how to start a research paper on human trafficking

129 Human Trafficking Essay Topic Ideas & Examples

📝 key points to use to write an outstanding human trafficking essay, 🏆 best human trafficking topic ideas & essay examples, ⭐ simple & easy human trafficking essay titles, 📌 most interesting human trafficking topics to write about, 👍 good research topics about human trafficking.

• ❓ Research Questions about Human Trafficking

Human trafficking is one of the most challenging and acute assignment topics. Students should strive to convey a strong message in their human trafficking essays.

They should discuss the existing problems in today’s world and the ways to solve them. It means that essays on human trafficking require significant dedication and research. But do not worry, we are here to help you write an outstanding essay.

Find the issue you want to discuss in your paper. There are many titles to choose from, as you can analyze the problem from various perspectives. The examples of human trafficking essay topics include:

• The problem of child trafficking in today’s world
• The causes of human trafficking
• Human trafficking: The problem of ethics and values
• The role of today’s society in fostering human trafficking
• Human trafficking as a barrier to human development
• The rate of human trafficking victims in the world’s countries
• How to prevent and stop human trafficking

Remember that you can select other human trafficking essay titles if you want. Search for them online or ask your professor for advice.

Now that you are ready to start working on your paper, you can use these key points for writing an outstanding essay:

• Study the issue you have selected and do preliminary research. Look for news articles, scholarly papers, and information from reputable websites. Do not rely on Wikipedia or related sources.
• Work on the outline for your paper. A well-developed outline is a key feature of an outstanding essay. Include an introductory and a concluding paragraph along with at least three body paragraphs. Make sure that each of your arguments is presented in a separate paragraph or section.
• Check out human trafficking essay examples online to see how they are organized. This step can also help you to evaluate the relevance of the topic you have selected. Only use online sources for reference and do not copy the information you will find.
• Your introductory paragraph should start with a human trafficking essay hook. The hooking sentence or a phrase should grab the reader’s attention. An interesting fact or a question can be a good hook. Hint: make sure that the hooking sentence does not make your paper look overly informal.
• Do not forget to include a thesis statement at the end of your introductory section. Your paper should support your thesis.
• Define human trafficking and make sure to answer related questions. Is it common in today’s world? What are the human trafficking rates? Help the reader to understand the problem clearly.
• Discuss the causes and consequences of human trafficking. Think of possible questions you reader would ask and try to answer all of them.
• Be specific. Provide examples and support your arguments with evidence. Include in-text citations if you refer to information from outside sources. Remember to use an appropriate citation style and consult your professor about it.
• Discuss the legal implications of human trafficking in different countries or states. What are the penalties for offenders?
• Address the ethical implications of the problem as well. How does human trafficking affect individuals and their families?
• A concluding paragraph should be a summary of your arguments and main ideas of the paper. Discuss the findings of your research as well.

Check out our samples (they are free!) and get the best ideas for your paper!

