Obstetrics and Gynecology
Volume 130, Issue 2, 2017, Pages 443-453

Identifying and Assisting Sexually Exploited and Trafficked Patients Seeking Women's Health Care Services (Article)

Tracy E.E.* , MacIas-Konstantopoulos W.
  • a Department of Obstetrics and Gynecology, Vincent Obstetrics and Gynecology, Global Health Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
  • b Emergency Medicine Department, Massachusetts General Hospital, Boston, MA, United States

Abstract

It is estimated that 21 million people are trafficked worldwide, including 11.4 million women and girls. Approximately 4.5 million are forced to do sexual labor. The exact prevalence of human trafficking is difficult to ascertain, however, given the limitations of data collection in an illegal industry. Obstetrician-gynecologists should not only be aware of the widespread nature of human trafficking, but also have the tools to assess patients for trafficking and respond to victim identifications. Patients may present with signs of physical abuse, depression, anxiety, posttraumatic stress disorder, substance use, sexually transmitted infections, pregnancy, and nonspecific somatic complaints. As with intimate partner violence, clinicians should be suspicious if the patient is accompanied by an individual who refuses to leave her side. Other potential red flags include patients with wounds in various stages of healing, patients appearing fearful or unable to answer specific questions, and patients who do not have any personal identification. Health care providers should speak with the patient privately, using professional interpreters when indicated. Although there are no validated screening questions for the health care setting, in this article, we provide sample questions such as, "Is anyone forcing you to do anything physically or sexually that you do not want to do?" The physical examination should be thorough with appropriate workup, sexually transmitted infection prophylaxis, and emergency contraception. Physicians and patients should be aware of their state's mandatory reporting requirements and careful documentation is essential. Finally, to ensure a comprehensive, interdisciplinary response to trafficked patients, practitioners should engage hospital-based and community-based services when appropriate. © 2017 by The American College of Obstetricians and Gynecologists. All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

Physician's Role emergency contraception community care human statistics and numerical data health service priority journal hospital care screening sexually transmitted disease sex trafficking Humans psychology Adolescent Mandatory Reporting female medical documentation risk factor Risk Factors pregnancy sexual exploitation prostitution victim human trafficking women's health Article Women's Health Services help seeking behavior prophylaxis physician attitude awareness physician Sex Work Sex Offenses Psychological Trauma psychotrauma Physical Examination sexual crime gynecology obstetrics Child

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85023203018&doi=10.1097%2fAOG.0000000000002144&partnerID=40&md5=0dab5c900935dacfe6c3dfb21cf63a9f

DOI: 10.1097/AOG.0000000000002144
ISSN: 00297844
Cited by: 2
Original Language: English