Skip to main content
×
Home

Prevalence and risk of violence and the mental, physical and sexual health problems associated with human trafficking: an updated systematic review

  • L. Ottisova (a1), S. Hemmings (a1), L.M. Howard (a1), C. Zimmerman (a2) and S. Oram (a1)...
Abstract
Background.

To update and expand on a 2012 systematic review of the prevalence and risk of violence and the prevalence and risk of physical, mental and sexual health problems among trafficked people.

Method.

Systematic review and meta-analysis. Searches of 15 electronic databases of peer-reviewed articles and doctoral theses were supplemented by reference screening, citation tracking of included articles and expert recommendations. Studies were included if they reported on the prevalence or risk of violence while trafficked, or the prevalence or risk of physical, mental or sexual health outcomes among people who have been trafficked. Two reviewers independently screened papers for eligibility and appraised the quality of included studies.

Results.

Thirty-seven papers reporting on 31 studies were identified. The majority of studies were conducted in low and middle-income countries with women and girls trafficked into the sex industry. There is limited but emerging evidence on the health of trafficked men and the health consequences of trafficking into different forms of exploitation. Studies indicate that trafficked women, men and children experience high levels of violence and report significant levels of physical health symptoms, including headaches, stomach pain and back pain. Most commonly reported mental health problems include depression, anxiety and post-traumatic stress disorder. Although serological data on sexually transmitted infections are limited, women and girls trafficked for sexual exploitation self-report symptoms suggestive of a high prevalence of infections. Limitations of the review include methodological weaknesses of primary studies and some differences in definition and operationalisation of trafficking, which hinder comparability and generalisability of the results.

Conclusions.

There is increasing evidence human trafficking is associated with high prevalence and increased risk of violence and a range of physical and mental health problems. Although more studies have emerged in recent years reporting on the health of trafficked men and people trafficked for forms of exploitation other than in the sex industry, further research is needed in this area. Appropriate interventions and support services to address the multiple and serious medical needs, especially mental health, of trafficked people are urgently needed.

