I have decided to post this video we recently made at Cinematheque. There are lots of art students who participate, and everyone wants to put it out there that this is where Show Me Your Life started. This is where it comes from. Real Stories Gallery and Tristan's Moon has made that possible. Students who have Cinematheque Mentors work through Show Me Your Life to acquire art and video skills. In doing so, they are also examining the dynamics of their lives and how art becomes a sharing, too. A bearing witness. At-risk does not mean we will remain invisible. We were here. http://www.le-too.tumblr.com

 

Having Been Whipped by Iron Old America

having been whipped by iron old america/ and her holy moral wars of rust/ i crawled away to france like the dead/ wrapped in a shroud of sheets/ to sleep beneath the streets with corpses and the skulls/ and the black black death/ riding my sinuous edges on the tongues/ and here it is to writing, cringe/ do not touch/ they are never subtle/ hate sags them down to wax/ their shadows must cover half the world/ never again/ how does one speak to a silence of the souls/ you just crawl away and keep/ crawling/ skin, bone/ flesh annihilated like the desert cats/ the reddened sky stirs our finish to the rusted iron of the walls/

 

 

 

The Whip Extended

how everything turns away/ all old men are dangerous

Tim Barrus, Founder/Director Cinematheque Films & Show Me Your Life

I was raped by a pediatrician in the fourth grade. While it was happening, I did not understand what he was doing (or why). But he was an authority figure and you had to respect authority figures unconditionally because if you didn’t, your father would beat the shit out of you. My parents were big into beating kids and authority.

I knew it hurt.

Where were my parents. My dad was nowhere to be found. My mother was waiting patiently in the dark (it was after office hours) in the waiting room in her old cloth coat. I do not know why I remember that coat so well, but I do. I think I see that old cloth coat (in twenty years I never saw her wear another coat) as a symbold of our poverty.

When Wikipedia explains to you all about what an evil man I am, they never refer to rape as an instrument of terror and parenting.

I go to a health clinic in Asheville. I will not undress or wear patient gowns. They characterize me (it is a federally defined category) as a survivor of sexual violence.

I allow them to take my vital signs but that is it. They begrudgingly accept this. They almost kicked me out at first; refusing to see me as a patient.

We got beyond all of that.

Almost.

“Isn’t it about time you started dealing with this,” my doctor says.

What he doesn’t understand is that I deal with it every day. And in the same nightmare night after night.

Newspapers have described me as a very angry man and defiant. So.

To this day, I have a huge problem with the fact that my parents failed to protect me.

I do not trust most authority.

Especially if it comes wrapped in a white coat.

I pushed the memory of it away for years. But now I remember. I remember the look on his face and he was mean. I think he hated children.

It wasn’t sex. It was violence.

I do not know how my mother never questioned the whole after office hours thing. His office was dark. Only a few lights were on. I remember thinking: What are you DOING to me. I had never heard of the word rape. I had no idea what it was.

I know now what rape is.

I keep wondering if they sold me.

Yesterday, the Department of Justice redefined the legal definition of rape to include men and boys.

Most of the people I know were surprised the law has never included men or boys.

The law also stated that in the case of females who were claiming rape, the female had to prove she had resisted.

The old law was draconian.

The new definition of the federal statute was only realized after years and years of pressure by the survivors of rape like me.

Doctors and priests who rape children will go DOWN.

The kids at Cinematheque are constantly hounded by men. One is a computer guru from Teas (who claims to know me which is a lie) who gets email addresses and harasses and stalks us on the Internet). There is another one who lives in Cyprus and goes by the name of VizJim. I call both of them them haters. They are sexually attracted to young boys. Most of the boys in Cinematheque are also the survivors of sexual trauma. When we are stalked and harassed, we fight back. We are constantly being challenged to come out in public ways. But why should we volunteer to trot ourselves out there — to be abused — and to relive it (or repeat the experience) again and again. To do that would be a recipe for suicide.

The new definition of the federal law regarding rape — now to include the male of the species — is going to change a lot of lives.

The fight with the bureaucracy to include men and boys was worth the grief, the work, the anguish, the rage.

Personally, I was shocked the law got reviewed at all. Let alone changed. Rape is bad enough. But when people who rape children are protected by the institutions they are associated with (our stalker is only somewhat protected by proxy servers but we do have his location) or work for, the walls that protect the castle must be challenged. It is not enough to tell me to simply “deal with it.”

