CEN , CPEN , SANE , began speaking on HT : the clinical presentations , physical findings , and red flags , such as an older companion who won ’ t leave a client . Suddenly , I had a flashback to that 16-year-old client .
After the presentation , I met with Ms . Toney-Butler and spoke of my experience . In a matter-of-fact manner , she turned to me and said , “ Absolutely , she was being trafficked , and her trafficker was sitting right there .” It was at that moment that my passion rose , and I swore I would do whatever I could to never let another victim of HT go unidentified by a healthcare professional ( HCP ). It was the catalyst and birth of our professional association , Nurses United Against Human Trafficking ( NUAHT ).
What Is Human Trafficking ?
HT is one of the fastest growing criminal enterprises across the globe ( Hilton , 2019 ). It is an evil that occurs in all geographical locations and has ties to illicit arms and drug trades , terrorism , and cryptocurrencies ( International Centre For Missing & Exploited Children , 2021 ; Metz-Howard , 2015 ). HT is a crime that is multi-faceted and complex ( Gilmer , 2021 ). According to the International Labour Organization ( ILO ), there are approximately 50 million individuals trafficked worldwide ( 2022 ). When looking at the U . S ., cases of HT have been reported in all 50 states and U . S . territories ( Office On Trafficking In Persons , 2020 ).
HT is “ the recruitment , harboring , transportation , provision , or obtaining of a person for labor or services , through the use of force , fraud , or coercion for the purpose of subjection to involuntary servitude , peonage , debt bondage , or slavery ” ( U . S . Department of Justice , 2022 , para . 1 ). It is an exploitation-based crime against a person for labor , services , or commercial sex . According to the Trafficking Victims Protection Act of 2000 ( TVPA ), a commercial sex act is defined as any sex act in which anything of value , such as money , shelter , food , or protection is given to or received by any person . Sex trafficking is defined as “ the recruitment , harboring , transportation , provision , obtaining , patronizing , or soliciting of a person for the purpose of a commercial sex act in which a commercial sex act is induced by force , fraud , or coercion , or in which the person induced to perform such act has not attained 18 years of age ” ( TVPA , 22 U . S . C . § 7102 ( 11 )( A )).
Sex and labor trafficking are the most widely recognized forms of HT , but others include organ trafficking , child soldiering , and forced criminal activity ( Hilton , 2019 ). The most recent far-reaching type is technology-facilitated sex trafficking ( TFST ) in which traffickers use digital platforms to expose victims to an infinite numbers of buyers ( Bono-Neri
& Toney-Butler , 2023 ; National Center on Sexual Exploitation [ NCOSE ], 2022 ). Globally , millions of victims are held in physical or psychological bondage and are being exploited through the various forms of trafficking ( Shift , 2022 ). It is happening in our nation ’ s schools , communities , and within our borders , as there is no prejudice or bias as to who gets recruited into “ the life ” ( Bono-Neri , 2022 ).
Intersection Of Human Trafficking with Healthcare
Although HT is predominantly viewed as a law enforcement , judicial , and social services issue , it is known that most trafficked persons in the U . S . access healthcare at some point during their exploitation ( Bono-Neri & Toney-Butler , 2023 ; Grace et al ., 2014 ; Jones Day , 2022 ). The intersection of HT with healthcare is massive . Retrospective studies show that between 70 % and 90 % of survivors reported being seen by HCPs during their trafficking life , but most were never identified as HT victims ( Chisolm-Straker et al ., 2016 ; Lederer & Wetzel , 2014 ).
The healthcare sector provides a unique opportunity to identify , treat , and respond to victims of HT . These individuals often experience acute medical conditions , sexually transmitted infections , unwanted pregnancies , overdose injuries , and mental health issues such as depression , anxiety , and suicidality ( Bono-Neri & Toney-Butler , 2023 ;
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