Survivors Of Sex Trafficking Research Articles

Child sex trafficking: A model of survivor inclusion and survivor-informed practice

Survivor inclusion is a fundamental component to the success of efforts to combat child sex trafficking. Recognizing, honoring, and leveraging the wisdom that comes from lived experience with adversity, and centering the voices of survivors of sex trafficking, can help to balance power relations and inform more effective interventions. This critical discussion article responds to appeals for meaningful and ethical engagement of survivor leaders in program development, implementation, and evaluation. We propose a trauma-informed, anti-oppressive, empowerment-based model of survivor inclusion and survivor-informed practice grounded in guiding principles and practice strategies derived from lived experience. This work emerged from a unique collaboration between a diverse group of survivor advisors and pediatric health care program specializing in child sex trafficking. It serves as a survivor-led resource for anti-trafficking and child maltreatment organizations across sectors as they move toward building survivor-centered approaches to care for children exposed to sex trafficking.

Power and Control Dynamics in Domestic Sex Trafficking: A Systematic Review

ABSTRACT U.S. citizens sex trafficked domestically (survivors of domestic sex trafficking, or SDSTs), a population comprising many cisgender women and girls, encounter complex power and control dynamics. The field of anti-sex trafficking research appears neither well-grounded in theory nor consistent in addressing the macro-level systems supporting sexual exploitation. The review objectives are to explore the application of the theory in studies with SDSTs that focus on the power and control dynamics and examine any patterns that may emerge across studies regarding theories and mechanisms used to explain these dynamics. Four electronic databases were systematically searched for research articles on power and control dynamics experienced by SDSTs identifying as cisgender women and girls. Eight studies, published between October 2000 and December 2023, in English-language peer-reviewed journals, met inclusion criteria. Criminological frameworks and the theory of coercive control were identified most frequently in included studies. Two quantitative studies used individualistic explanatory mechanisms, with the remaining six (two mixed methods and four qualitative studies) split evenly between a “middle ground” and using structural explanatory mechanisms. There was no discernible pattern of guiding theories and explanatory mechanisms; however, the synthesized findings offer research and social justice implications for promoting a more just and inclusive society.

Narrative exposure therapy for the treatment of trauma-related symptoms among adolescent survivors of sex trafficking: A pilot study

Background: India is home to 14 million survivors of human trafficking, with most being trafficked for sexual exploitation. Trafficking constitutes crimes that violate the rights of survivors, and despite its psychological consequences, there is little evidence-based guidance to meet the needs of these individuals. Aim: The current study aimed to examine the outcome of narrative exposure therapy (KIDNET) among adolescent survivors of sex trafficking in improving trauma-related symptoms, along with psychological distress, dissociation, depression, and anxiety. Methods: A pre-post study design was used with 20 adolescent female survivors of trafficking aged 13 to 17 years, with ten participants in the KIDNET group and ten participants in a waitlist control group. Trafficking Victim Identification Tool and Standard Progressive Matrices were administered as screening measures. The Clinician-Administered PTSD Scale for Children and Adolescents, Kessler’s Psychological Distress Scale, Shutdown Dissociation Scale, Patient Health Questionnaire, and Beck Anxiety Inventory were administered as outcome measures. Fourteen sessions of KIDNET were conducted for the clinical group, while sessions were conducted for the control group post delivery of intervention for the clinical group. Results: Findings suggest an overall improvement in the severity of trauma-related symptoms in the KIDNET group, with significant improvement in psychological distress, depression, and anxiety. Conclusion: Results indicate that KIDNET may be a promising and acceptable treatment for adolescent survivors of sex trafficking, and this intervention module may be safely delivered in further randomised controlled trials to ensure that the holistic needs of this vulnerable group are appropriately addressed.

