Advertisement

Journal of Urban Health

, Volume 94, Issue 3, pp 408–416 | Cite as

Identifying Health Experiences of Domestically Sex-Trafficked Women in the USA: A Qualitative Study in Rikers Island Jail

  • Anita RaviEmail author
  • Megan Rose Pfeiffer
  • Zachary Rosner
  • Judy A. Shea
Article

Abstract

While sex trafficking in the USA is a significant medical and public health issue, there is sparse data on the healthcare needs of and access for this population. This study was designed to identify experiences of domestically sex-trafficked women regarding healthcare access, reproductive health, and infectious diseases while trafficked. Trafficking survivors incarcerated in New York City’s Rikers Island women’s jail participated in audio-recorded interviews between July and September 2015. Recordings were transcribed, and a content analysis was completed to identify health-related themes. Twenty-one women ranging from 19 to 60 years old were included in this study. Reasons for accessing care included sexually transmitted infections (STIs) and HIV testing, unintended pregnancies, traumas, and chronic diseases. Emergency departments, Planned Parenthoods, and jails were common care sites. Traffickers and substance use impeded care and access to follow-up. Unintended pregnancy and STIs resulted in trafficker-perpetrated violence. Condoms, the most common form of contraception and HIV prevention, were inconsistently negotiated due to financial and violent consequences. These findings demonstrate that domestic sex trafficking survivors experienced chronic and acute health issues while trafficked and multiple barriers to care. Substance use and financial vulnerabilities furthered unintended pregnancy and infection risk. These findings can inform future research regarding healthcare access and practices for domestically trafficked women.

Keywords

Sex trafficking Access to care Women Condoms HIV Reproductive health 

Notes

Acknowledgment

This work was supported by the University of Pennsylvania’s Leonard Davis Institute of Health Economics.

Compliance with Ethical Standards

The Institutional Review Boards of the NYC Department of Health and Mental Hygiene and the University of Pennsylvania approved this study

Funding

Funding for this research was provided by the University of Pennsylvania’s Leonard Davis Institute of Health Economics. We sincerely thank Cecilia Flaherty, Carmen Gonzalez and Fatos Kaba of NYC Health and Hospitals and Virginia Shephard of Corizon Health for their generous time, feedback, and collaboration in designing and implementing this study.

References

  1. 1.
    106th Congress United States of America. Victims of trafficking and violence protection act of 2000. Washington D.C., U.S.A.2000.Google Scholar
  2. 2.
    Diaz A, Clayton EW, Simon P. Confronting commercial sexual exploitation and sex trafficking of minors. JAMA Pediatr. 2014; 168(9): 791–792.CrossRefPubMedGoogle Scholar
  3. 3.
    IOM (Institute of Medicine) and NRC (National Research Council). Confronting commercial sexual exploitation and sex trafficking of minors in the United States. Washington, DC: The National Academies Press; 2013.Google Scholar
  4. 4.
    Richards TA. Health implications of human trafficking. Nurs Womens Health. 2014; 18(2): 155–162.CrossRefPubMedGoogle Scholar
  5. 5.
    Department of State—United States of America. Trafficking in Persons Report June 2016. 2016:422. https://www.state.gov/documents/organization/258876.pdf
  6. 6.
    Human Smuggling and Trafficking Center. Domestic human trafficking—an internal issue. Washington DC, U.S. Department of State; December 2008 2008. https://www.state.gov/documents/organization/113612.pdf
  7. 7.
    Choi KR. Risk factors for domestic minor sex trafficking in the United States: a literature review. J Forensic Nurs. 2015; 11(2): 66–76.CrossRefPubMedGoogle Scholar
  8. 8.
    Macias Konstantopoulos W, Ahn R, Alpert EJ, et al. An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response. J Urban Health. 2013; 90(6): 1194–1204.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Lederer LJ, Wetzel CA. The health consequences of sex trafficking and their implications for identifying victims in healthcare facilities. Ann Health Law: Health Policy Law Rev Loyola University Chicago School of Law. 2014; 23(1): 30.Google Scholar
  10. 10.
    Ottisova L, Hemmings S, Howard LM, Zimmerman C, Oram S. Prevalence and risk of violence and the mental, physical and sexual health problems associated with human trafficking: an updated systematic review. Epidemiol Psychiatr Sci. 2016:1–25.Google Scholar
  11. 11.
    De Chesnay M. Sex trafficking: A clinical guide for nurses. New York, NY, Springer Publishing Company; 2012.Google Scholar
  12. 12.
    Grace AM, Lippert S, Collins K, et al. Educating health care professionals on human trafficking. Pediatr Emerg Care. 2014; 30(12): 856–861.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Beck ME, Lineer MM, Melzer-Lange M, Simpson P, Nugent M, Rabbitt A. Medical providers’ understanding of sex trafficking and their experience with at-risk patients. Pediatrics. 2015; 135(4): e895–902.CrossRefPubMedGoogle Scholar
  14. 14.
    Serita T. In Our Own Backyards: The need for a coordinated judicial response to human trafficking. N.Y.U. Review of Law & Social Change. 2013;36(4):25.Google Scholar
  15. 15.
    Latimer L. Rikers charge vacating question. In: Ravi A, ed 2014.Google Scholar
  16. 16.
    Centers for Disease Control and Prevention. Notes from the 576 field: outbreak of tuberculosis associated with a newly iden- 577 tified Mycobacterium tuberculosis genotype–New York 578 City, 2010–2013. MMWR Morb Mortal Wkly Rep. 579 2013;62(45):904.Google Scholar
  17. 17.
    Schonberg D, Bennett AH, Sufrin C, Karasz A, Gold M. What women want: a qualitative study of contraception in jail. Am J Public Health. 2015; 105(11): 2269–2274.CrossRefPubMedGoogle Scholar
  18. 18.
    Noska AJ, Roberts MB, Sufrin C, et al. History of sex exchange in women with a history of incarceration. J Health Care Poor Underserved. 2016; 27(2A): 149–162.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Parvez F, Katyal M, Alper H, Leibowitz R, Venters H. Female sex workers incarcerated in New York City jails: prevalence of sexually transmitted infections and associated risk behaviors. Sex Transm Infect. 2013; 89(4): 280–284.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    New York State Department of Health, New York State’s Ending the Epidemic Task Force “2015 Blueprint: End AIDS.” 2015, Accessed April 15, 2016, 2016. http://www.health.ny.gov/diseases/aids/ending_the_epidemic/docs/blueprint.pdf
  21. 21.
    Centers for Disease Control and Prevention’s Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexual Transmitted Diseases and Tuberculosis Prevention: “HIV Basics: PrEP.”; http://www.cdc.gov/hiv/basics/prep.html. Accessed April 15, 2016, 2016.
  22. 22.
    Petersen EE, Polen KN, Meaney-Delman D, et al. Update: interim guidance for health care providers caring for women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep. 2016; 65(12): 315–322.CrossRefPubMedGoogle Scholar

Copyright information

© The New York Academy of Medicine 2017

Authors and Affiliations

  1. 1.University of PennsylvaniaPhiladelphiaUSA
  2. 2.NYC Health and Hospitals, Correctional Health ServicesNew YorkUSA

Personalised recommendations