I am dealing with it. I was instrumental in changing the way the law is interpreted. For a woman to have to prove she resisted being raped is antediluvian. Many women are targeted because they can’t fight back.

The new interpretation of the law now reads to include such ideas as the use of alcohol and other drugs. Meaning: just because you might be too drunk or wiped out to know you were raped, you are still being raped, and it’s still against the law. The federal statue against rape had not been reviewed since 1929. The year my mother was born.

The doctor who raped me is dead.

I do sometimes wonder how many other children he got his animal hands on.

I didn’t know what rape was back then as a kid growing up in Lansing, Michigan. Another bitter little town where they claim (on the rooftops) they love their children.

It’s crap. The sexual abuse of children in the school system there was rampant. I do not know how I survived attending West Junior High School. I had to stand naked at attention while a teacher inspected me. Time and time again.

I have always written about that place as if it were a nightmare populated by monsters because to me it was.

When people say — WE LOVE OUR CHILDREN — I know rhetoric when I hear it. You only love your children when they shut the fuck up.

The law needed to be changed. It was changed. Some of us are no longer willing to sit patiently waiting in the dark in our old cloth coats. — tim barrus

Male Abuse Survivors and Their Care Providers

Childhood sexual abuse may be a primary risk factor for HIV infection, but violence is a major risk factor for mortality in HIV-positive adolescent males. For HIV-positive male adolescents, there is increased risk of domestic and institutional violence related to HIV status. The decision to test for HIV, disclosure of HIV status to family and peer groups, are all situations that may increase the risk for violence. Male adolescents have been beaten, abandoned, shot, and even murdered after revealing their HIV-positive status. Screening for HIV may set male adolescents up for further violence.

It is critical to be aware that a large proportion of male adolescents were sexually abused as children (estimates in the USA & Canada suggest 1 in 6 males is sexually violated by age 16). The emotional trauma of childhood sexual abuse is compounded by the fact that the perpetrator of the violence is usually a male living close by to the child. Often the abuse occurs in a family and/or community atmosphere of silence, secrecy, protection of the perpetrator and disbelief or blaming of the child victim.

Childhood sexual abuse often sets the stage for unsatisfactory relationships with health care providers. Clinicians who fail to screen for a history of childhood sexual abuse or current risk for domestic abuse often misread the symptoms.  An abused male adolescent may miss appointments and be considered noncompliant. Or he may report a range of physical digestive complaints, headaches, joint and muscle pains and chest pains. When clinicians are unable to find underlying medical causes for these symptoms they become frustrated and often label the patient a “malingerer.”

Sexual trauma can also result in post-traumatic stress syndrome. Common coping behaviors in sexual abuse survivors are denial, dissociation and repetition compulsion. Denial and repetition compulsion (repeating behaviors that lead to trauma) are major mechanisms operating when engaging in risk behaviors, or staying in an abusive situation. Dissociation (pushing painful experiences and emotions out of conscious recognition) often occurs when survivors are asked about the trauma. They may respond blankly or without any emotional affect. Care providers often interpret dissociative reactions as the patient being "not too bright," "spaced out" or "on drugs."

The available data on the incidence of sexual trauma and domestic abuse in the U.S. is staggering. It is estimated that seventy-five percent of sex workers (female and male) have experienced sexual abuse. A history of sexual abuse, physical abuse or domestic abuse has a highly correlation with engaging in risk behavior for HIV: use of IV drugs; exchange of sex for drugs, money or shelter; higher number of sexual partners; and having had a sexual relationship with a person at high risk for HIV.

To prevent further trauma for male adolescents, it is imperative that clinicians incorporate what is known about childhood sexual abuse when establishing a relationship with male adolescents at risk for HIV, or experiencing HIVAIDS related symptoms:

• Provide assurance that any abuse that has occurred was not the survivor's fault.
• Validate the experience of sexual abuse ("I believe you") and reassure the survivor that he is not alone ("This has happened to others").
• Offer the survivor support and the ability to be in control of his body during any medical examinations, especially during genital exams, rectal exams and other invasive procedures.
• Assess if the survivor is in a safe living situation at the present time.
• Assess if there are any children living with the survivor who are currently at risk for sexual abuse.
• Incorporate knowledge of the survivor's history into current and future interactions.
• Make appropriate referrals for counseling, crisis intervention, safe housing and other services.