• Three Ethical Lenses on Human Trafficking As a result of the issue’s illegality, a deontologist will always observe the law and, as a result, will avoid or work to eradicate human trafficking.
• Human Trafficking: Process, Causes and Effects To make the matters worse they are abused and the money goes to the pockets of these greedy people as they are left empty handed after all the humiliation they go through.
• Trafficking of Children and Women: A Global Perspective The scale of women and children trafficking is very large but difficult to put a figure on the actual number of women and children trafficked all over the world. The demand for people to work […]
• Stephanie Doe: Misyar Marriage as Human Trafficking in Saudi Arabia In this article, the author seeks to highlight how the practice of temporary marriages by the wealthy in Saudi Arabia, commonly known as misyar, is a form of human trafficking.
• Human Trafficking in the United States The paper also discusses the needs of the victims of human trafficking and the challenges faced in the attempt to offer the appropriate services.
• The Human Trafficking Problem Another way is through employment and this involves the need to create more jobs within the community that is at a higher risk of facing human trafficking.
• How Prostitution Leads to Human Trafficking This is a form of a business transaction that comes in the name of commercial sex either in the form of prostitution or pornography.
• Human Trafficking: Slavery Issues These are the words to describe the experiences of victims of human trafficking. One of the best places to intercept human trafficking into the US is at the border.
• Reflection on Human Trafficking Studies When researching and critically evaluating the global issue of human trafficking, I managed to enrich my experience as a researcher, a professional, and an individual due to the facts and insights gained through this activity.
• Human Trafficking Through the General Education Lens First and foremost, the numerous initiatives show that the regional governments are prepared to respond to the problem of human trafficking in a coordinated manner.
• Discussion: Human Trafficking of Adults Human trafficking of adults is one of the most essential and significant issues of modern times, which affects the lives of millions of people in almost every corner of the globe.
• Human Trafficking and Related Issues and Tensions In the business sector, therefore, discrimination leads to the workload of the trafficked employee to make a huge lot of work to be done at the right time required.
• Doctor-Patient Confidentiality and Human Trafficking At the same time, it is obligatory to keep the records of all the patients in the healthcare settings while Dr. To conclude, the decision in the case of an encounter with human trafficking should […]
• Policy Issues on Human Trafficking in Texas The challenge of preventing human trafficking in Texas and meeting the needs of its victims is complicated by the multifaceted nature of the problem.
• Dark Window on Human Trafficking: Rhetorical Analysis In this essay, Ceaser utilized his rhetorical skills to dive into the dark world of human trafficking, which severely hits Latin America and the USA, through the usage of images and forms of different societal […]
• Human Trafficking in Africa Therefore, Africa’s human trafficking can be primarily attributed to the perennial political instability and civil unrest as the root causes of the vice in the continent. Some traditions and cultural practices in Africa have significantly […]
• Human Trafficking: Giving a Fresh Perspective One question I find reoccurring is, “Are all victims of human trafficking being dishonest?” Throughout my career and law enforcement, I met the cases in which victims were dishonest, and I wanted to discover why.
• Human Trafficking and Variety of Its Forms The types of human trafficking that harshly break human rights are sex trafficking, forced labor, and debt bondage. To conclude, it is essential to say that human trafficking has been the worst type of crime […]
• Child Welfare and Human Trafficking Young people and children that live in “out-of-home care” due to reasons of abuse or lack of resources are at higher risk of becoming subjects of trafficking.
• Human Trafficking and Healthcare Organizations Human Trafficking, which is a modern form of slavery, is a critical issue nowadays since it affects many marginalized people around the world.
• Human Trafficking Is a Global Affair It refers to the unlawful recruitment, harboring and transportation of men, women and children for forced labor, sex exploitation, forced marriages, through coercion and fraud.
• Human Trafficking and Nurses’ Education Therefore, there is a need to educate nurses in understanding human trafficking victims’ problems and learning the signs or ared flags’ of human trafficking.
• Intelligence Issues in Human Trafficking To begin with, the officer is to examine the social groups of migrants and refugees, as they are the most vulnerable groups in terms of human trafficking.
• Intelligence Issues in Border Security, Human Trafficking, and Narcotics Trafficking This paper aims to emphasize drug trafficking as the main threat for the nation and outline intelligence collecting methods on drug and human trafficking, border security, and cybersecurity.
• Human Trafficking in the UK: Examples and References The bureaucracy and lack of flexibility pose quite significant threats to the success of the UK anti-trafficking strategies. An illustration of this lack of flexibility and focus is the case of the Subatkis brothers.
• Criminology: Human Trafficking However, the UAE clearly has admitted that there is a high level of rights infringement against women by the ISIS in Iraq and Syria.
• Human Trafficking: Labor Facilitators and Programs Labor trafficking is a significant issue in the modern world because it refers to people who are forced to engage in labor through the use of coercion, fraud, and force.
• Human Trafficking: Solution to Treat Survivors And A Public Health Issues Ultimately, this led to the child’s lack of a sense of security, to the presence of a strong desire to be loved and important to someone.
• Human Trafficking and Its Social and Historical Significance Human trafficking is a type of crime that involves kidnapping and transporting of women, men, and children out of the country with the purposes of slave labor, prostitution, organ harvesting, and other nefarious purposes.
• Egypt and Sudan Refugees and Asylum Seekers Face Brutal Treatment and Human Trafficking In this report by Amnesty International, the issue of the security of refugees and asylum seekers in Shagarab refugee camps, which are located in the eastern parts of Sudan, is raised.
