Trafficking Survivors Research Articles

The Impact of COVID-19 on Survivors of Human Trafficking in Kenya: A Participatory Approach

The Impact of COVID-19 on Survivors of Human Trafficking in Kenya: A Participatory Approach

Violence predicts physical health consequences of human trafficking: Findings from a longitudinal study of labor trafficking in Ghana

Research consistently finds high rates of both poor physical health and violent victimization among survivors of human trafficking. While this literature documents the immediate effects of human trafficking on health, no published literature has compared short- and longer-term physical health consequences of trafficking or examined the role of violence in shaping physical health outcomes across the period of reintegration. Here, we utilize longitudinal data to document the prevalence of various forms of violence experienced by women and girls trafficked for labor in Ghana, as well as examine the effects of violence on self-reported physical health conditions at two time points following exit from trafficking. Consistent with the stress process model, we find a higher prevalence of physical health complaints during the second wave of data collection, suggesting a delayed somatization effect. We also find that while psychological violence has a strong effect on the number of physical health complaints in the period immediately after exit from trafficking, sexual violence experienced while being trafficked is most predictive of physical health complaints later in the reintegration period. These findings have implications for understanding the role of violence, more generally, in shaping physical health. Our research also suggests the importance of monitoring the physical health of trafficking survivors beyond the immediate post-trafficking period and of providing on-going access to healthcare.

Shelter-based services for survivors of human trafficking in Cambodia: Experiences and perspectives of survivors

In Southeast Asia, services for survivors of human trafficking have historically been centralized within shelter programs. Minimal research has, however, been conducted regarding trafficking-specific shelters, particularly research that highlights the perspectives of survivors themselves. This manuscript presents the perspectives of survivors of human trafficking and sexual exploitation on their own experiences pertaining to trafficking-specific shelter services. We analyzed data from the Butterfly longitudinal research (BLR) study, a 10-year longitudinal study exploring the lives, trajectories, and viewpoints of survivors of human trafficking and sexual exploitation in Cambodia. We analyzed 236 in-depth interviews and narrative summaries of interviews conducted between 2011 and 2016 using an interpretive phenomenological approach ( n = 79). Four themes were identified: feeling privileged to live in a shelter; lacking freedom and feeling imprisoned by rules; limited engagement with family; and mixed experiences with counseling. Findings inform critical recommendations for implementing trauma-informed care and strengthening mental health services for survivors, including services provided within shelter programs and within the anti-human trafficking movement more broadly.

Responding to the mental health needs of trafficked women

BackgroundStudies suggest a high prevalence of depression and PTSD among survivors of human trafficking in contact with shelter services. However, evidence for interventions to support the recovery of survivors of trafficking is lacking. The broader literature on PTSD and depression indicates that ongoing social stressors can exacerbate and perpetuate symptoms. Advocacy-based, or “casework”, interventions, which address current stressors and social support, may represent a promising avenue of enquiry. Objectives (1) Describe risk and protective factors for mental distress among trafficked people; (2) Present a preliminary theory of change describing how advocacy-based interventions may contribute to an improvement in mental health and wellbeing among survivors of human trafficking.Methods(1) Survey of adult male and female survivors of trafficking in contact with shelter services in England; symptoms of depression, anxiety, and post-traumatic stress disorder were measured using the PHQ-9, GAD-7, and PCL-C. (2) Theory of change workshop and review of intervention studies that assessed the effectiveness of casework, client support, or advocacy interventions delivered in health or community settings to survivors of trafficking or vulnerable migrants.Results150 survivors of trafficking participated in the survey, 98 women and 52 men. In multivariate analyses, psychological distress was associated with higher number of unmet needs and lacking a confidante, suggesting that practical and social support is important in facilitating mental health recovery. The theory of change identifies common components in advocacy interventions delivered to survivors of trafficking, and proposes pathways by which these components contribute to improved mental health.DisclosureNo significant relationships.

Of Vulnerability and Agency: Perspectives from Survivors of Sex Trafficking in India

The recent Anti-Trafficking Bill in India (2018) has received considerable criticism for perpetuating a paternalistic attitude towards victims of sex trafficking. Scholars, activists and legal experts have pointed out the failure of the Act to recognise the agency of trafficked girls and women. In thinking about victimhood and agency, we draw attention to the need for thinking of ‘vulnerability’ in terms of complex intersectional processes and situations that render certain persons more vulnerable to trafficking. This article delves into contexts and vulnerabilities in the process of trafficking by drawing on women’s narratives about the lived experiences of sex trafficking. It is based on a qualitative field study through in-depth interviews of 51 survivors of sex trafficking who were sheltered in government and non-government organisations in the cities of Chennai and Hyderabad.

