Department of Counseling Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA.
J Adv Nurs. 2022 Feb;78(2):458-470. doi: 10.1111/jan.15019. Epub 2021 Sep 6.
The aims of this study were to (1) explore the barriers and challenges of sex trafficking identification and (2) understand how sex trafficking indicators are perceived (i.e. relevance and utility) by healthcare providers at five sites of a large sexual health care organization in a Midwestern state within the United States.
A qualitative, collective case study was conducted.
In-depth, semi-structured interviews were conducted with 23 healthcare staff (e.g. medical assistants, nurse practitioners) who provided sexual and reproductive healthcare between fall 2018 and spring 2020.
Findings suggest that providers perceived behavioural and verbal sex trafficking indicators (e.g. patients appearing nervous or being unable to answer questions) as relevant, particularly with a female patient accompanied by a 'controlling' male. Medical and physical indicators (e.g. repeat STIs, bruises and tattoos) were perceived as generally lacking clinical utility or irrelevant. Some indicators were only perceived as relevant when combined or only later, upon reflection (e.g. older, female adult accompanying one or more female patients).
Healthcare providers may be aware of sex trafficking indicators conducive to identifying female patients, in relationships with older men, who are at risk of sex trafficking. Our study finds that healthcare providers may not be aware of all recommended sex trafficking indicators and the nuances of how patients present.
Provider trainings on sex trafficking dynamics and nuanced clinical presentations should include observing ST indicators in simulated interviews, assessing and safety planning (including using harm reduction strategies) with seemingly ambiguous cases. In addition, we recommend that trainings emphasize the relationship between the continuum of agency and victimization in sex trafficking and patient presentations.
本研究旨在：(1) 探讨识别性交易的障碍和挑战；(2) 了解医疗保健提供者如何看待性交易指标(即相关性和实用性)，该研究在美国中西部一个州的一个大型性保健组织的五个地点进行。
采用定性、集体案例研究方法。
对 2018 年秋季至 2020 年春季期间提供性和生殖保健的 23 名医疗保健人员(例如医疗助理、执业护士)进行了深入的半结构化访谈。
研究结果表明，提供者认为行为和言语性交易指标(例如，患者表现紧张或无法回答问题)是相关的，特别是当女性患者伴有“控制欲强”的男性时。医疗和身体指标(例如，重复的性传播感染、瘀伤和纹身)被认为通常缺乏临床实用性或不相关。一些指标只有在组合或事后反思时才被认为是相关的(例如，陪伴一名或多名女性患者的老年女性成年人)。
医疗保健提供者可能意识到有助于识别处于与老年男性关系中、有性交易风险的女性患者的性交易指标。我们的研究发现，医疗保健提供者可能没有意识到所有建议的性交易指标以及患者表现的细微差别。
关于性交易动态和细微临床表现的培训应包括在模拟访谈中观察性传播感染指标，对看似模棱两可的病例进行评估和安全计划(包括使用减少伤害策略)。此外，我们建议培训强调性交易和患者表现中代理和受害连续性之间的关系。