• Effects of Human Trafficking in Teenagers: The Present-Day Situation In this case, the inclusion of the additional factor, the type of human trafficking, will contribute to a better understanding of the problem and develop a solution.
• Aftermath of Human Trafficking in Children and Teenagers The major part of the available research is concentrated on the victims of sex abuse and the applied means of their treatment.
• Human Trafficking in the USA However, the development of the society and rise of humanism resulted in the reconsideration of the attitude towards this phenomenon and the complete prohibition of all forms of human trafficking.
• Human Trafficking and Exploitation in Modern Society It is necessary to determine the essence of human trafficking to understand the magnitude of the problem of slavery in the modern world.
• Child Welfare: Human Trafficking in San Diego The paper consists of an introduction, the consecutive sections addressing the definition of the issue, its legal background, the occurrence of child trafficking, and the interventions initiated by the authorities to fight the threat.
• Human Trafficking as an Issue of Global Importance Being a threat to global safety and well-being, the phenomenon of human trafficking has to be managed by reconsidering the existing policy statements of organizations responsible for monitoring the levels of human trafficking and preventing […]
• Psychotherapy for Victims of Human Trafficking The use of different dependent variables is the primary feature that differs a single-subject design from a program evaluation the essence of which is to cover a range of questions and evaluate them all without […]
• Human Trafficking: Enforcing Laws Worldwide This essay focuses on the issue of enforcement of laws concerning human trafficking, the influence of country prosperity on the approaches to solving this problem, the vulnerable categories at high risk of becoming victims, and […]
• Social Work: Human Trafficking and Trauma Theory One of the theoretical frameworks is trauma theory that focuses on the traumatic experiences victims are exposed to as well as the influence of these traumas on their further life.
• Human Trafficking Problems in Canada The authors describe the government’s influence on the level of human trafficking and argue that the concept of slavery is almost the same as modern human trafficking.
• Terrorism, Human Trafficking, and International Response One of the key positive results of the global counter-terrorism efforts was the reduction of Al Qaeda’s presence both globally and in the Middle East, and the enhancement of travel safety.
• Human Trafficking in Mozambique: Causes and Policies “Human Trafficking in Mozambique: Root Causes and Recommendations” is a policy paper developed by the research team of UNESCO as a powerful tool in order to analyze the situation with human trafficking in Mozambique and […]
• Human Trafficking as a Terrorist Activity The biggest problem that is worth mentioning is that it is believed that the number of such activities is growing at an incredibly fast rate, and it is important to take necessary measures to limit […]
• Human Trafficking and Modern-day Slavery One of the biggest challenges in addressing modern slavery and human trafficking is the fact that the vice is treated as a black market affair where facts about the perpetrators and the victims are difficult […]
• Combating Human Trafficking in the USA It is necessary to note, however, that numerous researchers claim that the number of human trafficking victims is quite difficult to estimate due to the lack of effective methodology.
• The Fight Against Human Trafficking Human trafficking constitutes a gross violation of the human rights of the individual as he/she is reduced to the status of a commodity to be used in any manner by the person who buys it.
• Criminal Law: Human Trafficking Promises of a good life and the absence of education opportunities for women have led to the increased levels of human trafficking.
• Human Trafficking: Definition, Reasons and Ways to Solve the Problem That is why, it becomes obvious that slavery, which is taken as the remnant of the past, prosper in the modern world and a great number of people suffer from it.
• Human Trafficking and the Trauma It Leaves Behind According to Snajdr, in the United States, most of the Black immigrants who came to the country during the colonial era were actually victims of human trafficking.
• Mexican Drug Cartels and Human Trafficking Reports from Mexico says that due to the pressure exerted on the drug cartels by the government, they have resolved in other means of getting revenue and the major one has been human trafficking alongside […]
• Human Trafficking between Africa and Europe: Security Issues This situation is usually made possible by the fact that the traffickers are usually criminal groups that have a potential to do harm to the victims and to the family of the victims.
• Tackling the Issue of Human Trafficking In Europe, prevention of human trafficking is interpreted to mean both awareness raising and active prevention activities that ideally look into the primary causes of human trafficking.
• Human trafficking in Mozambique The reason for this goes back to the fact the government in place has failed to put the interests of its people as a priority.
• “Not For Sale: End Human Trafficking and Slavery”: Campaign Critique To that extent, Not for Sale campaign attempts to enhance the ability of the people in vulnerable countries to understand the nature and form of trafficking and slavery.
• Human Trafficking in the United States: A Modern Day Slavery The question of the reasons of human trafficking is a complex one to answer since there are various causes for it, but the majors causes include; Poverty and Inequality: It is evident that human trafficking […]
• Definition of Human Rights and Trafficking One of the infamous abuses of human rights is the practice of human trafficking, which has become prevalent in the current society.
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• The Issue of Human Trafficking and the Backlash of Saving People
• The Role of Corruption in Cambodia’s Human Trafficking
• A Theoretical Perspective on Human Trafficking and Migration-Debt Contracts
• Conditions That Allow Human Trafficking
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• Causes and Consequences of Human Trafficking in Haiti
• Fishing in Thailand: The Issue of Overfishing, Human Trafficking and Forced Labor
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• The Issue of Human Trafficking and Forced Child Prostitution Around the World
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Human trafficking and exploitation: A global health concern