Care Providers should be cognizant that the USA has ratified (signed up to support and enforce) the Convention of the Rights of the Child's optional protocol: Sale of Children, Child Prostitution and Child Pornograhy:

Although the USA has not yet ratified the Main Convention it has signed up to support and enforce the Convention’s Optional Protocol: Sale of Children, Child Prostitution and Child Pornography.  In so doing, all local criminal justice and healthcare systems become responsible for securing the best interests of each violated child. This includes ensuring each child receives the appropriate medical, psychological, logistical and financial support that is necessary for his/her rehabilitation and reintegration into their communities. It is imperative these humanitarian responsibilities be urgently honored to prevent related and ongoing trauma for each child who has been violated and infected with HIV, and is living with the debilitating consequences within our communities.

The Convention on the Rights of the Child urges EVERYONE to assist in raising and disseminating awareness and urges civil society—including children themselves—to participate in the process of implementing child rights.

TABOO:  1 in 6 males is sexually abused by age 16 in the USA.

***

Our first focus at Cinematheque was to work with adolescent boys who had done sex work. That continues to be a focus. No one works with this group of at-risk males anywhere in the art/media arena. In typical educational theory, adult issues and kid issues are kept separate and are clearly defined as apart. Even when those kid issues and adult issues are the same. Consider access. Access can be anything from HIV medication to a camera you can learn photography from. Access is the real issue. Not gender. Not age. Not sexuality. And not religion. Access to the tools we need to express who we are leads us to a place where we reinvent who we can be. The old paradigms in terms of what access is and who owns it are no longer fitting for anyone. They can and must be changed. A new paradigm that is fundamentally based in the belief that internal perspective and external perspective are not mutually excludable -- but are inherently related -- is long overdue, and the tools to access belong to everyone.

Timothée Bârrus: This is the First Study Done Corroborating What I Have Known For Years. 
It is WAY past time studies like this were conducted. 
This one is a first. Duke University.



The Journal of Acquired Immune Deficiency Syndromes, www.jaids.com
: The Pervasive Effects of Childhood Sexual Abuse: Challenges for Improving HIV Prevention and Treatment Interventions
. By, Conall O’Cleirigh, PhD, Steven A. Safren, PhD, and Kenneth H. Mayer, MD


Even since the early days of the AIDS epidemic, childhood sexual abuse (CSA) and trauma have been found to be highly prevalent and associated with HIV transmission and acquisition across the diverse HIV risk groups and particularly among men who have sex with men (MSM). Thirty years in to the epidemic, there is a large and growing body of research documenting the complexity of the associations between childhood trauma and subsequent HIV risk taking: these pathways include increased difficulties appraising risk, confusion about sexual identity, depression, anxiety, hostility, dissociation, and substance and alcohol abuse. Two of the articles in the current issue correctly focus attention on the formative influences of childhood trauma generally and CSA specifically on HIV prevention and treatment outcomes. This new information provides important new insights that inform the existing research base supporting evidence that posttraumatic stress reactions to early trauma provides a conceptual model for understanding the multiple pathways that early life events result in sequelae potentiating the global AIDS epidemic. We conclude that integrated HIV prevention interventions must address sexual risk and other health outcomes within the posttraumatic stress context.


Using data from the National Epidemiologic Survey on Alcohol and Related Conditions, Sweet and Welles provide the most current estimates of CSA across sexual minority subgroups and, for the first time, with a heterosexual referent group. These comparisons allow for reliable population-based estimates of CSA and for meaningful comparisons between sexual minorities and heterosexuals. Although a greater proportion of women (14.9%) reported CSA than men (5.2%), gay and bisexual identified men had dramatically higher odds of reporting CSA, (9.5 and 12.8, respectively), compared with heterosexual men. Similarly, lesbian and bisexual identified women had increased odds for reporting CSA (3.4 and 5.3, respectively), compared with heterosexual women. These estimated rates of CSA among sexual minority men and women are worrisome and are consistent with earlier reports using convenience samples. In addition, in the Sweet and Welles analyses, sexual orientation moderated the relationship between CSA and odds of HIV/sexually transmitted infection incidence, increasing the odds most dramatically for gay and bisexual men. These findings provide the most compelling evidence to date identifying CSA as a critically important context for HIV prevention programming particularly for gay and bisexual men, the risk group most affected by HIV domestically. MSM represent 53% of all new HIV infections, and their incidence of other viral and bacterial sexually transmitted infections has been steadily increasing over the past decade.