Integrating pastoral care and appreciative inquiry for sex trafficking survivors: A framework for healing

Integrating appreciative inquiry (AI) and pastoral care may help address the complex issues of commercial sexual exploitation and sex trafficking. This article explores the benefits of incorporating AI principles into pastoral care for survivors of commercial sexual exploitation and sex trafficking. Commercial sexual exploitation and trafficking involve exploitation, degradation, and violence, making them complex issues. By understanding the sex trade, we can recognise that prostitution is an act of exploitation. Some scholars believe that prostitution and human trafficking are interconnected, with a focus on exploiting the poor, especially women and children. Commercial sexual exploitation can cause mental, emotional, and spiritual distress. Survivors require comprehensive aftercare to address their spiritual, self-esteem, and dignity needs. Organisational development-based AI is constructive and strength-based. Appreciative inquiry promotes positive development, community and individual strength, and resilience by re-contextualizing narratives and envisioning brighter futures. The use of AI could improve pastoral care and holistic rehabilitation. Pastoral caregivers using AI can promote reconciliation, development, and rehabilitation. Using strengths-based strategies, pastoral care practitioners can help survivors regain agency and purpose. Survivors receive spiritual support through the Appreciative Way, which combines contemplative spirituality and inquiry. Narrative exploration can help trauma survivors envision a bright future based on love and resilience. This study suggests that AI principles may benefit pastoral care recipients who have experienced commercial sexual exploitation and sex trafficking. Pastoral caregivers can help survivors regain dignity, calling, and well-being by implementing an appreciative healing approach.Contribution: The article sheds light on the dehumanising consequences of sex trafficking on vulnerable populations in South Africa, particularly women and children. This article aims to explain how AI concepts can be applied to Practical Theology. Specifically, this article will demonstrate how the Appreciative Way can be utilised in pastoral care for healing from sex trafficking trauma.

"It's Not Love, Baby Doll. It's Science": Experiences of Trauma Bonding Among Survivors of Sex Trafficking.

Trauma bonds between sex trafficking survivors and their traffickers or other perpetrators are one of the most complex and least understood concerns facing survivors. This community-based participatory research phenomenological study sought to understand how survivors have experienced trauma bonding. The sample consisted of 19 female survivors who were all participants in or graduates of a human trafficking specialty docket. Two themes emerged from the data. The first theme is the source of the trauma bond, namely who survivors had trauma bonds with. The second theme is features of trauma bonds, which included three subthemes: survivors have experienced trauma bonds (a) as involuntary, (b) as having lingering power, and (c) as consisting of both love and hate. These findings contain significant implications for practice, policy, and future research.

Emotion regulation reduces victim blaming of vulnerable sex trafficking survivors.

This research applied emotion regulation to negative emotions felt toward a sex trafficking victim so that judgments were made to offer her services rather than to favor her arrest for prostitution. We predicted that participants would favor police not arresting a trafficking survivor for prostitution when she was vulnerable (Hypothesis 1) or she showed no sex work history (Hypothesis 2). We predicted a moderated mediation model (Hypothesis 3), in which emotion regulation training to reduce feelings of contempt, anger, and disgust (CAD) toward the survivor interacted with vulnerability and prior sex work such that the effects of the latter two manipulations were the strongest in the successful emotion regulation conditions (i.e., cognitive reappraisal and cognitive reappraisal with motivation), with CAD emotions mediating those relationships. Participants (N = 421, 54% women, Mage = 42.63 years, 75% White) read a modified version of a sex trafficking case and decided whether the police should arrest the survivor for prostitution. Each participant was randomly assigned to one of 16 conditions in a 4 (emotion regulation: control vs. cognitive reappraisal vs. motivation vs. cognitive reappraisal plus motivation) × 2 (vulnerability: vulnerable background vs. nonvulnerable background) × 2 (prior prostitution history: engaged in prostitution before the trafficking incident vs. not engaged in prostitution before the incident) factorial design. Participants with cognitive reappraisal training, but not controls, who read about a vulnerable survivor were less likely to favor arrest. Moreover, those who trained with cognitive reappraisal plus motivation to decrease their CAD emotions, compared with the controls, showed weaker CAD feelings toward the vulnerable survivor, which in turn predicted a lower probability of favoring arrest. Reducing CAD emotions through emotion regulation supported the impact of emotions on culpability judgments and showed how emotion regulation can be used to support a victim-centered approach to fighting sex trafficking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Understanding the Retrospective and Current Health Care Needs and Service Experiences of Adult Survivors of Minor Sex Trafficking