Copyright
Corresponding author
*Address for correspondence: S. Oram, Health Services and Population Research Department, King's College London, London, UK. (Email: sian.oram@kcl.ac.uk)
References
Hide All
Abas M, Ostrovschi NV, Prince M, Gorceag VI, Trigub C, Oram S (2013). Risk factors for mental disorders in women survivors of human trafficking: a historical cohort study. BMC Psychiatry 13, 204.
Brewin C, Andrews B, Valentine JD (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma exposed adults. Journal of Consulting and Clinical Psychology 68, 748766.
Critical Appraisal Skills Programme (CASP) (2014). CASP Checklists. Retrieved 2 June 2015 from http://www.casp-uk.net/#!checklists/cb36. Oxford: CASP.
Churakova IE (2014). Social Psychological research of victimity of girls – victims of sex slavery. Psikhologicheskii Zhurnal 35, 7787.
Crawford M, Kaufman MR (2008). Sex trafficking in Nepal: survivor characteristics and long-term outcomes. Violence Against Women 14, 905916.
Cwikel J, Chudakov B, Paikin M, Agmon K, Belmaker R (2004). Trafficked female sex workers awaiting deportation: comparison with brothel workers. Archives of Women's Mental Health 7, 243249.
Dal Conte I, Di Perri G (2011). Human trafficking: social, medical and infectological aspects. Giornale Italiano di Medicina Tropicale 16, 2529.
Decker MR, Mack KP, Barrows JJ, Silverman JC (2009). Sex trafficking, violence victimization, and condom use among prostituted women in Nicaragua. International Journal of Gynecology and Obstetrics 107, 151152.
Decker MR, McCauley HL, Phuengsamran D, Janyam S, Silverman JG (2011). Sex trafficking, sexual risk, sexually transmitted infection and reproductive health among female sex workers in Thailand. Journal of Epidemiology and Community Health 65, 334339.
Dharmadhikari AS, Gupta J, Decker MR, Raj A, Silverman JG (2009). Tuberculosis and HIV: a global menace exacerbated via sex trafficking. International Journal of Infectious Diseases 13, 543546.
Di Tommaso ML, Shima I, Strom S, Bettio F (2009). As bad as it gets: well-being deprivation of sexually exploited trafficked women. European Journal of Political Economy 25, 143162.
Falb KL, McCauley HL, Decker MR, Sabarwal S, Gupta J, Silverman JG (2011). Trafficking mechanisms and HIV status among sex-trafficking survivors in Calcutta, India. International Journal of Gynecology & Obstetrics 113, 8687.
George A, Sabarwal S (2013). Sex trafficking, physical and sexual violence, and HIV risk among young female sex workers in Andhra Pradesh, India. International Journal of Gynaecology & Obstetrics 120, 119123.
Goldenberg SM, Rangel G, Staines H, Vera A, Lozada R, Nguyen L, Silverman JG, Strathdee SA (2013). Individual, interpersonal, and social-structural correlates of involuntary sex exchange among female sex workers in two Mexico–US border cities. Journal of Acquired Immune Deficiency Syndromes 63, 639646.
Gray GG, Luna L, Seegobin W (2012). Exploring resilience: strengths of trafficking survivors in Cambodia. International Journal of Adolescent Medicine and Health 24, 363371.
Gupta J, Raj A, Decker MR, Reed E, Silverman JG (2009). HIV vulnerabilities of sex-trafficked Indian women and girls. International Journal of Gynaecology and Obstetrics 107, 3034.
Gupta J, Reed E, Kershaw T, Blankenship KM (2011). History of sex trafficking, recent experiences of violence, and HIV vulnerability among female sex workers in coastal Andhra Pradesh, India. International Journal of Gynecology and Obstetrics 114, 101105.
Higgins JPT, Thompson SG (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine 21, 15391558.
Hossain M, Zimmerman C, Abas M, Light M, Watts C (2010). The relationship of trauma to mental disorders among trafficked and sexually exploited girls and women. American Journal of Public Health 100, 24422449.
International Labour Organisation (2012). Global Estimate of Forced Labour: Results and Methodology. International Labour Organization: Geneva.
Joarder MAM, Miller PW (2014). The experiences of migrants trafficked from Bangladesh. Annals of the American Academy of Political and Social Science 653, 141161.
Kiss L, Pocock NS, Naisanguansri V, Suos S, Dickson B, Thuy D, Koehler J, Sirisup K, Pongrungsee N, Nguyen VA, Borland R, Dhavan P, Zimmerman C (2015). Health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam: an observational cross-sectional study. Lancet Global Health 3, e154e161.
Kissane M, Szymanski L, Upthegrove R, Katona C (2014). Complex posttraumatic stress disorder in traumatised asylum seekers: a pilot study. European Journal of Psychiatry 28, 137144.
Le PD (2014). Human trafficking and psychosocial well-being: A mixed-methods study of returned survivors of trafficking in Vietnam. Dissertation Abstracts International: Section B: The Sciences and Engineering 75. Retrieved 17 April 2015 from https://escholarship.org/uc/item/3c5088hh.
McCauley HL, Decker MR, Silverman JG (2010). Trafficking experiences and violence victimization of sex-trafficked young women in Cambodia. International Journal of Gynaecology and Obstetrics 110, 266267.
Moher D, Liberati A, Tetzlaff J, Altman DG (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine 6, e1000097.
Ostrovschi NV, Prince MJ, Zimmerman C, Hotineanu MA, Gorceag LT, Flach C, Abas MA (2011). Women in post-trafficking services in Moldova: diagnostic interviews over two time periods to assess returning women's mental health. BMC Public Health 11, 232.
