Recommendations to Improve Services and Supports for Domestically Sex Trafficked Persons Derived from the Insights of Health Care Providers.

Health care providers are highly likely to encounter persons who have been domestically sex trafficked and, therefore, possess valuable insights that could be useful in understanding and improving existing services and supports. In-depth interviews were conducted with 31 health care providers residing and working in Canada's largest province, Ontario. Results were analyzed using Braun and Clarke's analytical framework. Across providers, a key theme was identified: "Facilitators to improve care", which was comprised of two sub-themes, "Address needs in service provision" and "Center unique needs of survivors". From these results, eight wide-ranging recommendations to improve services and supports were developed (eg, Jointly mobilize an intersectoral, collaborative, and coordinated approach to sex trafficking service provision; Employ a survivor-driven approach to designing and delivering sex trafficking services). These recommendations hold the potential to enhance services in Canada and beyond by reducing barriers to access and care, facilitating disclosure, aiding in recovery, and empowering those who have been domestically sex trafficked.

Impacts of the COVID-19 Public Health Crisis on Caring for Sex-Trafficked Persons.

BACKGROUND: Sex trafficking of persons, a pervasive public health issue disproportionately affecting the most marginalized within society, often leads to health as well as social consequences. Social service provision to meet the resulting needs is critical, however, little is known about the current pandemic's impact on providers' capacity to deliver requisite care. METHOD: To examine social service providers' perspectives of care provision for domestically sex-trafficked persons in Ontario, Canada, during the COVID-19 pandemic, we conducted semi-structured interviews with 15 providers and analyzed these using Braun and Clarke's analytic framework. RESULTS: Impacts of the COVID-19 pandemic on social service care provision were connected to individuals' increased vulnerability to trafficking, difficulties safely and effectively providing services to sex-trafficked persons amid pandemic restrictions, and reduction in in-person educational activities to improve providers' capacity to serve this client population. Securing safe shelter was particularly difficult and inappropriate placements could at times lead to further trafficking. CONCLUSION: The pandemic created novel barriers to supporting sex-trafficked persons; managing these sometimes led to new and complex issues. Future efforts should focus on developing constructive strategies to support sex-trafficked persons' unique needs during public health crises.

Labor trafficking of children and youth in the United States: A scoping review.

BACKGROUND: Child labor trafficking is a largely unexplored and unpublished phenomenon in the United States. OBJECTIVE: To 1) characterize the state of the science on child labor trafficking, and 2) identify empirical information regarding risk and protective factors, and physical/behavioral health needs of labor-trafficked children/adolescents. METHODS: This scoping review involved an electronic review of five databases; the search was restricted to studies in English or Spanish and published between Jan 1, 2010-Oct 16, 2020. The search yielded 1190 articles; 48 studies qualified for full review and 8 met inclusion criteria (US-based study addressing risk factors/vulnerabilities for child labor trafficking; protective factors; health impact; or health/behavioral healthcare). RESULTS: Only one study had sufficient sample size to compare sex to labor trafficking among minors; some did not separate data by age group or by type of trafficking. A few shared data from a common source; one was a single case review. Findings suggested that sex and labor trafficking may share common risk factors (e.g., prior child maltreatment and out-of-home placement) as well as within group differences (e.g., labor trafficked children had less prior child welfare involvement than those involved in sex trafficking and were more likely to be younger, male, Black or non-white, and Hispanic). Multiple physical/behavioral health symptoms were reported and may be useful items for a healthcare screen. CONCLUSIONS: Child labor trafficking research in the U.S. is in its infancy, although the results of this review point to opportunities for screening and case conceptualization that may be useful to practitioners.

Addressing human trafficking as a public health issue.

Human trafficking is increasingly recognized as a significant global public health issue. Human trafficking (HT) exists in all nations, including Canada, and is estimated to impact 25 million people globally. HT is a crime that is not always visible. It is associated with a myriad of deleterious health outcomes arising from adverse living and working conditions, and the physical, sexual, and/or psychological violence often accompanying it. Human trafficking also disproportionately affects people living under vulnerable circumstances, particularly those with intersecting vulnerabilities. Public health can advance health equity for trafficked persons and add value to existing anti-trafficking (AT) efforts. Among its many contributions, public health can bring its expertise in health promotion and surveillance. While efforts to incorporate a public health perspective are already underway in at least the United States and the United Kingdom, the nexus of public health and AT is still nascent and requires further development. A public health approach to trafficking focused on intervening on the upstream drivers of well-being can add value to the extant counter-trafficking paradigm. This commentary is intended to catalyze discussion in Canada and elsewhere as to what public health can contribute to this emergent field.

RéSUMé: Le trafic d'êtres humains (TEH) est de plus en plus reconnu comme un grave problème de santé publique dans le monde. Il est présent dans tous les pays, y compris au Canada, et toucherait 25 millions de personnes selon les estimations. Le TEH est un crime qui n'est pas toujours visible. Il est associé à d'innombrables résultats cliniques délétères découlant de mauvaises conditions de vie et de travail et de la violence physique, sexuelle et/ou psychologique qui l'accompagne souvent. Le trafic d'êtres humains touche aussi démesurément les personnes en situation de vulnérabilité, surtout celles ayant des vulnérabilités croisées. La santé publique peut favoriser l'équité en santé chez les victimes et ajouter de la valeur aux efforts existants de lutte contre ce fléau. Elle peut, entre autres, contribuer son savoir-faire en promotion et en surveillance de la santé. Une démarche d'intégration d'une perspective de santé publique est déjà entamée, du moins aux États-Unis et au Royaume-Uni, mais la jonction entre la santé publique et la lutte contre la traite est encore naissante et doit être développée. Une démarche de santé publique à l'égard du trafic d'êtres humains qui intervienne sur les facteurs favorisant le bien-être en amont pourrait ajouter de la valeur au paradigme existant de la lutte contre la traite. Notre commentaire se veut un moyen de susciter un débat au Canada et ailleurs dans le monde sur ce que la santé publique peut apporter à ce domaine en émergence.

A Descriptive Study of United States-Based Human Trafficking Specialty Clinics.

Human trafficking is a crime associated with serious adverse health and mental health outcomes. It has been estimated that more than 40 million people worldwide have been victimized, which has resulted in high rates of traumatic injuries, unwanted and high-risk pregnancies, mental illness, substance use disorders; and suicidality among trafficked persons. Little is known as to what models of health care delivery are best in engaging and sustaining the involvement of trafficked individuals with health care and trafficked individuals have reported discouragement and/or re-traumatization as a result of inadequate or fragmented care. To address the gap in knowledge regarding best practices for engaging and sustaining trafficked patients with health care, the authors of this study set out to identify and describe medical and mental health specialty clinics that work exclusively with trafficked adults, with the goal of assisting organizations and health care providers in program development and to improve clinical outcomes. A patient-centered, comprehensive, interdisciplinary, and trauma informed approach to clinical care is recommended for the treatment of trafficked patients. The authors strongly suggest that human trafficking specialty clinics prioritize psychiatric care and mental health services given the high rate of trauma and mental health issues among trafficked persons.