* E-mail: [email protected]

Affiliation London School of Hygiene and Tropical Medicine, London, United Kingdon

• Cathy Zimmerman, 

Published: November 22, 2017

• https://doi.org/10.1371/journal.pmed.1002437
• Reader Comments

Citation: Zimmerman C, Kiss L (2017) Human trafficking and exploitation: A global health concern. PLoS Med 14(11): e1002437. https://doi.org/10.1371/journal.pmed.1002437

Copyright: © 2017 Zimmerman, Kiss. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This work was supported by UKaid from the Department for International Development, grant number PO 5732. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Abbreviations: MOU, Memorandum of Understanding; PPE, personal protective equipment

Provenance: Commissioned; part of a Collection; externally peer reviewed

Summary points

• Labor migration is an economic and social mobility strategy that benefits millions of people around the world, yet human trafficking and the exploitation of low-wage workers is pervasive.
• The negative health consequences of human trafficking—and labor exploitation more generally—are sufficiently prevalent and damaging that they comprise a public health problem of global magnitude.
• Human trafficking and labor exploitation are substantial health determinants that need to be treated as preventable, drawing on public health intervention approaches that target the underlying drivers of exploitation before the harm occurs.
• Exploitative practices are commonly sustained by business models that rely on disposable labor, labyrinthine supply chains, and usurious labor intermediaries alongside weakening labor governance and protections, and underpinned by deepening social and economic divisions.
• Initiatives to address human trafficking require targeted actions to prevent the drivers of exploitation across each stage of the labor migration cycle to stop the types of harm that can lead to generational cycles of disability and disenfranchisement.

Introduction

While migration within and across national borders has been an economic and social mobility strategy that has benefited millions of people around the world, there is growing recognition that labor exploitation of migrant workers has become a problem of global proportions. Human trafficking and other forms of extreme exploitation, including forced labor and forced marriage, now collectively under the terminological umbrella “modern slavery,” are reported to affect an estimated 40.3 million people globally, with 29.4 million considered to be in situations of forced labor [ 1 ]. PLOS is launching a collection of essays and research articles on “Human Trafficking, Exploitation and Health” to increase awareness of the problem and to urge health and nonhealth professionals alike to engage in international and local responses to protect the health of individuals and populations affected by trafficking.

Human trafficking is a multidimensional human rights violation that centers on the act of exploitation. The United Nations defines trafficking in persons as “the recruitment, transportation, transfer, harbouring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation” [ 2 ]. The elements of coercion, exploitation, and harm link human trafficking with other forms of modern slavery, forced labor and forced marriage.

In this introduction to the Collection on Human Trafficking, Exploitation and Health, we describe the magnitude of the problem, discuss the complex characteristics of trafficking, indicate the harm and associated health burden of trafficking, and offer a public health policy framework to guide robust responses to trafficking. Ultimately, however, in this introductory paper, we assert that human trafficking is a global health concern. That is, the health consequences of human trafficking are so widespread and severe that it should be addressed as a public health problem of global magnitude. Furthermore, because human trafficking has pervasive global health implications, we propose that these abuses—and perhaps labor exploitation more generally—be treated as preventable.

The dimensions of human trafficking and global health implications

Early discussions about trafficking in persons focused almost solely on sex trafficking of women and girls and drew primarily on law enforcement responses. But human trafficking is now understood more broadly to occur in a wide array of low- or no-wage hazardous labor. In fact, the contemporary amalgam of mobility and low-wage labor fosters many opportunities for labor exploitation. Men, women, and children are trafficked for various purposes, including domestic servitude, agricultural and plantation work, commercial fishing, textiles, factory labor, construction, mining, and forced sex work as well as bride trafficking and petty crime [ 3 – 5 ]. These types of abusive work situations are especially viable in low- and middle-income countries [ 6 ] where low-cost labor is in high demand and where informal and precarious employment proliferates and labor governance is weak [ 7 , 8 ]. A substantial proportion of human trafficking occurs within the same country, although international trafficking has received greater global attention [ 6 ].

The exploitation that is at the heart of trafficking comprises different forms of abuse, such as extensive hours, poor pay, extortionate debt, physical confinement, serious occupational hazards, violence, and threats. These forms of abuse occur across a spectrum at varying levels of severity. And, importantly, the impact of exploitation on the health and wellbeing of a person who has been trafficked depends on the combination of types and severity of the acts she or he suffers ( Fig 1 ).

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https://doi.org/10.1371/journal.pmed.1002437.g001

Harmful in what ways and to whom

There is growing evidence on the wide-ranging health consequences of human trafficking. A systematic review on health and human trafficking found that survivors experienced multiple forms of abuse, numerous sector-specific occupational hazards, and dangerous living conditions [ 9 ] and suffered a range of poor health consequences. Among trafficking surviors in Southeast Asia, nearly half (48%) reported physical or sexual abuse and 22% sustained severe injuries, including lost limbs, and reported symptoms indicative of depression and anxiety disorders [ 10 ]. At the same time, however, there has been limited evidence on the social, financial, and legal harm suffered by trafficked persons—which often have further implications for ill health.