Strengthening Services for Survivors of Human Trafficking: Recommendations from Survivors in Cambodia

ABSTRACT Survivors’ voices have historically been excluded from research on human trafficking. Although research on the importance of survivor voice is growing, minimal research has explored survivors’ own perspectives on their experiences in anti-human trafficking programming and their recommendations for strengthening services. In this manuscript, we share recommendations from survivors of human trafficking and sexual exploitation for improving direct services in the anti-human trafficking movement. We analyzed data from the Butterfly Longitudinal Research (BLR) study, a 10-year longitudinal study committed to centering the voices and exploring the lives and trajectories of survivors of human trafficking and sexual exploitation in Cambodia. We analyzed 362 interviews and narrative summaries of interviews conducted from 2011 to 2016 (n = 111). This manuscript presents a series of recommendations from BLR participants which have been categorized into four thematic areas: promote survivor agency and adopt an empowerment-based approach, ensure shelters are responsive to the needs and priorities of survivors, foster healthy engagement between staff and survivors, and strengthen re/integration support and community-based services. Participants’ recommendations are consistent with human rights-based and trauma-informed approaches, while simultaneously raising new considerations. This paper provides a novel contribution to the sector and reinforces the heightened call to genuinely and diligently include survivor voices in all aspects of anti-human trafficking organizations’ decision-making processes.

A Pilot Study Comparing Sex Trafficking Indicators Exhibited by Adult and Minor Service Populations

ABSTRACT Indicators of sex trafficking are widely disseminated by organizations in the criminal justice, social service, healthcare, and community sectors. Drawing from a larger pilot study examining survey responses of providers working with sex trafficking survivors (N = 86), the present study specifically examines providers’ observations of 62 sex trafficking indicators comparing minor and adult service populations (n = 47) in a Midwestern metropolitan area. Respondents indicated how commonly such indicators appeared among their service populations. Robust MANOVA identified a significant effect of age group on five out of the six domains of indicators. Univariate Mann-Whitney tests showed that overall there were few differences in observed indicators comparing adults and minors, yet participants reported significant differences for several mental health indicators. Median responses similarly showed overlap as well as differences in observed indicators among adult and minor service populations. Implications for further research examining indicators with the aim of improving identification, screening questions, and practice are provided.

Call to Freedom: A Promising Approach to Supporting Recovery among Survivors of Sex Trafficking

ABSTRACT Researchers and practitioners have expressed an urgency to identify effective strategies for treating the complex needs of sex trafficking survivors. However, to date, we know very little about what types of services are most effective in promoting recovery among this population. The purpose of this article is to provide an overview of Call to Freedom, a highly promising program based in Sioux Falls, South Dakota (SD) that provides comprehensive, ongoing, and coordinated service to sex trafficking survivors. Grounded in survivor-centered and trauma-informed principles, Call to Freedom provides survivors with various on-site services such as case management, occupational therapy, and transitional housing in addition to connecting survivors to community-based agencies that provide various services (e.g., mental health care, medical/dental services, legal services). Call to Freedom also ensures that community partners are trained in trauma-informed practices to enhance the effectiveness of their work with survivors of sex trafficking. Moreover, Call to Freedom engages in legislative advocacy to decriminalize illegal activities in which survivors may have engaged while being trafficked and mandate tougher penalties for perpetrators of trafficking. Call to Freedom’s work is survivor-centered; all services are voluntary and individualized based on survivors’ needs with the ultimate goal of navigating their journey to freedom. Plans for conducting a rigorous evaluation of the Call to Freedom service model are discussed as well as suggestions for other communities wishing to provide comprehensive, ongoing, and coordinated service to sex trafficking survivors.