The findings presented by Pence et al from the Coping with HIV/AIDS in the Southeast (CHASE) cohort that relate childhood trauma to accelerated HIV disease progression, medication nonadherence, and recent unprotected sex (among others) suggest also that childhood trauma not only confers increased vulnerability for HIV infection among sexual minorities (64% of the men in the sample identified as MSM) but also may interfere with optimal disease management/self-care behaviors among those already infected. With recent findings demonstrating that HIV treatment can be an effective tool in decreasing HIV incidence, addressing the significant psychosocial barriers to effective HIV disease management assumes additional public health significance. Pence et al consideration of putative mediators was extensive, and their sequential consideration of developmentally similar mediators (trait characteristics, recent stressful events, current mental health) may well be a valuable innovation for identifying the mechanisms linking distal childhood trauma to current adult behavior. However, their analyses did not identify the variables that explained the relationship of CSA with either antiretroviral therapy nonadherence or sexual risk behavior. In addition to the interpretations provided by the authors, it is possible that the way that they grouped potential mediators may not fully reflect the complexities of these interrelationships. Moreover, the diversity of their sample with respect to gender, race, and sexual orientation added the additional burden of characterizing complex developmental relationships that may differ substantially across HIV risk groups. A principal challenge for HIV prevention science is that the pathways leading to sexual risk taking are multiple and combine in heterogeneous ways, particularly for different populations. For example, in the con- text of CSA, a young African woman in a serodiscordant marriage may or may not have similar concerns in negotiating safer sex as an American gay man meeting sexual partners in different venues, such as through online websites.


For gay and bisexual men, other psychosocial problems often co-occur in the presence of CSA histories and interact to increase their sexual risk behavior with some indication that these complex interrelationships may operate in a similar, but not identical, way for young MSM. More recent reports suggest that these pathways to HIV risk are further complicated by enduring disturbances to adult sexual behavior among MSM and disturbances to romantic relationships among a general cohort of abused children followed to adulthood. This work identifying syndemics (co-occurring psychosocial health problems) that increase risk for HIV or interfere with HIV disease management among those already infected may create opportunities to augment traditional moderation and mediation analyses to help explicate these complex pathways.


By incorporating the full range of psychosocial stressors into explanatory models regarding HIV risk and health behaviors after infection, the functional context that place individuals at risk for HIV or poorer disease course can be better understood. This will provide a full range of relevant prevention and treatment targets that can be foci of evidence-based interventions. This may be particularly important as co-occurring psychosocial problems are not only associated with increased sexual risk for HIV but can also reduce the
impact of traditional prevention interventions or traditional models underlying such interventions. The impact of childhood trauma may effect prevention and care engagement at multiple loci. For example, the EXPLORE Study found that HIV-uninfected MSM with CSA histories were at greater risk for acquiring HIV infection, reported higher rates of HIV sexual risk behavior during the study, and derived less benefit from the HIV prevention intervention.

Interestingly, previous analyses in both of the samples in the articles under consideration have examined posttraumatic stress as an important variable explaining adverse outcomes in HIV-related behavior. Within the National Epidemiologic Survey on Alcohol and Related Conditions data, the relationship between early life trauma (including CSA) and the odds of HIV infection were mediated, in part, by diagnostic levels of posttraumatic stress disorder (PTSD) among a nationally representative sample of US men. Similarly, previous results from the CHASE cohort have linked trauma and symptoms of PTSD to health-related outcomes in HIV, independent of disease stage and treatment status. These results were replicated in a cohort of HIV-infected MSM in primary care where PTSD and depression symptom severity were strongly and uniquely associated with multiple measures of functional impairment (general health estimates, pain, and role and work-related impairment) and increased health care utilization after controlling for background characteristics, disease stage, and treatment.