Reports on human trafficking regularly highlight that child workers, minorities, and irregular migrants are at particular risk of more extreme forms of exploitation. Over half of the world’s 215 million young workers are estimated to be in hazardous sectors including forced sex work and forced street begging [ 11 ]. Ethnic minority and highly marginalized populations are known to work in some of the most exploitative and damaging sectors, such as leather tanning, mining, and stone quarry work [ 12 ]. Irregular or illegal migration status can be used to threaten and coerce workers. Poor language skills can prevent migrant workers from understanding and negotiating employment terms and enagaging in job training, and, importantly, it can hinder their understanding of local rights and assistance resources [ 13 , 14 ]. Human trafficking also frequently manifests in highly gendered ways [ 1 ]. For example, women and girls are commonly trafficked for sexual exploitation, forced marriage, and domestic work [ 1 , 4 ], while males appear to be more vulnerable to trafficking into various armed conflicts, and men in Southeast Asia are more likely than women to be recruited for commercial fishing, sometimes referred to as “sea slavery” [ 15 , 16 ]. Government can play a role in restricting migration, such as Nepal’s migration bans affecting younger prospective female migrants [ 17 ], or can promote migration through, for example, the Bangladeshi government’s Memorandum of Understanding (MOU), which subsidizes recruitment fees for females migrating to numerous Gulf States [ 18 ].

The public health burden of human trafficking and labor exploitation

Because of the challenges of conducting surveys on human trafficking, there has been little population-based prevalence data on trafficking-related morbidity and mortality. In fact, globally, there is very little research on the health of low-wage migrant workers in general, especially in low-income countries [ 19 ]. Nonetheless, broader research indicates that labor market inequalities are closely associated with mortality, healthy life expectancy, and injury rates [ 20 , 21 ]. Takala et al. suggest there are 2.3 million work-attributable deaths annually, with the greater share of work-related morbidity and injuries in low-income countries, and highlight the gradual shift of hazardous labor to Asia, in particular [ 22 ]. The economic burden of work-related injury and illness on states is also substantial, with global estimates indicating a worldwide price tag of US$2.8 trillion [ 23 ]. While it is currently not possible to know how extreme forms of exploitation might be represented in such figures, especially in hazardous sectors in low- and middle-income countries, the probability that the health burden is substantial can hardly be discounted.

Prevention: A public health approach

Recent epidemiological shifts away from infectious diseases towards noncommunicable diseases [ 24 ] has led to growing knowledge about the influence of socioeconomic and cultural determinants in mortality and morbidity patterns. This has resulted in increased recognition of the effect of precarious employment, multiple forms of marginalization, and legal and entitlement structures in individual and population health [ 14 ]. Addressing these structural determinants is at the core of effective prevention efforts for many public health problems. Extreme exploitation, like other complex social phenomena, such as violence against women or substance misuse, has multiple and interacting causes and effects [ 25 , 26 ]. Labor exploitation can be seen as a health determinant and preventable social problem and benefit from public health prevention approaches that target the harm before it occurs [ 27 ]. A prevention lens directs us to consider the interaction of multiple factors that protect or put individuals and populations at risk of labor exploitation and to seek potential mechanisms to minimize these risks or enhance protection. It also suggests that we examine how various dimensions of exploitation might contribute to aspects of harm among different populations. Moreover, from this vantage point, we might reflect somewhat provocatively on the striking similarities between the harm sustained by people who are officially identified as “trafficking victims” versus migrant workers in the same sectors [ 19 ].

A public health policy framework to address human trafficking, exploitation, and health

To prevent the exploitation of aspiring labor migrants, evidence is urgently needed on the determinants of exploitation and factors that promote safe migration and decent work. Moreover, theoretical or policy frameworks are required to look specifically at the ways that individual, group, and structural factors (including economic, social, legal, and policy-related aspects) influence exploitation and health along a migration trajectory, which can guide our search for evidence to inform interventions [ 28 – 31 ].

Fig 2 depicts factors associated with labor exploitation across a migration process, dimensions of exploitation, and various dimensions of harm. It is worth noting, however, that while structurally driven social, economic, and gendered power imbalances underpin exploitation more generally, they often manifest differently between different forms of exploitation. For example, there are critical distinctions between various types of labor trafficking and sex trafficking versus conflict-related trafficking. In many low-wage production sectors, for instance, exploitative practices are sustained by business models that rely on labyrinthine supply chains, myriad labor intermediaries, and high demand for inexpensive and disposable labor. It is not coincidental that exploitation of workers has occurred alongside the diminishing power and density of trade unions and shrinking freedom of association and collective bargaining [ 32 ]. These interactions are exacerbated by weak labor governance [ 33 ] that fails to protect workers from production processes frequently fueled by demands for low-cost goods and services—despite international conventions to protect workers [ 34 ]. The framework in Fig 2 depicts a process of complex, cumulative causation of potential harm throughout a migration cycle. It highlights interactions between macrolevel structural factors (e.g., global, national, social, etc., systems and institutions) that influence the persistence of trafficking and harm among individuals in communities (microlevels). And, while not explicit, this conceptualization also acknowledges the role of inequalities such as age, gender, nationality, ethnicity, and class [ 35 ] to each individual’s vulnerability to exploitation [ 36 ].