Minor sex trafficking is an urgent public health problem, but we lack data about how such experiences impact health and health care access. Utilizing data collected from in-depth interviews with 35 adult survivors of minor sex trafficking across the U.S. we explored the physical and psychological healthcare access and healthcare experiences of adult survivors of minor sex trafficking. Negative healthcare experiences before, during, and following sex trafficking foster a lack of trust and confidence in healthcare systems as adults. Recommendations are provided to help overcome barriers to meeting healthcare needs and improving health care experiences for survivors of minor sex trafficking.

Lessons from the Teca Ho/New Voices Project on Best Practices for Interviewing Native Youth Survivors of Sex Trafficking

Although there are high rates of commercial sexual exploitation of Native American children, there are still not established best practices for interviewing them about their experiences. This pilot study sought to learn more about best practices for interviewing Native including gender diverse youth in the United States about sex trafficking. In the process, lessons were learned about conducting this kind of research. The initial practices suggested included ways of linking with participants, incorporating culturally-specific healing elements, orienting clinicians to cultural humility and agility, and preparing to provide a clear rationale for how and why the information learned would be disseminated.

Projecting the Potential Clinical and Economic Impact of Human Immunodeficiency Virus Prevention Resource Reallocation in Tennessee.

In 2023, Tennessee replaced $6.2 M in US Centers for Disease Control and Prevention (CDC) human immunodeficiency virus (HIV) prevention funding with state funds to redirect support away from men who have sex with men (MSM), transgender women (TGW), and heterosexual Black women (HSBW) and to prioritize instead first responders (FR), pregnant people (PP), and survivors of sex trafficking (SST). We used a simulation model of HIV disease to compare the clinical impact of Current, the present allocation of condoms, preexposure prophylaxis (PrEP), and HIV testing to CDC priority risk groups (MSM/TGW/HSBW); with Reallocation, funding instead increased HIV testing and linkage of Tennessee-determined priority populations (FR/PP/SST). Key model inputs included baseline condom use (45%-49%), PrEP provision (0.1%-8%), HIV testing frequency (every 2.5-4.8 years), and 30-day HIV care linkage (57%-65%). We assumed Reallocation would reduce condom use (-4%), PrEP provision (-26%), and HIV testing (-47%) in MSM/TGW/HSBW, whereas it would increase HIV testing among FR (+47%) and HIV care linkage (to 100%/90%) among PP/SST. Reallocation would lead to 166 additional HIV transmissions, 190 additional deaths, and 843 life-years lost over 10 years. HIV testing reductions were most influential in sensitivity analysis; even a 24% reduction would result in 287 more deaths compared to Current. With pessimistic assumptions, we projected 1359 additional HIV transmissions, 712 additional deaths, and 2778 life-years lost over 10 years. Redirecting HIV prevention funding in Tennessee would greatly harm CDC priority populations while conferring minimal benefits to new priority populations.

Barriers and Facilitators of Treatment Engagement: Perspectives Shared by Survivors of Adolescent Sex Trafficking and Experienced Clinicians

Barriers and Facilitators of Treatment Engagement: Perspectives Shared by Survivors of Adolescent Sex Trafficking and Experienced Clinicians

Judgments of sex trafficked women: The role of emotions.