How does a consideration of PTSD related to childhood trauma further our understanding of the complex relationships between CSA and HIV risk taking and nonengagement in care? Diagnostic levels of PTSD are characterized by enduring high levels of distress related to the CSA experience and associated impairment in functioning. The 3 symptom clusters of PTSD provide plausible mechanisms as to how this occurs. The symptoms clusters are (1) highly distressing intrusive thoughts of the sexual abuse, (2) avoidance of thoughts, emotions, and situations related to the abuse, and (3) hyperarousal. These intrusions, often thoughts (eg, self-blame, self-loathing) are then avoided through dissociation, substance use, or other avoidant-coping strategies. This avoidant stance, in sexual situations, can be hazardous as it interferes with the ability to confront risk, negotiate safer sex, and assert safety behaviors. Hyperarousal, chronic activation of the alarm response, interferes with the person’s ability to distinguish safe from unsafe situations. In sexual situations, the symptoms of hyperarousal impede the ability to make accurate and realistic sexual risk appraisals. This may lead to a loss of self-efficacy (or other important social or cognitive variables integral to self-care), as one doubts one’s ability to identify risk or one’s ability take steps to offset it.


A CASE EXAMPLE: 
For example, a gay man with PTSD related to an experience of CSA will have clinically significant symptoms in each of the PTSD symptom clusters.


Intrusions
: He experiences frequent distress from intrusive memories, thoughts, and feelings (often uncontrolled) related to
 his sexual abuse. His intrusive thoughts are generally negative thoughts about himself (eg, “It was my fault”, I am weak”, “I am unlovable”). His intrusive feelings are fear and self-loathing. These distressing thoughts and feelings are most distressing when he finds himself in adult sexual situations. He is fearful of being rejected by his sexual partner or exposed as a “bad” or “weak” person. This often leads him to focus on meeting his partners’ needs at the expense of protecting his own sexual health. As a result, he only uses condoms when his sexual partners insist.


Avoidance
: To cope with this high level of distress in sexual situations, he drinks and gets high before sex. He distracts himself from the most distressing thoughts and feelings during sex by not being fully present or aware of his situation and he may even dissociate.


Hyperarousal
: He generally feels on edge and is often irritable and angry and easily startled. He is not always sure if he is in a safe or risky sexual situation. This example demonstrates how the 3 symptom clusters of PTSD can account for many of the, seemingly disparate, pathways to sexual risk. The conceptualization accounts for high levels of negative emotion (depression, anxiety, hostility, anger), heavy alcohol and substance use, inaccurate sexual risk appraisals, and inadequate or absent condom negotiation skills. Recent studies from our group relating PTSD to unprotected sex among MSM33 and identifying PTSD diagnosis as a mediator of childhood trauma and increased HIV incidence provide some support for this conceptualization. In the presence of this level of posttraumatic disturbance, it is not surprising that MSM with CSA histories have difficulty deriving benefit from traditional HIV prevention interventions.

Several recent HIV prevention intervention initiatives have reported some success integrating traditional HIV risk reduction strategies into treatments that address the symptoms of CSA-related trauma. Sikkema et al randomized 247 HIV-infected men and women with HIV and CSA histories to either a 15 session, group based intervention integrating coping strategies for CSA-related trauma and sexual risk reduction or to a time-matched control. The intervention was associated with significant reductions in sexual risk behavior that maintained at 1-year follow-up.

Our group recently reported the initial outcomes of an individual-based 10-session intervention that integrated Cognitive Processing Therapy (an empirically supported treatment for PTSD) with sexual risk reduction counseling (Project THRIVE). Forty- three HIV-uninfected MSM with histories of CSA and recent sexual risk for HIV were randomized to receive the intervention or standard HIV testing and counseling. The intervention was associated with a significant reduction in the proportion of those reporting sexual risk for HIV: at posttreatment, 61% of the control group and only 35% of the treatment group reported episodes of unprotected anal intercourse in the previous 3 months with HIV-infected or unknown status partners. The intervention was also associated with a
significant reduction in trauma symptom severity and with significant increases in condom use self-efficacy (one of the mechanisms hypothesized to link successful remediation of trauma symptoms to reductions in sexual risk).


Symptoms or clinically diagnostic levels of CSA-related PTSD may be important targets for HIV prevention and treatment, particularly among sexual minority men. The experience of being sexually traumatized during the developmental stage in childhood or adolescence clearly interferes with adult sexual behavior, later in life, in a way that places MSM at increased risk for HIV and may compromise optimal disease management for those already living with HIV. The findings from these integrated studies provide some promising indications of the benefit of addressing co-occurring and interfering CSA-related posttraumatic stress symptoms in the context of HIV prevention.