https://doi.org/10.1371/journal.pmed.1002437.g002

Labor intermediaries and migrant networks frequently play a key role in recruitment processes. Some labor recruiters may assist with job placement into decent work, while others might facilitate exploitation. Unscrupulous intermediaries are known to use extortion, deception, or coercion to exploit workers or to usher them towards abusive employers [ 37 ]. Notably, people can be recruited into trafficking situations multiple times over a single journey. Labor intermediaries can include a chain of connected or separate, formal or informal, trustworthy or untrustworthy agents. For instance, Nepali workers from rural areas often seek jobs abroad (e.g., domestic work, construction jobs) through a local agent who connects them to more formal manpower agencies in urban centers [ 38 ]. Informal migrant networks or social networks are often thought to confer greater protection from exploitation; however, this is not always the case [ 39 ]. Recent research indicated that Bolivian migrants were exploited by compatriots for textile work in Argentina, whereas the opposite was true among Kyrgyz construction workers who secured decent work in Kazakhstan through their own Kyrgyz networks [ 19 ]. Additionally, as recruitment processes or networks become more established, they can become a regular labor conduit, potentially feeding people into exploitative situations [ 40 ].

Importantly, this framework conceptualizes exploitation as a potentially preventable cause of harm [ 41 ]. This perspective incorporates forms of harm beyond physical, psychological, and occupational health problems and includes social, financial, and legal harm and further suggests that the damage from exploitation can transmit across generations.

The discussion that follows focuses primarily on trafficking of labor migrants and exploitation, but the core features underpinning exploitation, power, control, and abuse, are applicable to other forms of human trafficking (forced sex work, forced marriage, for armed conflict).

Predeparture

Most migrants leave home in search of a better life for themselves and their family, sometimes inspired by income disparities between neighboring migrant and nonmigrant households. The effects of climate change on local production, market-driven land exhaustion, humanitarian crises, and weak social assistance have each contributed in different ways to distress migration [ 42 ]. Local livelihood challenges have pushed millions of individuals away from their homes towards income opportunities that are often difficult to refuse or in which conditions are nonnegotiable—including situations of human trafficking [ 43 ]. To reduce people’s vulnerability to extreme forms of exploitation, the international community has made substantial investments in community-based awareness raising and migration knowledge building [ 44 ]. These efforts are often based on the premise that, if individuals were more informed about migrating for work, they would be less susceptible to being exploited. However, there remains little evidence to demonstrate that human trafficking is caused by information deficits among prospective migrants or about the positive effects of premigration awareness interventions [ 45 ].

People may be at greater risk of entering potentially exploitative arrangements when they are compelled to make urgent migration decisions, such as when confronted by humanitarian crises such as armed conflict, environmental disasters (tsunamis, flooding, earthquake), organized and gang violence (e.g., Northern Triangle of Honduras, Guatemala, El Salvador), or personal crises such as family illness or death [ 46 – 48 ]. Household debt can push people to accept extortionate job placement or employment terms and conditions—and, conversely, people may take out loans at difficult repayment rates to fund their migration [ 49 ]. For example, 91% of Bangladeshi migrants reported multiple migration-related debts, including labor brokers’ fees [ 50 ]. Social support and job assistance schemes [ 51 ], where available, can mitigate distress migration but are sometimes perceived as inadequate to overcome financial pressures, long-term poverty, or to secure financial self-sufficiency [ 52 ].

Destination

At the work destination, labor exploitation and related abuses and their converse, ‘decent, safe employment,’ are generally determined by a combination of employment arrangements and work conditions [ 28 , 53 ]. The terms of employment set the parameters for the ways and extent to which a person can be exploited (e.g., low wages, piecework pay, extended hours, penalties for early termination of contract). For instance, among posttrafficking service users in the Mekong, an average work day (7 days per week) for fishermen was 19 hours, was 15 hours for domestic workers, and was 13 for factory workers [ 54 ]. Trafficked individuals are rarely given a contract, and if one is provided, they may not be able to read or change it [ 38 ]. Workers are rarely provided personal protective equipment (PPE) or medical insurance and few workplaces are equipped with health or safety measures, especially in less regulated sectors. Labor inspections are also uncommon, and when they do occur, inspectors are unlikely to check if workers are trafficked [ 55 ].

