Ravi Anita, Pfeiffer Megan R, Rosner Zachary, Shea Judy A
*Institute for Family Health†Department of Medicine, University of Pennsylvania‡New York City Health and Hospitals, Correctional Health Services.
Med Care. 2017 Dec;55(12):1017-1022. doi: 10.1097/MLR.0000000000000820.
Sex-trafficked persons experience significant trauma while exploited, resulting in complex health issues and barriers to health care. Incorporating survivor perspectives is critical in optimizing health care delivery for this population.
We interviewed sex-trafficking survivors regarding their experiences with trauma while being trafficked and elicited advice about health care delivery.
Qualitative interviews were conducted in New York City's Rikers Island jail from July to September 2015.
In total, 21 English-speaking women who had experienced sex trafficking were the subjects of the study.
Interview domains included: interpersonal violence, behavioral health, and health care delivery advice.
Interviewees described experiencing severe and chronic trauma perpetrated by traffickers and sex buyers. Substance use was the primary method of coping with trauma. With regard to mental health, interviewees noted diagnoses of depression, anxiety and posttraumatic stress disorder, low self-esteem, and challenges in intimate relationships. Health care delivery themes included approaches to discussing trafficking in health care settings, concerns regarding sexual assault examinations, and suggestions for improving direct-services and prevention programming.
With this perspective into the complex intersection of trauma and behavioral health that sex-trafficked women can experience, health care providers can better understand the context and recommendations regarding trauma-informed care practices for this population. Our results also offer several avenues for future studies with regard to discussing trafficking in clinical settings and an opportunity for stakeholders to incorporate survivor-based input to improve health care for this population.
遭受性交易剥削的人在被剥削过程中经历了重大创伤，导致复杂的健康问题和获得医疗保健的障碍。纳入幸存者的观点对于优化这一人群的医疗保健服务至关重要。
我们就性交易幸存者在被贩运期间的创伤经历进行了访谈，并征求了他们对医疗保健服务的建议。
2015年7月至9月在纽约市赖克斯岛监狱进行了定性访谈。
共有21名经历过性交易的英语女性成为该研究的对象。
访谈领域包括：人际暴力、行为健康和医疗保健服务建议。
受访者描述了遭受贩运者和性买家实施的严重和长期创伤。药物使用是应对创伤的主要方法。在心理健康方面，受访者指出被诊断患有抑郁症、焦虑症和创伤后应激障碍、自尊心低以及亲密关系方面存在挑战。医疗保健服务主题包括在医疗保健环境中讨论贩运问题的方法、对性侵犯检查的担忧以及改善直接服务和预防方案的建议。
通过了解性交易女性可能经历的创伤与行为健康的复杂交叉情况，医疗保健提供者可以更好地理解针对这一人群的创伤知情护理实践的背景和建议。我们的研究结果还为未来在临床环境中讨论贩运问题的研究提供了几个途径，并为利益相关者提供了一个机会，将基于幸存者的意见纳入其中，以改善这一人群的医疗保健。