This study examined how incidental emotions influence decisions to arrest or release sex trafficking survivors. Community members (N = 984) completed an autobiographical memory task invoking disgust, sympathy, or no emotion and read case facts from United States v. Bell (2014) varying whether the survivor had a prior history of sex work and whether she came from a vulnerable or nonvulnerable background. Participants in the vulnerable condition believed that the survivor was less able to resist the trafficker's proposal. Furthermore, women but not men made to feel disgust believed that she should have resisted. Regarding arresting the survivor for prostitution versus releasing her for services, invoking either incidental disgust or sympathy, but especially disgust, triggered feelings of disgust, which in turn predicted an arrest decision. Finally, our data supported a moderated mediation model in which the belief that the survivor should have been able to resist the trafficker predicted a greater probability of an arrest judgment. Furthermore, participants in the vulnerable condition believed that the survivor had less ability to resist, and they disfavored her arrest. However, this was only true when we invoked no emotion. When we invoked disgust, vulnerability ceased to have this moderation effect. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"I Had to Allow Myself to Heal": How Survivors of Sex Trafficking Have Experienced Healing From Trauma Bonding.

Among the many issues facing sex trafficking survivors, the trauma bonds they develop with their perpetrators are one of the most complex and least understood concerns. This community-based participatory research phenomenological study explored this phenomenon by asking: How have survivors of sex trafficking experienced healing from trauma bonding? The sample consisted of 19 female survivors who were all participants in or graduates of a human trafficking specialty docket. Three themes emerged: survivors shared that (a) building trusting and honest relationships, (b) their relationships with themselves, and (c) education all played a pivotal role in the healing they had experienced.

Predatory Helpfulness: A Replication (and Expansion) Study Examining Grooming and Recruitment Tactics in Sex Trafficking

ABSTRACT Sex trafficking occurs when a trafficker uses force, fraud, or coercion to trap their victim into exploitative commercial sex work. Focusing on the fraud and coercion, Basra et al. proposed a new framework, Predatory Helpfulness, which consists of a two-prong process of both a grooming stage priming the victim for seduction, and a recruitment stage which activates the victim into exploitative commercial sex. The Predatory Helpfulness framework provides cohesive terminology with which to organize, assess, and understand how traffickers form relationships with their intended victims. The current study used qualitative methods to evaluate the application of the Predatory Helpfulness framework in a geographically and ethnically diverse sample of sex trafficking survivors (n = 59). Participants were recruited both within the domestic United States and internationally. Results showed strong support for the presence of Predatory Helpfulness tactics. Specifically, 58 of the 59 participants described experiences matching Predatory Helpfulness tactics in both the grooming and recruitment stages; 50 of the 59 participants also spontaneously identified a relational shift that occurred between the grooming and recruitment stages. Additionally, findings support the idea that traffickers are far more likely to prevail upon those in crisis via multiple grooming tactics, and to do so quickly (i.e. move to shift the relationship into exploitation within six months). In sum, Predatory Helpfulness offers a clear way for legal actors to identify sex trafficking victims using both the federal legal definitions and survivors’ own language and narratives.

The Reconsecration of the Self: A Qualitative Analysis of Sex Trafficking Survivors' Experience of the Body.

The understudied bodily harm women experience after commercial sex (CS) may be partially explained by the prominence of Cartesian mind-body dualism in psychological science. Accordingly, we qualitatively explored the mind-body relationship among 79 female sex trafficking survivors. Survivors reported long-term negative alterations in feelings about the body, sex, and physical touch posttrafficking and these negative outcomes did not differ across women who self-perceived as consenting and women who self-perceived as forced. Implications for future research are presented, particularly on measuring dehumanization in CS which contributes to extensive harm even in the absence of physical aggression.