There are several challenges to developing and implementing these integrated programs. Mental health issues in HIV primary care settings are often underidentified and undertreated. Increased screening for mental health issues in primary care will help to identify those most at risk and support triage and referral of those requiring these more intensive levels of treatment. These interventions, though considered brief from the perspective of mental health care, are considered lengthy by some from the perspective of public health, and as such may not be scalable in all settings, particularly those constrained by resources. However, thoughtful design in the development and efficacy testing of these interventions will help to promote sustainability in, or adaptation to, community settings such as the use of comparably trained mental health professionals as interventionists, or efficacy testing as community settings. As reviewed above, CSA frequently co-occurs with other mental health and substance use issues and results in increasing individual risk to become HIV-infected and poorer HIV management after infection. Most ambulatory health care settings may not be able to support separate HIV prevention programs to address these differing issues. The development of modular integrated programs that have the flexibility to address the heterogeneous presentation of mental health and substance use issues may support the functionality and sustainability of these programs. As noted by the 2 new publications in this issue of J Acquir Immune Defic Syndr., failure to address childhood trauma and posttraumatic stress in the context of HIV may well potentiate the spread of HIV and limit treatment benefits for many others.


Correspondence to: Conall O’Cleirigh, PhD, Instructor, Harvard Medical School, Associate Director, Behavioral Medicine, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 7th Floor, Boston, MA 02114 (e-mail: cocleirigh@partners.org). Copyright © 2012 by Lippincott Williams & Wilkins
J Acquir Immune Defic Syndr Volume 59, Number 4, April 1, 2012 www.jaids.com | 331 Editorial J Acquir Immune Defic Syndr Volume 59, Number 4, April 1, 2012
.

***

Optional Protocol to the Convention on the Rights of the Child: Sale of Children, Child Prostitution and Child Pornography (2002)

Article 1

States Parties shall prohibit the sale of children, child prostitution and child pornography as provided for by the present Protocol.

Article 2

For the purposes of the present Protocol:

(a) Sale of children means any act or transaction whereby a child is transferred by any person or group of persons to another for remuneration or any other consideration;

(b) Child prostitution means the use of a child in sexual activities for remuneration or any other form of consideration;

© Child pornography means any representation, by whatever means, of a child engaged in real or simulated explicit sexual activities or any representation of the sexual parts of a child for primarily sexual purposes.

Article 3

1. Each State Party shall ensure that, as a minimum, the following acts and activities are fully covered under its criminal or penal law, whether such offences are committed domestically or transnationally or on an individual or organized basis:

(a) In the context of sale of children as defined in article 2:

(i) Offering, delivering or accepting, by whatever means, a child for the purpose of:

a. Sexual exploitation of the child;

b. Transfer of organs of the child for profit;

c. Engagement of the child in forced labour;

(ii) Improperly inducing consent, as an intermediary, for the adoption of a child in violation of applicable international legal instruments on adoption;

(b) Offering, obtaining, procuring or providing a child for child prostitution, as defined in article 2;

© Producing, distributing, disseminating, importing, exporting, offering, selling or possessing for the above purposes child pornography as defined in article 2.

2. Subject to the provisions of the national law of a State Party, the same shall apply to an attempt to commit any of the said acts and to complicity or participation in any of the said acts.

3. Each State Party shall make such offences punishable by appropriate penalties that take into account their grave nature.

4. Subject to the provisions of its national law, each State Party shall take measures, where appropriate, to establish the liability of legal persons for offences established in paragraph 1 of the present article. Subject to the legal principles of the State Party, such liability of legal persons may be criminal, civil or administrative.

5. States Parties shall take all appropriate legal and administrative measures to ensure that all persons involved in the adoption of a child act in conformity with applicable international legal instruments.

Article 4

1. Each State Party shall take such measures as may be necessary to establish its jurisdiction over the offences referred to in article 3, paragraph 1, when the offences are committed in its territory or on board a ship or aircraft registered in that State.

2. Each State Party may take such measures as may be necessary to establish its jurisdiction over the offences referred to in article 3, paragraph 1, in the following cases:

(a) When the alleged offender is a national of that State or a person who has his habitual residence in its territory;

(b) When the victim is a national of that State.

3. Each State Party shall also take such measures as may be necessary to establish its jurisdiction over the aforementioned offences when the alleged offender is present in its territory and it does not extradite him or her to another State Party on the ground that the offence has been committed by one of its nationals.