After being exploited, many trafficked workers are encumbered by physical and/or psychological health problems and debt. Trafficking victims seldom have access to health or social assistance or legal remedies such as financial compensation for work-related injuries or illness, disability-related lost future earnings, or unpaid wages. Debts and other financial obligations, including for medical care, can increase survivors’ vulnerability to further exploitation [ 49 ]. Additionally, returnee migrants who failed to gain the income they and their family expected commonly feel deep disappointment and sometimes stigma, which can lead to poor mental health outcomes and potential risk of retrafficking [ 56 , 57 ]. Moreover, when one family member is disabled, other family members, including children, may be pushed into exploitative situations. This can begin a generational cycle of entry into hazardous labor, such as has been observed among families and children working in palm oil plantations in Indonesia, mica mines in India, or tobacco farms in the United States [ 58 , 59 ].

Because there has been limited theoretical work conducted on labor exploitation and harm, this broad framework is meant to help guide future intervention research and prevention strategies. However, each of the categories and variables proposed must be understood within differing historical and socioeconomic contexts and the reigning political climate that might, for instance, fuel discriminatory public discourse on migrants and migrant workers.

Slavery and its like have existed for millennia; so have social and economic inequalities. Through the declaration of the 2030 Sustainable Development Goals, the international community has promised that efforts will be dedicated to reducing poverty, ensuring healthy lives, and, most encouragingly, promoting decent work. This brings us back to the proposition we posed initially: human trafficking should be considered a global health concern. First, in terms of prevalence, when compared with other well-recognised global health problems such as the approximately 35 million people infected with HIV or the 1 million girls under age 15 who give birth every year [ 60 , 61 ], human trafficking seems to deserve similar attention, with current estimates at approximately 40.3 million people [ 1 ]. Next, when considering harm, findings from studies around the world indicate consistently that most trafficked people experience violence and hazardous, exhausting work, and few emerge without longer-term, sometimes disabling, physical and psychological damage [ 54 ].

To date, there has been very limited engagement by the global health community in the dialogue on or responses to trafficking. Similarly, those working to address “modern slavery” have given little attention to the health impact of trafficking. So, how does one bring these communities together? As the first medical journal collection on human trafficking, exploitation, and health, the PLOS collection offers a good start towards gaining greater attention from the health sector. Providing evidence alongside expert commentary, this collection points to the range of clinical specialties and policy considerations required to address human trafficking as a global health determinant. Similarly, initiatives to tackle modern slavery, forced labor, and human trafficking need to make the links between human trafficking and health by working more closely with the health sector [ 62 ]. For both communities, a public health approach that treats the harm from exploitation as preventable will help foster interventions on the large scale that is needed. We urgently need to know more about the health burden posed by exploitative, low-wage, and hazardous labor, and, most importantly, the associated risk factors, especially in Asia and Africa—locations where some of the most exploitative labor occurs [ 63 ]. This is the type of evidentiary groundwork that was laid to address complex social problems such as intimate partner violence and that is now included in many routine health surveys and the international calculation of the Global Burden of Disease [ 25 , 64 ]. Importantly, to intervene in effective and efficient ways, evidence is also needed on the determinants of human trafficking and on who is most affected and in what ways so that precious funds for intervetions are well targeted. The ecological framework introduced in this paper might serve as a starting point to direct research to investigate key structural, social, and individual drivers of exploitation.

Moreover, a public health approach to prevent human trafficking should simultaneously generate greater attention to its less recognized sibling, labor exploitation. That is, initiatives to address human trafficking will benefit from including actions to prevent exploitation and harm among low-wage laborers, more broadly—in what is often known as 3D work: dirty, dangerous, and demeaning. A dialogue is needed about how much and in what ways low-wage workers are currently exploited and about the ways that work-related hazards might harm individuals, including by disabling parents, who may then be forced to send their children to work—perhaps producing a generational cycle of disability and disenfranchisement.

In an era in which the value of human labor appears to be systematically degraded and political rhetoric further marginalizes already disregarded migrants and disadvantaged workers, now is a propitious moment to launch, in earnest, global health actions to tackle endemic labor exploitation.

