The phrase "child sex trafficking" usually conjures images of brothels that prostitute children in places like Bangkok and Rio de Janeiro. And that's an impediment to curbing the trafficking here, organizations that work with trafficking victims say.

Law enforcement agencies have only recently begun to improve training in investigating child sex trafficking, said Elizabeth Scaife, a program associate with Shared Hope International, an anti-sex-trafficking nonprofit. And most people still don't recognize the signs of trafficking situations and are often hesitant to report something that seems out of place for fear of making a false report.

"That lack of awareness and understanding of the issue is part of the reason that it thrives," she said.

There's simply a reluctance to accept that children in this area are victims of sex trafficking, said Jeanne Allert, executive director of The Samaritan Women, which runs the Maryland Rescue and Restore Coalition on human trafficking.

"People don't believe it happens in the States, let alone in Maryland," Allert said. Her organization is working with groups who are likely to encounter victims -- such as nurses, pastors, teachers and coaches -- to help them learn about sex trafficking and know how to respond.

Law enforcement officials, for their part, say they're increasing training efforts.

U.S. Attorney for Maryland Rod Rosenstein said his state's human trafficking task force has focused on training investigators who first interact with child prostitutes to treat them as victims, not criminals, and to follow up on cases to prosecute the traffickers.

-Emily Babay