The Journey through Sex Trafficking, Motherhood, and Building Resilience: A Qualitative Study among Women Living in Kamathipura Red-light Area

ABSTRACT Within the red-light area of Kamathipura in Mumbai, India, the majority of female sex workers (FSWs) arrive as victims of sex trafficking. Many of these FSWs are mothers who must care for their children amongst multiple challenges including those associated with sex work and their traumas from the past. This research explores the experiences of survivors of sex trafficking who are currently FSWs through a resilience lens. In-depth interviews were held with 14 FSWs in Kamathipura. Data analysis consisted of inductive coding to identify categories and themes. Three themes were identified through the resilience lens: autonomy, affinity, and aspirations. Participants displayed autonomy through their resistance to committing to a partner, taking care of themselves, and focusing on their children. Participants also demonstrated affinity through the development of trusting relationships with other FSWs, landlords, and brothel owners. Aspirations focused on their children and positive outlooks for their futures. Overall, though these FSWs have experienced trauma and abuse from being trafficked, they demonstrated resilience within their lives. Through these findings, greater awareness about resilience and strengths-based approaches can develop more culturally responsive policies, practices, and future research.

Mental health needs of sex trafficking survivors in New York City: Reflections on exploitation, coping, and recovery.

Objective: It is increasingly acknowledged by academics, practitioners, and policymakers that sex trafficking can lead to various mental health sequelae, such as depression, anxiety, and trauma symptoms, and have lasting effects on the survivors' health and well-being. What has been lacking in this dialogue, however, are the firsthand stories of survivors. This qualitative, exploratory study was designed to capture the depth and complexity of survivors' lived experiences of mental health, pathways of recovery, and social reintegration posttrafficking. Method: Six female sex trafficking survivors were recruited for this study in partnership with two legal agencies in New York City. In-depth semistructured individual interviews were conducted with each survivor, and an interpretative phenomenological analysis method was used to analyze and interpret interview transcripts. Results: Participants shared about the chronic betrayal and violence in their trafficking experiences, struggles living with the effects of trafficking on their mental health, how they cope, and their recommendations for supporting other sex trafficking survivors. Practitioners are urged to build trust, address safety and shame, foster agency, avoid judgment, and develop unique knowledge and skills important for this population. Conclusion: These findings attempt to address a crucial gap in the field by amplifying survivor voices, providing valuable insights for practitioners working with this population, and paving the way for further research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A qualitative interpretive meta-synthesis of evangelical Christian sex trafficking narratives

ABSTRACT The purpose of the present qualitative interpretive meta-synthesis (QIMS) is to explore, categorize, and confront one of the powerful narratives present within the counter-trafficking movement—that of evangelical Christian communities in the United States. The authors focused on the analysis of scholarly ethnographies and autoethnographies (N=7) of the evangelical Christian counter-trafficking culture. The QIMS yielded four themes that can be used to explain and categorize the denouement that is often visible in evangelical sex trafficking narratives, including 1) the perfect victim, 2) sexual objectification, 3) rescue for a greater purpose, and 4) co-optation of narratives. Results of this study point to how laypeople, social workers, and professional activists can shape and promote survivor-centered narratives that more fully advance the human rights of sex trafficking survivors.

“They Did Not Pay Attention or Want to Listen When We Spoke”: Women’s Experiences in a Trafficking-Specific Shelter in Cambodia

Human trafficking is a global challenge that violates fundamental human rights. While the risk factors and health impacts of human trafficking have been well documented, the potential for survivors’ resilience is far less understood. In Southeast Asia, the majority of trafficking-specific services have historically been concentrated in shelters, and yet evidenced-based protocols for shelter services are lacking. This study aligns with the growing literature that emphasizes the importance of feminist and trauma-informed services to support the long-term well-being of survivors of human trafficking. Drawing on qualitative data collected over a 6-year period, the analysis foregrounds the lived experiences and perspectives of 10 women who resided in the same trafficking-specific shelter. Six core themes emerged: being labeled as a victim of human trafficking despite contesting this classification, feeling forced to live in the shelter, a strong desire to leave the shelter environment, disempowering engagement with staff, lack of professionalism among staff, and limitations in vocational services. Collectively, these participant narratives reflect a marked divergence from feminist principles and illustrate the potential for recreating conditions that curtail women’s agency and cause harm within the shelter system. We conclude with a discussion of the implications for a feminist approach to shelter-based service delivery and practice.

Mental Health Workers’ Perceptions of Risk Factors for Human Trafficking in Nairobi, Kenya: A Preliminary Qualitative Investigation

The researchers of this pilot study conducted three in-depth semi-structured interviews with four mental health workers in Nairobi to obtain a deeper understanding of their perceptions of human trafficking in Kenya. Four themes that increased vulnerability for entrance into the human trafficking trade were identified. Individuals were at increased risk for forced labor exploitation due to socioeconomic factors, traditional African practices, cultural beliefs, and political risk factors. This article provides implications for practice and support for community mental health workers, counselors, and educators working with survivors of human trafficking. Implications for future research and practice are discussed.

