Human Trafficking: What to Look for and Next Steps
Human trafficking is “the use of force, fraud or coercion to get another person to provide labor or commercial sex.” Inducing a minor into commercial sex is always considered human trafficking regardless of the use of force, fraud or coercion. Cases of human trafficking have been documented in all 50 US states, the District of Columbia, on Tribal lands, and the U.S. territories. In 2021, the International Labor Organization estimated that on any average day, 27.6 million people experienced forced labor and/or commercial sex exploitation throughout the world.1,2
Risk factors for victims of human trafficking include recent migration, substance use, mental health disorders, homeless youth or runaways, LGBTQ+ status, and individuals experiencing extreme poverty.1-3 Perpetrators range from individuals, business owners (including farms and restaurants), criminal gangs or organizations, parents, family members, intimate partners, and job recruiters.1-3 Victims are lured through deceit, fraud or manipulation initially and then controlled through physical and emotional abuse, isolation, and economic abuse. An individual does not need to be moved to be trafficked. Many victims are trafficked in their own town.
Nearly two-thirds of trafficked survivors stated they had accessed health care services for treatment of conditions caused by their exploitation. Over half stated that they were never asked questions related to trafficking and/or received dismissive or insensitive comments from the providers. A lack of awareness of human trafficking is the biggest barrier for victims to receive help.
Board Certified PAs and all health care providers should educate themselves on the warning signs of human trafficking and become familiar with common health issues. Most trafficked individuals will be seen in the emergency room, family planning clinics, or urgent care settings. General warning signs might include evidence of physical injury, inappropriate dress for the season or setting, signs of drug addiction, malnutrition, or tattoos with a person’s name, barcode, or other symbols ($, ATM, and crowns).3 Studies have shown that 98% of trafficked victims have at least one psychological issue during exploitation; and 96% experience psychological issues afterwards, including depression, PTSD, and attempted suicide.3 Sex trafficked victims also have an increased risk of STIs, HIV, and unwanted pregnancies.
Providers should strive to identify and appropriately refer victims to health, safety, and legal resources while managing the individual’s acute healthcare needs. For adult patients, it is important to obtain informed consent to report suspected trafficking to local authorities before the patient answers a provider’s questions.
Here are some additional tips:
- Attempt to build rapport and trust with the individual.
- Remain unbiased and non-judgmental.
- Make every attempt to separate the individual from the alleged perpetrator while performing the history and physical exam.
- Provide a safe environment with educational pamphlets or posters in bathrooms and exam rooms that include the National Human Trafficking hotline number: 1-888-373-7888.
Providers can also contact the hotline number or use their website to find local resources and to learn how to support someone you suspect is being trafficked. As PAs work in all settings and specialties, we are positioned to bridge gaps by recognizing potential signs of human trafficking and being ready to connect patients to additional resources.
Resources
National Human Trafficking Hotline: https://humantraffickinghotline.org/en: Call (1-888-373-7888, Text: HELP to 233733 or chat online.
References
1. United States Department of Health and Human Services. Office on Trafficking in Persons, Human Trafficking. https://acf.gov/otip/education-training/humantrafficking, accessed May 5, 2025.
2. National Human Trafficking Hotline https://humantraffickinghotline.org/en/human-trafficking, accessed May 5, 2025.
3. Greenbaum VJ, Titchen K, Walker-Descartes I, Feifer A, Rood CJ, Fong H. Multi-level prevention of human trafficking: The role of the health care professionals. Preventive Medicine.2018;114, 164-167.