4. The present Protocol does not exclude any criminal jurisdiction exercised in accordance with internal law.

Article 5

1. The offences referred to in article 3, paragraph 1, shall be deemed to be included as extraditable offences in any extradition treaty existing between States Parties and shall be included as extraditable offences in every extradition treaty subsequently concluded between them, in accordance with the conditions set forth in such treaties.

2. If a State Party that makes extradition conditional on the existence of a treaty receives a request for extradition from another State Party with which it has no extradition treaty, it may consider the present Protocol to be a legal basis for extradition in respect of such offences. Extradition shall be subject to the conditions provided by the law of the requested State.

3. States Parties that do not make extradition conditional on the existence of a treaty shall recognize such offences as extraditable offences between themselves subject to the conditions provided by the law of the requested State.

4. Such offences shall be treated, for the purpose of extradition between States Parties, as if they had been committed not only in the place in which they occurred but also in the territories of the States required to establish their jurisdiction in accordance with article 4.

5. If an extradition request is made with respect to an offence described in article

3, paragraph 1, and the requested State Party does not or will not extradite on the basis of the nationality of the offender, that State shall take suitable measures to submit the case to its competent authorities for the purpose of prosecution.

Article 6

1. States Parties shall afford one another the greatest measure of assistance in connection with investigations or criminal or extradition proceedings brought in respect of the offences set forth in article 3, paragraph 1, including assistance in obtaining evidence at their disposal necessary for the proceedings.

2. States Parties shall carry out their obligations under paragraph 1 of the present article in conformity with any treaties or other arrangements on mutual legal assistance that may exist between them. In the absence of such treaties or arrangements, States Parties shall afford one another assistance in accordance with their domestic law.

Article 7

States Parties shall, subject to the provisions of their national law:

(a) Take measures to provide for the seizure and confiscation, as appropriate, of:

(i) Goods, such as materials, assets and other instrumentalities used to commit or facilitate offences under the present protocol;

(ii) Proceeds derived from such offences;

(b) Execute requests from another State Party for seizure or confiscation of goods or proceeds referred to in subparagraph (a) (i) and (ii);

© Take measures aimed at closing, on a temporary or definitive basis, premises used to commit such offences.

Article 8

1. States Parties shall adopt appropriate measures to protect the rights and interests of child victims of the practices prohibited under the present Protocol at all stages of the criminal justice process, in particular by:

(a) Recognizing the vulnerability of child victims and adapting procedures to recognize their special needs, including their special needs as witnesses;

(b) Informing child victims of their rights, their role and the scope, timing and progress of the proceedings and of the disposition of their cases;

© Allowing the views, needs and concerns of child victims to be presented and considered in proceedings where their personal interests are affected, in a manner consistent with the procedural rules of national law;

(d) Providing appropriate support services to child victims throughout the legal process;

(e) Protecting, as appropriate, the privacy and identity of child victims and taking measures in accordance with national law to avoid the inappropriate dissemination of information that could lead to the identification of child  victims;

(f) Providing, in appropriate cases, for the safety of child victims, as well as that of their families and witnesses on their behalf, from intimidation and retaliation;

(g) Avoiding unnecessary delay in the disposition of cases and the execution of orders or decrees granting compensation to child victims.

2. States Parties shall ensure that uncertainty as to the actual age of the victim shall not prevent the initiation of criminal investigations, including investigations aimed at establishing the age of the victim.

3. States Parties shall ensure that, in the treatment by the criminal justice system of children who are victims of the offences described in the present Protocol, the best interest of the child shall be a primary consideration.

4. States Parties shall take measures to ensure appropriate training, in particular legal and psychological training, for the persons who work with victims of the offences prohibited under the present Protocol.

5. States Parties shall, in appropriate cases, adopt measures in order to protect the safety and integrity of those persons and/or organizations involved in the prevention and/or protection and rehabilitation of victims of such offences.

6. Nothing in the present article shall be construed to be prejudicial to or inconsistent with the rights of the accused to a fair and impartial trial.

Article 9

1. States Parties shall adopt or strengthen, implement and disseminate laws, administrative measures, social policies and programmes to prevent the offences referred to in the present Protocol. Particular attention shall be given to protect children who are especially vulnerable to such practices.

2. States Parties shall promote awareness in the public at large, including children, through information by all appropriate means, education and training, about the preventive measures and harmful effects of the offences referred to in the present Protocol. In fulfilling their obligations under this article, States Parties shall encourage the participation of the community and, in particular, children and child victims, in such information and education and training programmes, including at the international level.