Share our stories: An exploration of the healthcare experiences of child sex trafficking survivors

BackgroundThe trafficking of children and adolescents is widespread, and pediatric providers are on the front line. Current research demonstrates that trafficked children do access health care. However, few studies describe these interactions from their perspectives. In order to elucidate the healthcare experiences of sex trafficked children, we designed a qualitative study utilizing semi-structured interviews to explore their health care interactions. Participants and settingHomeless youth currently aged 18–21 who were sex trafficked before age 18. MethodsSemi-structured interviews were conducted with seventeen youth who met the study criteria. Interview transcripts were coded and analyzed using constant comparative methods. Themes were inductively extracted by consensus with the study team, and thematic saturation was determined when no new themes emerged. ResultsThemes included: victims endured serious injuries and illnesses without being brought to medical attention, traffickers limited victims’ access to care, logistical barriers limited access, traffickers directed victims to lie to providers, and medical providers rarely separated victims to interview them separately resulting in missed opportunities. ConclusionsThese themes illustrate the experiences of sex trafficked youth experiencing homelessness and provide pediatric practitioners the opportunity to become more informed and equipped to recognize them. They also highlight serious health consequences of not being identified and egregious examples of providers exhibiting denial or inappropriate responses to their disclosure.

Compassionate Care-Going the Extra Mile: Sex Trafficking Survivors' Recommendations for Healthcare Best Practices.

Human Trafficking (HT) persists in the US, despite multi-level measures designed to mitigate its societal costs. HT instruction for healthcare providers is growing, but there is a dearth of resources and training presenting obstacles for victims accessing suitable healthcare services. Voices of survivors are also scant in the literature, despite the fact that their recommendations would appear essential when designing best practices. This study aimed to methodically gather recommendations from sex trafficking (ST) survivors who sought medical care during their victimization. An exploratory concurrent mixed-methods design was used, and semi-structured interviews (N = 22) were conducted between March 2016 and March 2017, in San Diego, CA, and Philadelphia, PA. Data were analyzed through a coding system to identify meaningful analytical themes. Study participants were recruited through survivor-centered organizations, and their identification was kept anonymous and confidential. Findings included three main themes: (A) Red Flags; (B) supportive healthcare practices; and (C) resources for ST-patient study participants’ recommendations aimed to improve healthcare practice in response to their medical needs in a compassionate and caring manner, with trust building, rapport, and an opportunity to instill hope among ST-patients. Implementing Compassionate Care approaches when caring for ST-patients could positively impact patient–provider interactions, while creating opportunities for intervention.

Child Sex Trafficking: Strategies for Identification, Counseling, and Advocacy.

The human rights violation of sex trafficking continues to occur in the United States at alarming rates. Although sex trafficking affects individuals across various demographic groups, this crime disproportionately affects children. Counselors who work with children and adolescents are uniquely positioned to identify, support, and advocate on behalf of sex trafficked youth who may experience barriers to emotional and physical wellness. Extant literature on counseling sex trafficking survivors remain scarce and illuminate the need for victim identification, trauma-informed interventions, and advocacy strategies that support the unique needs of child sex trafficking survivors. To address these disparities, this article describes victim identification techniques, outlines trauma-focused interventions for counseling sex trafficked youth, and presents advocacy strategies. The implications for counseling child sex trafficking survivors are illuminated through a case study.

A longitudinal study of justice characteristics among girls participating in a sex trafficking court program

BackgroundSex trafficking is a public health and social justice issue that has traditionally been addressed with criminal justice solutions. Because many sex trafficking survivors are incarcerated for crimes related to their exploitation, specialty, human trafficking courts were developed to offer resources and assistance to labor and sex trafficking survivors. This study assessed justice-involved youth participating in a specialty, anti-trafficking court program. The purpose of this study was to investigate justice-related outcomes of participants in a specialty court program. We examined: (1) the relationship between age at first citation and justice characteristics (number of bench warrants, number of citations, number placements, and number of times ran away); and (2) the number of months between first citation and enrollment into the program with the aforementioned justice characteristics. We used negative binomial models to estimate the relationships between age at first citation, number of months between first citation and program enrollment, with the four justice characteristics (n = 181).ResultsAdjusted models showed that younger age at first citation was associated with significantly more bench warrants and citations while in the program. Likewise, fewer months between first citation and program entry was related to more bench warrants and citations.ConclusionsThere is a need to evaluate the appropriateness of specialty, trafficking court programs in reducing continued justice involvement and these programs ability to meet the evolving needs of sex trafficking survivors over time. We recommend universal screening for trafficking indicators for all systems-involved youth and relocating trafficking specialty courts out of juvenile courts to dependency courts.

