A/HRC/22/54 and the cheaper it is to support their upkeep. 28 While a young child is also seen as less likely to carry an infectious disease, there are beliefs in some cultures that one may be cured of one’s illness by having sexual relations with a virgin. 38. Families most at risk include those living in extreme poverty with no access to health care, education and the labour market, those dependent on seasonal economies or those from minority groups. Push factors within the family may include alcoholism and other addictions, unemployment, illnesses, domestic violence, single parent families, debts and migration from rural to city areas. Families may themselves promote the exploitation of the child, expecting him/her to help provide for the family, while both exploiters and paedophiles may easily deceive them by offering quick money and a supposedly better future for their children. In the worst cases, neighbours, friends and even close relatives consciously sell these children to be exploited. 39. Risk factors linked to the environment include the lack of understanding and respect for human rights (women and children in particular), dependency on international tourism as income source, the high number of vulnerable children and consumerism. These factors create a foundation for this type of abuse. More specific risk factors include the demand (including from locals), existing infrastructure providing sexual services, weakness or insufficiency of national legislation regarding the prohibition and prevention of and the protection of children from all forms of sexual exploitation (including CST). The fact that extraterritoriality is not established, the lack of prosecutions because of corruption and impunity and the low pay and lack of training of police also have a negative impact. The weakness or insufficient regulation and monitoring of travel and tourism, the lack of involvement of tourism and travel services, the fear of HIV/AIDS, weak legal frameworks, implicit social tolerance on the issue and the existence of criminal networks also considerably increase the risks of sexual exploitation of children. C. Responses to combat child sex tourism 40. Efforts have been made by Governments, international agencies, the travel and tourism industry, national and international non-governmental organizations (NGOs) and research centres to prevent and combat the issue. While few countries openly tackling the issue provided feedback for this report, it can be noted that most elements provided by States related to the fight against trafficking. 1. Legislative and regulatory framework 41. While all but two States29 have ratified the Convention on the Rights of the Child, an instrument which provides legal accountability for the protection of children from all forms of sexual exploitation, their commitment applies to all children, not just those within their jurisdiction. By ratifying the Convention, States commit to undertaking national, bilateral and multilateral measures to prevent the exploitative use of children in prostitution and other unlawful sexual practices. 42. By ratifying the Optional Protocol on the sale of children, child prostitution and child pornography, 161 States have strengthened this commitment. Sex tourism involving children is directly linked to the offences covered by the Optional Protocol, since it involves child prostitution and child pornography and may also involve the sale of children. 28 29 10 ECPAT International, Sexual Exploitation, p. 8. The United States of America and Somalia have not yet ratified the Convention.