Is Your Patient Being Trafficked?

Summary and Comment |
July 28, 2017

Is Your Patient Being Trafficked?

  1. Diane E. Judge, APN/CNP

How to tell — how to help.

  1. Diane E. Judge, APN/CNP

About 4.5 million women and girls are forced into sexual labor worldwide; in the U.S., about 17% of the 18,500 runaway children in 2016 were probably sex-trafficked. A study of 98 survivors of sex trafficking found most (88%) had seen a physician during their captivity. These authors detail how clinicians can identify and assist exploited women and girls.

Red flags for trafficking include:

  • Companion who refuses to leave the room, answers questions for the patient, or does not allow use of a professional interpreter

  • Unexpected material possessions

  • Excessive familiarity with sex

  • Body language indicating fear or distrust

  • Injuries suggesting physical abuse or sexual trauma

  • Examination inconsistent with history, which may be “scripted”

  • Vague or inconsistent answers

  • Lack of identification documents

  • Inability to provide an address or identify current location, date, or time

The authors suggest strategies for interviewing the patient alone (e.g., accompanying her to the restroom to “instruct her in urine collection”) and for circumventing traffickers' tracking devices (e.g., providing a hospital gown, putting the patient's clothing and personal items — including cellphones — elsewhere). Supportive interventions include contacting the National Human Trafficking Resource Center's 24/7 hotline (1-888-373-7888) as well as local law enforcement and intimate partner violence (IPV) advocates. However, women may refuse assistance, fearing harm to themselves or relatives, deportation, or incarceration. Providing emergency contact information in an easily concealed format (e.g., cards that can be hidden in shoes) may be helpful.

Comment

As with IPV, we must be aware that women and girls in forced labor may present in our practices. We still lack evidence-based, successful intervention strategies; for now, more information (including an algorithm that can provide a basis for protocols) is available at https://humantraffickinghotline.org/resources/framework-human-trafficking-protocol-healthcare-settings/.

Editor Disclosures at Time of Publication

  • Disclosures for Diane E. Judge, APN/CNP at time of publication Equity Stryker Corporation

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