Criminal Record Relief for Human Trafficking Survivors: Analysis of Current State Statutes and the Need for a Federal Model Statute

This Note defines criminal record relief and analyzes the effectiveness of three state criminal record relief statutes at protecting trafficking survivors. This analysis is based on State Report Cards: Grading Criminal Record Relief Laws for Survivors of Human Trafficking by Polaris, a leading human trafficking nonprofit. It next discusses the absence of federal criminal record relief and how a statute at the federal level could provide relief for survivors with federal convictions while simultaneously providing a model for states to ensure their statutes incorporate best practices for record relief moving forward. This Note then discusses how Polaris’s report stops short of providing a model statute for states to draw from. Finally, this Note provides a best practice statute based on Polaris’s evaluation criteria and recommends it be added as an amendment to the Trafficking Victims Protection Act.

The Impact of Human Trafficking on Veterans: Increasing Awareness among Veterans and Employees through Education

Background Health care systems serve an essential role in identifying and treating individuals impacted by human trafficking. The Department of Veterans Affairs (VA) Veterans Health Administration recognizes that human trafficking is a public safety concern and has intentionally increased awareness of human trafficking and how it relates to Veteran care. In 2020, the VA National Social Work Program Office, Care Management and Social Work launched a national Human Trafficking Tiger Team to understand the impact of human trafficking within the Veteran community. Methods Initial Human Trafficking Tiger Team efforts focused on qualitative reviews of existing VA health care services data to identify trends and themes. A series of three trainings for VA staff including Social Workers, Licensed Marriage and Family Therapists (LMFT), Licensed Professional Counselors (LPC), Psychologists (PsyD/PhD), Registered Nurses (RN), and Certified Rehabilitation Counselors (CRC) were completed. A pre and post-test was administered to assess VA staff’s knowledge about human trafficking and the impact on the Veteran community. Results Upon examination of qualitative review of evidence, formal study is needed to develop programming to address human trafficking in the Veteran community. Discussion Further study is needed to understand the prevalence of human trafficking among the Veteran population. While the VA’s human trafficking initiatives are integral initial steps, additional research remains necessary to identify treatment needs and services gaps. Conclusion Human Trafficking Tiger Team Knowledge Needs Assessment trainings revealed that VA staff had contact with survivors of human trafficking, suspected victims, as well as traffickers. 38% of staff acknowledged missed opportunities to assess and intervene with potential trafficking victims. This revealed a clear need for standardized screening, protocols, and implementing routine training to Veterans impacted by human trafficking.

A Survivor-Derived Approach to Addressing Trafficking in the Pediatric ED.

Our objective was to elicit the perspectives of survivors of child trafficking on addressing trafficking in the pediatric emergency department (ED) and, secondarily, to provide a survivor-derived framework to help pediatric emergency medicine (PEM) providers discuss trafficking with their patients. We conducted in-depth, semistructured interviews with young adults who experienced trafficking as children and/or as adolescents. In the interviews, we employed a novel video-elicitation method designed by the research team to elicit detailed participant feedback and recommendations on the pediatric ED through an interactive, immersive discussion with the interviewer. A grounded theory approach was employed. Seventeen interviews were conducted revealing the following themes, which we present in an integrated framework for PEM providers: (1) fear is a significant barrier; (2) participants do want PEM providers to ask about trafficking, and it is not harmful to do so; (3) PEM providers should address fear through emphasizing confidentiality and privacy and encouraging agency; (4) PEM providers should approach the patient in a direct, sensitive, and nonjudgmental manner; and (5) changes to the ED environment may facilitate the conversation. Suggested wordings and tips from survivors were compiled. Trafficking survivors feel that the pediatric ED can be a place where they can be asked about trafficking, and that when done in private, it is not harmful or retraumatizing. Fear is a major barrier to disclosure in the pediatric ED setting, and PEM providers can mitigate this by emphasizing privacy and confidentiality and increasing agency by providing choices. PEM providers should be direct, sensitive, and nonjudgmental in their approach to discussing trafficking.