The Human Rights of Sex Trafficking Survivors: Trends and Challenges in American Vacatur Laws

For years, survivors of sex trafficking, people compelled by force or circumstance to engage in sex acts, were often wrongly convicted of prostitution and many collateral crimes in the United States. These convictions became a permanent part of survivors’ criminal records, inhibiting their ability to satisfy necessities for a dignified life—finding work and a place to live, or going to school. Since 2010, forty-five state legislatures across the US have sought to solve this problem by passing vacatur laws. These laws allow the survivors of sex trafficking a means to erase certain charges and convictions from their records. The American movement to support the human rights of sex trafficking victims is part of a larger, global non-criminalization movement to support survivors’ human rights. This article surveys the recent and robust diffusion of American vacatur laws, situates them amidst the larger, global non-criminalization movement, and highlights both the strengths and weaknesses of the current US vacatur laws with an eye toward closing the rights gap for sex trafficking survivors. We argue that extant vacatur legislation should be expanded to include all crimes traffickers compel victims to commit, should incorporate trauma-informed means for establishing victimhood, and should be passed at the federal level to ensure complete and uniform protection.

Systematic Review of Competencies for Counseling Survivors of Sex Trafficking

ABSTRACT Increasing numbers of survivors of sex trafficking are seeking mental health treatment, yet no frameworks currently exist to guide counseling practice with this specific client population. To address this need, we conducted a systematic review to understand which specific awareness, knowledge, skills, and actions are indicated as competencies for mental health professionals to possess when working with survivors. We analyzed 34 relevant articles published between 2010–2021 from peer-reviewed journals and analyzed themes via qualitative content analysis. We identified 33 competencies within the literature, which we organized via axial coding into the a priori domains of awareness (four competencies), knowledge (11 competencies), skills (15 competencies), and actions (three competencies). We reflect on these competencies to provide suggestions for mental health professional preparation and training alongside recommendations for future research, with the intent to support progress toward UN Sustainable Development Goal 16: Promoting just, peaceful, and inclusive societies.

He's to blame, she is lying: Judgments of child sex trafficking survivors

AbstractUS Federal legislation mandates the treatment of underaged youth induced to sell themselves for commercial sex as victims and not criminal offenders of prostitution laws. Nonetheless, state prosecutors often take action in juvenile court against these youth. This study explored the impact of negative moral emotions, victim blame, and victim believability on public judgments of child sex trafficking victims under varying case facts. We presented an online scenario involving a trafficking case to 682 participants and manipulated youth sex, trafficker sex, vulnerability background, and prior arrest history to determine how emotions, victim blame, and believability mediate child sex trafficking decisions. Two different paths emerged depending on the youth's sex. Participants reported greater victim responsibility and greater negative moral emotions towards a male youth trafficked by a female when he had a prior commercial sex arrest, which in turn predicted a lower certainty of recommending social services over legal consequences. With the same facts, participants reported lower believability for a female youth when she had a prior commercial sex arrest, which in turn predicted a lower certainty of recommending social services over legal consequences. The paper ends with a discussion of the implications of the findings for practice and theory.

Validation of the Trauma Bonding Scale for Adults© in Kenya.

Recently validated among a sample of young adults in the United States, the Trauma Bonding Scale for Adults© is a much-needed instrument for assessing trauma bonding, which refers to the emotional attachment that often develops between perpetrators and victims of violent and exploitive crimes and is common among survivors of sex trafficking. To assess its utility with other populations, this study aimed to validate the Trauma Bonding Scale for Adults© with a sample of young adults in Kenya. An anonymous survey containing demographic items, the Trauma Bonding Scale for Adults©, and 12 items from an open-source measure of posttraumatic stress disorder was administered to 538 young adults aged 18 to 29 in Kenya using Qualtrics XM. Findings from an analysis of psychometric properties suggest that the Trauma Bonding Scale for Adults© is a valid and reliable measure of trauma bonding that may be useful in a global context.