3. States Parties shall take all feasible measures with the aim of ensuring all appropriate assistance to victims of such offences, including their full social reintegration and their full physical and psychological recovery.

4. States Parties shall ensure that all child victims of the offences described in the present Protocol have access to adequate procedures to seek, without discrimination, compensation for damages from those legally responsible.

5. States Parties shall take appropriate measures aimed at effectively prohibiting the production and dissemination of material advertising the offences described in the present Protocol.

Article 10

1. States Parties shall take all necessary steps to strengthen international cooperation by multilateral, regional and bilateral arrangements for the prevention, detection, investigation, prosecution and punishment of those responsible for acts involving the sale of children, child prostitution, child pornography and child sex tourism. States Parties shall also promote international cooperation and coordination between their authorities, national and international non-governmental organizations and international organizations.

2. States Parties shall promote international cooperation to assist child victims in their physical and psychological recovery, social reintegration and repatriation.

3. States Parties shall promote the strengthening of international cooperation in order to address the root causes, such as poverty and underdevelopment, contributing to the vulnerability of children to the sale of children, child prostitution, child pornography and child sex tourism.

4. States Parties in a position to do so shall provide financial, technical or other assistance through existing multilateral, regional, bilateral or other programmes.

Article 11

Nothing in the present Protocol shall affect any provisions that are more conducive to the realization of the rights of the child and that may be contained in:

(a) The law of a State Party;

(b) International law in force for that State.

Article 12

1. Each State Party shall, within two years following the entry into force of the present Protocol for that State Party, submit a report to the Committee on the Rights of the Child providing comprehensive information on the measures it has taken to implement the provisions of the Protocol.

2. Following the submission of the comprehensive report, each State Party shall include in the reports they submit to the Committee on the Rights of the Child, in accordance with article 44 of the Convention, any further information with respect to the implementation of the present Protocol. Other States Parties to the Protocol shall submit a report every five years.

3. The Committee on the Rights of the Child may request from States Parties further information relevant to the implementation of the present Protocol.

Article 13

1. The present Protocol is open for signature by any State that is a party to the Convention or has signed it.

2. The present Protocol is subject to ratification and is open to accession by any State that is a party to the Convention or has signed it. Instruments of ratification or accession shall be deposited with the Secretary- General of the United Nations.

Article 14

1. The present Protocol shall enter into force three months after the deposit of the tenth instrument of ratification or accession.

2. For each State ratifying the present Protocol or acceding to it after its entry into force, the Protocol shall enter into force one month after the date of the deposit of its own instrument of ratification or accession.

Article 15

1. Any State Party may denounce the present Protocol at any time by written notification to the Secretary- General of the United Nations, who shall thereafter inform the other States Parties to the Convention and all States that have signed the Convention. The denunciation shall take effect one year after the date of receipt of the notification by the Secretary-General.

2. Such a denunciation shall not have the effect of releasing the State Party from its obligations under the present Protocol in regard to any offence that occurs prior to the date on which the denunciation becomes effective. Nor shall such a denunciation prejudice in any way the continued consideration of any matter that is already under consideration by the Committee on the Rights of the Child prior to the date on which the denunciation becomes effective.

Article 16

1. Any State Party may propose an amendment and file it with the Secretary- General of the United Nations. The Secretary-General shall thereupon communicate the proposed amendment to States Parties with a request that they indicate whether they favour a conference of States Parties for the purpose of considering and voting upon the proposals. In the event that, within four months from the date of such communication, at least one third of the States Parties favour such a conference, the Secretary-General shall convene the conference under the auspices of the United Nations. Any amendment adopted by a majority of States Parties present and voting at the conference shall be submitted to the General Assembly of the United Nations for approval.

2. An amendment adopted in accordance with paragraph 1 of the present article shall enter into force when it has been approved by the General Assembly and accepted by a two-thirds majority of States Parties.

3. When an amendment enters into force, it shall be binding on those States Parties that have accepted it, other States Parties still being bound by the provisions of the present Protocol and any earlier amendments they have accepted.

Article 17

1. The present Protocol, of which the Arabic, Chinese, English, French, Russian and Spanish texts are equally authentic, shall be deposited in the archives of the United Nations.

2. The Secretary-General of the United Nations shall transmit certified copies of the present Protocol to all States Parties to the Convention and all States that have signed the Convention.