrian refugees, Ages 18+ years	Early or forced marriage	informal tents, economic insecurity, need for employment	Families need to be made more aware of the risk of abduction.	Perpetrators were host country men, employers, aid workers, and family members.	increased social/physical abuse, maternal mortality, human trafficking, commercial sexual exploitation, sexually transmitted diseases (STDs), HIV	70%
Betancourt [37]	Sierra Leone	Conflict affected regions	Former child soldiers Age 10–17 caregivers, Former child soldiers’ relatives, key informants	Sexual exploitation of combatants	-	A high majority of the sample youth reported joining the Revolutionary united Front (RUF) by force/abduction.		stigma, decline in adaptive and pro-social behaviours, internalizing problems	70%
Brosnan [27]	Jordan, Turkey, Lebanon, Iraq	Refugee camps and urban displacement	Refugees, Government officials, IGO representatives, Non-governmental organization (NGO) staff	Early or forced marriage	displacement, economic insecurity, walking to school, rape	Families used early marriage as a way to safeguard their daughters honour.	Perpetrators were family members, host country citizens and armed forces personnel.	shame, stigma, anxiety, trauma, interrupted education, repeated rape	45%
Carlson [28]	Uganda	Internally displaced persons camps	Formerly abducted women/girls Additional use of key informants to target group	Early or forced marriage, Sexual exploitation of combatants	customary practices, economic hardship, puberty, living in an internally displaced persons camp, youth	Abduction was carried out by the Lord’s Resistance Army personnel and the field commanders had priority to forced marriages.	Often field commanders were the greatest culprits with multiple wives.	pregnancy, physical harm, mental harm, separation from family, death	70%
CSUCS [53]	DRC	Conflict affected regions, North and South Kivu	Military officials, government officials, NGO workers, child protection workers, community members, relatives	Sexual exploitation of combatants	war, absence of parents vulnerable children, armed groups, displacement, legal protection	-	The perpetrators were members of the Forces Armées de la République Démocratique du Congo (FARDC).	injury, death	50%
Denov [42]	Sierra Leone	Conflict affected regions	RUF former child soldiers Age 14–21 (all were 18 or under at time of exposure)	Sexual exploitation of combatants	war, widespread impoverishment, the breakdown of human security, and the gradual atomization of families and communities	Abductions often lasted between 2–18 months.	Victims were abducted by RUF soldiers.	physical, psychological, and social effects, community rejection, education dropout,	60%
Denov [43]	Sierra Leone	All regions	Former child soldiers	Sexual exploitation of combatants	war, unprotected children, fragmented political economy, disempowered women	All the participants had been abducted by the RUF under circumstances of extreme coercion, violence, and fear.	The RUF were most often responsible for abductions.	depression, violent injuries, pregnancy, stabbing, vomiting	60%
Gottschalk [29]	Uganda	Refugee camps	Refugees	Early or forced marriage	financial constraints, displacement, absence of parents, reduced livelihood options, war, untrained police, limited protective services, extramarital sexual relationships, physical insecurity	-	Often it is parents or guardians arranging the early marriages.	physical injury, social stigmas, rejection from family, school drop out	65%
Higonnet [30]	Cote d’Ivoire	Conflict affected regions	Survivors and witnesses of sexual violence	Early or forced marriage, Sexual exploitation of combatants, Sex slavery	low status of women and girls, conflict, low social status, economic disadvantage, traveling employment, political leaders wives and family members, displacement	-	Often girls were abducted by combatants and when they resisted abduction they were physically punished.	death, unwanted pregnancy, STIs, anxiety, shame, anger, depression, and fear	65%
Kaya [47]	Afghanistan	All regions	victims of trafficking or kidnapping, smuggled migrants, key informants	Sex slavery	protracted conflict, insecurity, limited access, instability, poverty, lack of trafficking awareness, loss of livelihood, high proportion of widows/orphans/people with disabilities, criminal networks, multiple neighbouring countries	A majority of trafficking victims are abducted under the lure of a better life or positive outcome and the remaining are kidnapped by force.	Many traffickers are involved in complex criminal networks. Often an individual's own family will sell them.	stigmatization, psychological harm, physical distress, pregnancy, loss of education	80%
Kippenberg [31]	DRC	Conflict affected regions	victims of rape, relatives, witnesses, community members, military combatants	Early or forced marriage, Sex slavery	conflict insecurities, insufficient pay for soldiers	-	The sample reported that the sexual exploitation was predominantly committed by the 14th brigade of the FARDC.	injury, death	70%
Save the Children [32]	Jordan	Refugee camps	refugees	Early or forced marriage	poverty, insecurity, fear of violence, conflict, youth	Many Syrian refugee families arranged the daughters’ weddings to Jordanian men.	-	poverty, loss of education, separation from family and friends, limited access to reproductive health, physical harm, mental and emotional strain, domestic violence, premature pregnancy	35%
Schlecht [33]	Uganda	Refugee camps	Ugandan and Congolese refugees	Early or forced marriage, Sexual exploitation of combatants	conflict, poverty, divided family, school dropout, early relationships, loss of livelihood	Families often planned early marriages and bride prices. During conflict there is militia-perpetrated abduction, forced marriage, and sex slavery.	-	poor health outcomes, poor social outcomes, early sexual debut, high risk pregnancy, limitations in negotiating condom use, STDs, school dropout, limited economic opportunity	70%
Stavrou [34]	Angola	Conflict affected regions	Formerly abducted girl soldiers Avg. 21 years	Early or forced marriage	combat zones, presence of soldiers, youth, displacement	-	The perpetrators were most often military personnel.	STDs, pregnancy, exhaustion, malnutrition, TB, abuse, death	60%
Weber [35]	Uganda	Conflict affected regions	victims of military violence, relatives of victims, and former LRA abductees	Early or forced marriage, Sexual exploitation of combatants	conflict, youth, displacement, travel	-	The perpetrators were most often military personnel.	unwanted pregnancy, STDs, injury, death	50%