Empowerment or Exploitation? Ethical Engagement of Survivor Leaders in Anti-Trafficking Organizations

In recent years, anti-trafficking organizations have increased the use of survivor voices in fundraising, direct service, and leadership. While empowerment is the goal, tokenism can be the outcome when organizations do not engage survivors ethically. This integrative literature review article provides an overview of the research on engagement of sex trafficking survivors in organizations leading anti-trafficking efforts in the United States and summarizes findings to emphasize ethical engagement practices from an organizational culture perspective. Overall, it is recommended that organizations ethically engage survivors in a variety of roles within the organization. To do this well, organizations should create opportunities for professional capacity building, enhancement of survivor leadership roles and responsibilities, and adoption of a trauma-informed and survivor-informed organizational culture to empower survivors.

965. Projecting the Potential Clinical and Economic Impact of HIV Prevention Resource Reallocation in Tennessee

Abstract Background In 2023, the State of Tennessee rejected $6.2M in US Centers for Disease Control and Prevention (CDC) HIV prevention funding, redirecting support away from men who have sex with men (MSM), transgender women (TGW), people who inject drugs (PWID), and heterosexual Black women (HSBW), and towards first responders (FR), pregnant people (PP), and survivors of sex trafficking (SST). Methods We used a microsimulation model of HIV to compare the clinical impact of Current, present allocation of condoms, pre-exposure prophylaxis (PrEP), and HIV testing to CDC priority risk groups (MSM/TGW/PWID/HSBW); with Reallocation, diverting funds to increase HIV testing and linkage of Tennessee-determined priority populations (FR/PP/SST). We simulated Tennesseans with undiagnosed and incident HIV. Model inputs included condom use (45-67%), PrEP use (0.2-8%), HIV testing frequency (every 2.5-4.8 years), and 30-day linkage to HIV care (56-65%). We assumed Reallocation would reduce condom use (-4%), PrEP provision (-26%), and HIV testing (-47%) in MSM/TGW/PWID/HSBW while it would increase HIV testing among FR (+47%) and 30-day linkage to HIV care (to 100%/90%) among PP/SST; we varied these assumptions in sensitivity analyses. We conservatively assumed no impact of Reallocation on people with HIV already in care. 10-year model outcomes included HIV transmissions, numbers diagnosed and virologically suppressed, deaths, life-years lost, and cost/death averted. Results Over 10 years, Current would lead to 6,678 total HIV transmissions, 1,989 deaths, and 85,270 life-years in Tennessee (Table 1). Reallocation would lead to 178 additional HIV transmissions, 219 additional HIV deaths, and 985 more life-years lost; more people would be undiagnosed and fewer would be virologically suppressed (Figure 1). Under Current, Tennessee would spend $263,830/death averted; under Reallocation, $4,133,330/death averted, a 1,470% increase in cost/death averted (Table 2). Results were most sensitive to reductions in HIV testing rates under Reallocation.Figure 1.Number of simulated people with HIV in Tennessee who have undiagnosed HIV, compared to people who have diagnosed HIV and are virologically suppressed at 10 years Figure 1 presents the projected number of people with HIV across each risk group who are undiagnosed (light shade) compared to those who are diagnosed and virologically suppressed (dark shade) at 10 years under the Current (blue) and Reallocation (gray) scenarios. Under Current, there are fewer total people with undiagnosed HIV, and more people with diagnosed HIV at year 10 compared with Reallocation. Reallocation does increase the number of people with HIV who are virologically suppressed amongst first responders, pregnant people, and survivors of sex trafficking; however, the increase is relatively small compared to the decrease in virologic suppression among men who have sex with men, transgender women, people who inject drugs, and heterosexual Black women. *Survivors of sex trafficking are assumed to be diagnosed when freed from sex trafficking in Current and Reallocation, but in Reallocation the linkage to HIV care is assumed to increase from 56% to 90%. Conclusion Reallocation of HIV prevention funding in Tennessee would greatly harm MSM/TGW/PWID/HSBW, confer minimal benefits for FR/PP/SST, and cannot be justified on either clinical or epidemiological grounds. Disclosures Allison Agwu, MD, MSc, Gilead: Board Member|Gilead: Grant/Research Support|Merck: Advisor/Consultant|Merck: Grant/Research Support|ViiV: Board Member