Cross-sectional survey of survivors of human trafficking in contact with services in England: Violence and health

Introduction: Trafficking is a human rights violation and public health issue, but evidence to inform policies and services for survivors is limited.  Research to date focuses mainly on women trafficked for sexual exploitation and comes predominantly from low and middle income countries.  This study examines health risks and outcomes of survivors of human trafficking in contact with support services in England.  

Methods: Cross-sectional survey of trafficked men and women in contact with post-trafficking services in England.  Depression, anxiety and Post-traumatic Stress Disorder (PTSD) were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and primary care Post-traumatic Stress Disorder screen (PC-PTSD).

Results: The sample included 98 women and 52 men, trafficked for sexual exploitation (30%), domestic servitude (30%), and forced labour (40%). 77% of women and 44% of men reported experiencing physical violence while trafficked and 66% of women reported forced sex, including 95% trafficked for sexual exploitation and 54% trafficked for domestic servitude.  Pre-trafficking physical violence was reported by 58% of women and 29% of men, and pre-trafficking sexual violence by 30% of women.  High levels of psychological symptoms were reported by 49% of men and 79% of women. 

Conclusions: Healthcare, including timely and culturally appropriate psychological support, must be a fundamental component of post-trafficking care.  Post-trafficking services for female survivors should include access to sexual and reproductive healthcare and counselling for sexual violence, regardless of whether individuals were trafficked for sexual or other forms of exploitation.