Educating Healthcare Providers to Identify and Heal Victims of Sex Trafficking

Saturday, 29 July 2017

Kupiri Ackerman-Barger, PhD, MSN
Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
Jann L. Murray-García, MD
School of Nursing, Betty Irene Moore School of Nursing at University of California, Davis, Sacrament0, CO, USA
Ellen E. Goldstein, PhD
Departments of Family Medicine and School of Nursing, University of Wisconsin, Madison, WI, USA
Jerry John Nutor, MSN, BSN
College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA


Human trafficking is recognized as a gross violation of human rights that victimizes tens of millions of vulnerable women, men and children worldwide (Ahn et al., 2013). A United States Congressional Research Service report estimated the number of victims who are trafficked at any one time worldwide may reach as high as 27 million (Siskin & Wyler, 2013). Millions of trafficked victims are unaccounted for and remain invisible to law enforcement, medical providers and other professionals. A lack of awareness of this invisible population has meant missed opportunities to improve both the health of individuals, including minors, and population health. Sex trafficking, a specific type of human trafficking, is a priority health issue because of the physical and mental health risks and outcomes faced by the victims. Sex trafficking occurs when “…a commercial sex act is induced by force, fraud or coercion, or when the person induced to perform such an act has not attained 18 years of age (U.S Department of State, 2014, p. 29).  Research suggests that sex trafficking victims, in many instances, have had contact with a health care provider. However, most health care professionals have difficulty recognizing and have limited education and training to appropriately respond to victims of sex trafficking.

Aims: This study aimed to 1) assess and increase knowledge, ability and confidence of healthcare providers to identify and heal victims of sex trafficking; 2) assess and build institutional capacity to appropriately and constructively serve victims of sex trafficking.


IRB approval was obtained prior to the workshop. A four-hour workshop was provided that featured the lived experience from a sex trafficking survivor; statistics and referrals from local nonprofit community organizations; trauma-informed primary care; and law enforcement actively working on mitigating and ameliorating the impact that sex trafficking has had on the lives of individuals. The structure of the workshop was intended to provide specific information to healthcare providers, but intentionally recruited community members, advocates and healthcare consumers to brainstorm and develop a collective effort to create structures, practices and resources to help and heal victims of sex trafficking. Paper pre- and post-event surveys with a 4-point Likert scale were administered to participants who identified as health professionals or health professional students to assess their perceived levels of knowledge, ability, and confidence during clinical encounters with patients who are victims of sex trafficking. Pre- and post- surveys with open-ended questions were administered to both health care professionals and non-health care professional participants to assess perceptions of institutional capacity. A brainstorming session was conducted to gather data regarding perceptions of potential solutions to better serve the needs of sex trafficking victims and survivors.


Of the 67 participants who completed the questionnaire, 52 were healthcare providers and 15 were staff, administrators or community members. Pre-event distributions indicated that 47.8% (22) healthcare providers had heard that sex trafficking may be a problem, but did not know more than that. Results from the study indicated that the workshop increased knowledge, ability and confidence and promoted a desire to advocate on behalf of sex trafficking victims. The results of a thematic analysis of qualitative participant responses resulted in five prominent themes that included: training, community and institutional capacity, awareness and advocacy, knowledge of local resources, and coordination of care.


Although equipping individual healthcare providers with knowledge, awareness and confidence is critical, workshops like this will yield little without institutional support, resource availability, and community partnerships. The findings from this study add to the existing literature by demonstrating that building institutional capacity and collective efficacy are critical to provide and sustain optimal care for sex trafficking victims and to make critical change in the harm created by sex-trafficking