Youth Survivors of Human Trafficking: On Improving Health Care Access and Treatment

Author: Titchen, Kanani; Chang, Elizabeth; Kim, Jessica; Tran, Shannon; Nyhan, Ellora & Chisolm-Straker, Makini

Abstract: Human trafficking (HT) is a public health issue, with adolescents disproportionately at risk for reasons spanning multiple biopsychosocial domains. We explored youth HT survivors’ health care barriers, experiences, and needs. In this qualitative multimethods study, 24 participants (≤26 years old) with HT experience receiving services from nonprofit organizations in San Diego, California completed an electronic survey and were invited to participate in online interviews. Thematic analysis for interview responses was performed using constant comparative methodology. Authors created codes and connections between codes and refined findings by discussion. All participants endorsed labor trafficking, 96% endorsed sex trafficking and 46% reported seeing a health care professional (HCP) while exploited. Nine survey respondents completed follow-up interviews: 100% endorsed labor and sex trafficking and 44% seeing an HCP. Interview participants’ barriers to presenting to health care and receiving needed help were categorized into patient-focused—lack of awareness of exploitation and medical needs, emotional bonds to the trafficker, and misperceptions about their ability to obtain care; versus health care system (HCS)-focused—negative experiences and need for consistency with HCPs, and desire for targeted resources and effective care. Barriers to health care for trafficked youth included factors the HCS could change versus those that could be reduced with universal patient education. Participants named lack of legal guardian support and proof of insurance as barriers to health care access while being exploited. Participants noted conventional mental health interventions for recovery are not appropriate and lack survivor-led guidance; participants offered alternatives about how they would receive effective care.

Keywords: adolescent, exploitation, health care, human trafficking