Sex trafficking, violence, and sexual/reproductive health outcomes

Background: Sex trafficking of women and girls is an increasingly recognized form of gender-based violence. Among female sex workers (FSWs), sex trafficking victims are thought to face a range of sexual and reproductive health concerns, brought forth by unique vulnerabilities such as compromised ability to insist on condom use, violent sexual initiation into sex work, lack of HIV knowledge, and greater levels of sexual risk. Little empirical data exist to describe these patterns.

Objectives: The current study is intended to characterize the extent of trafficking as the entry mechanism to FSW, and describe its relations with a range of sexual risk mechanisms, and sexual and reproductive health outcomes.

Methods: A national survey of FSWs in Thailand (n=815) was conducted; participants reported mechanisms of FSW entry, violence victimization, sexual risk (i.e., condom non-use, client condom refusal), and health outcomes (i.e., STI symptoms, unwanted pregnancy). Consistent with United Nations guidelines, trafficking was defined as having been coerced, forced, or deceived into entering sex work, or entering prior to age 18.

Results: Preliminary results indicate that one in ten Thai FSWs meet trafficking criteria. As compared with their non-trafficked counterparts, trafficked FSWs demonstrated greater levels of violence, sexual risk, and negative sexual/reproductive health consequences.

Discussion: Results contribute to our understanding of the health implications of trafficking as a form of gender-based violence. Findings will be discussed in the context of informing primary prevention efforts, refining existing health promotion efforts for FSWs, and conducting appropriate research with this hard-to-reach population.