Oram S, Ostrovschi NV, Gorceag VI, Hotineanu MA, Gorceag L, Trigub C, Abas M (2012 a). Physical health symptoms reported by trafficked women receiving post-trafficking support in Moldova: prevalence, severity and associated factors. BMC Women's Health 12, 20.
Oram S, Stockl H, Busza J, Howard LM, Zimmerman C (2012 b). Prevalence and risk of violence and the physical, mental, and sexual health problems associated with human trafficking: systematic review. PLoS Medicine 9, e1001224.
Oram S, Khondoker M, Abas M, Broadbent M, Howard LM (2015). Characteristics of trafficked adults and children with severe mental illness: a historical cohort study. Lancet Psychiatry 2, 10841091.
Ozer EJ, Best SR, Lipsey TL, Weiss DL (2003). Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychological Bulletin 129, 5273.
Sarkar K, Bal B, Mukherjee R, Chakraborty S, Saha S, Ghosh A, Parsons S (2008). Sex-trafficking, violence, negotiating skill, and HIV infection in brothel-based sex workers of eastern India, adjoining Nepal, Bhutan, and Bangladesh. Journal of Health, Population and Nutrition 26, 223231.
Servin AE, Brouwer KC, Gordon L, Rocha-Jimenez T, Staines H, Vera-Monroy RB, Strathdee SA, Silverman JG (2015). Vulnerability factors and pathways leading to underage entry into sex work in two Mexican-US border cities. Journal of Applied Research on Children: Informing Policy for Children at Risk 6, 3.
Silverman JG, Decker MR, Gupta J, Maheshwari A, Patel V, Raj A (2006). HIV prevalence and predictors among rescued sex-trafficked women and girls in Mumbai, India. Journal of Acquired Immune Deficiency Syndromes 43, 588593.
Silverman JG, Decker MR, Gupta J, Maheshwari A, Willis BM, Raj A (2007). HIV prevalence and predictors of infection in sex-trafficked Nepalese girls and women. Journal of the American Medical Association 298, 536542.
Silverman JG, Decker MR, Gupta J, Dharmadhikari A, Seage GR III, Raj A (2008). Syphilis and hepatitis B co-infection among HIV-infected, sex-trafficked women and girls, Nepal. Emerging Infectious Diseases 14, 932934.
Silverman JG, Raj A, Cheng DM, Decker MR, Coleman S, Bridden C, Pardeshi M, Saggurti N, Samet JH (2011). Sex trafficking and initiation-related violence, alcohol use and HIV risk among HIV+ female sex workers in Mumbai. Journal of Infectious Diseases 204, S1229S1234.
Silverman JG, Saggurti N, Cheng DM, Decker MR, Coleman SM, Bridden C, Pardeshi M, Dasgupta A, Samet JH, Raj A (2014). Associations of sex trafficking history with recent sexual risk among HIV-infected FSWs in India. AIDS and Behaviour 18, 555561.
Stockman JK, Lucea MB, Campbell JC (2013). Forced sexual initiation, sexual intimate partner violence and HIV risk in women: a global review of the literature. AIDS and Behaviour 17, 832847.
Tsutsumi A, Izutsu T, Poudyal AK, Kato S, Marui E (2008). Mental health of female survivors of human trafficking in Nepal. Social Science and Medicine 66, 18411847.
Turner-Moss E, Zimmerman C, Howard LM, Oram S (2014). Labour exploitation and health: a case series of men and women seeking post-trafficking services. Journal of Immigrant & Minority Health 16, 473480.
United Nations (2000). Optional Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime, GA Res 55/25. Retrieved 2 August 2015 from http://www.unodc.org/documents/treaties/UNTOC/Publications/TOC%20Convention/TOCebook-e.pdf.
Urada LA, Silverman JG, Tsai LC, Morisky DE (2014). Underage youth trading sex in the Philippines: trafficking and HIV risk. AIDS Care 26, 15861591.
Varma S, Gillespie S, McCracken C, Greenbaum VJ (2015). Characteristics of child commercial sexual exploitation and sex trafficking victims presenting for medical care in the United States. Child Abuse & Neglect 44, 98105.
Wirth KE, Tchetgen Tchetgen EJ, Silverman JG, Murray MB (2013). How does sex trafficking increase the risk of HIV Infection? An observational study from Southern India. American Journal of Epidemiology 177, 232241.
Zimmerman C, Hossain M, Yun K, Gajdadziev V, Guzun N, Tchomaroa M, Ciarrocchi RA, Johansson A, Kefurtova A, Scodanibbio S, Motus MN, Roche B, Morison L, Watts C (2008). The health of trafficked women: a survey of women entering posttrafficking services in Europe. American Journal of Public Health 98, 5559.
Zimmerman C, Hossain M, Yun K, Roche B, Morison L, Watts C (2006). Stolen Smiles: A Summary Report on the Physical and Psychological Health Consequences of Women and Adolescents Trafficked in Europe. London School of Hygiene and Tropical Medicine: London.
Zimmerman C, Yun K, Shvab I, Watts C, Trappolin L, Treppete M, Bimbi F, Adams B, Jiraporn S, Beci L, Albrecht M, Bindel J, Regan L (2003). The health risks and consequences of trafficking in women and adolescents. Findings from a European study. London School of Hygiene & Tropical Medicine (LSHTM): London.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology and Psychiatric Sciences
  • ISSN: 2045-7960
  • EISSN: 2045-7979
  • URL: /core/journals/epidemiology-and-psychiatric-sciences
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Type Description Title
WORD
Supplementary Materials

Ottisova supplementary material
Ottisova supplementary material 1

 Word (63 KB)
63 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 73
Total number of PDF views: 498 *
Loading metrics...

Abstract views

Total abstract views: 2243 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st November 2017. This data will be updated every 24 hours.