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Innovations in empirical research into human trafficking: introduction to the special edition

• Published: 25 July 2019
• Volume 72 , pages 1–7, ( 2019 )

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• Ella Cockbain 1 &
• Edward R. Kleemans 2  

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When it comes to human trafficking, hype often outweighs evidence. All too often, the discourse on trafficking – increasingly absorbed under discussions of so-called ‘modern slavery’ too – is dominated by simplistic treatments of a complex problem, sweeping claims and dubious statistics [ 1 , 2 , 3 ]. Such an approach might help to win attention, investment and support for an anti-trafficking agenda in the short term, but ultimately risks causing credibility problems for the entire field and contributing to ineffective, even harmful, interventions [see, e.g., 2 , 4 – 6 ]. From the 1990s onwards, levels of interest and investment in counter-trafficking expanded rapidly [ 3 , 7 , 8 ]. In tandem, the literature on trafficking has proliferated [ 9 , 10 ]. Yet, actual empirical (data-driven) research remains relatively rare [ 11 , 12 , 13 , 14 ]. Of course, non-empirical approaches have value too – for example in challenging how we conceptualise trafficking or highlighting tensions in governments’ or businesses’ commitments to anti-trafficking measures. Nevertheless, empirical research is clearly crucial to advance understanding of the trafficking phenomenon and shape nuanced, evidence-informed policy and practice. Even where empirical research exists, its quality can be highly variable, with many publications (even peer-reviewed ones) found to fall short of even rudimentary scientific standards [ 13 , 15 ]. Additionally, there is a particular dearth of rigorous, independent evaluations of interventions [ 7 , 13 ] – despite the many millions of dollars spent thus far on anti-trafficking efforts worldwide [ 12 , 16 ].

Before proceeding, it is worth acknowledging some fundamental tensions in researching human trafficking. First, trafficking is not a neatly delineated phenomenon that can be consistently identified and readily counted [ 1 , 2 ]. Instead, it is a relatively fuzzy social construct that exists upon what is increasingly recognised as a ‘continuum  of exploitation’ running from decent conditions through to severe abuses [ 17 ]. Second, trafficking is not – and has never been – ‘discursively neutral terrain’ [ 18 ]. Instead it is contested territory that has long been tied up with broader political, economic and ideological agendas [ 3 , 19 ]. Third, trafficking is a sensitive topic involving hidden populations [ 20 ]. Whether those involved are identified at all – let alone assigned the trafficking label – is heavily contingent on other factors, ranging from victims’ willingness to disclose abuses to funding and prioritisation of counter-trafficking efforts [for further discussion, see 21 , 22 ].

Despite these issues, it would be hard to argue that the extremes of exploitation that are – or could be – conceptualised as trafficking do not merit attention and intervention. If the trafficking field is to evolve and maintain credibility, therefore, more high-quality empirical research is needed. With so many gaps, there are many directions its expansion could take. Here, we highlight some of the gaps and limitations that are particularly pronounced and well-documented. Traditionally, research has focused overwhelmingly on sex trafficking and other trafficking types have been relatively overlooked [ 12 , 13 ]. Victim-focused research dominates the literature, leaving offenders comparatively neglected [ 23 , 24 , 25 ]. Most trafficking research is qualitative in nature and quantitative studies are far rarer, particularly those that go beyond descriptive statistics alone [ 9 , 13 ]. Accessing research data and participants is notoriously challenging and remains a key barrier to the development of the field [ 11 , 21 , 26 ]. On the one hand, existing datasets (e.g. police or other administrative data) have obvious under-tapped potential for academic research and could be used far more extensively and effectively [ 21 , 27 , 28 ]. On the other, increased investment in primary data collection – such as via survey methods – is also necessary to address questions that existing data cannot answer. Perhaps linked to difficulties accessing data, trafficking studies typically focus on a single country and robust comparative analyses across multiple jurisdictions are rare [see, e.g., 29 ]. Although researchers have often approached human trafficking through a criminological or sociological lens, trafficking is clearly not just a crime problem. Other disciplines, such as geography, public health, management and computer science (to name but a few), also clearly have much to contribute [see, e.g., 30 – 32 ]. Linked to this disciplinary expansion, pushback continues against exceptionalising trafficking: rather than treating it as the product of a few isolated criminals (i.e. ‘bad apples’), there is a need to examine more closely how exploitation can be enabled or exacerbated by broader systems (i.e. ‘bad barrels’) such as those involved in the neoliberal labour market and its regulation as well as migration policies [see, e.g., 33 – 36 ]. Finally, it is not enough just to do more research on trafficking: the research itself needs to consistently meet high standards, for example in terms of methodological transparency and rigour, solid research designs and robust ethical conduct [ 13 , 37 ].

Given this context, we are delighted this special edition begins to address many of these key gaps. The papers in it have been written by some of the world’s leading academic experts on trafficking and span a range of countries, topics and approaches. What unites the contents is a shared grounding in original, empirical research and innovative contributions to the literature, be it in thematic, methodological and/or conceptual terms. Thanks to funding from the Economic and Social Research Council of the UK, the process included a symposium in London in July 2018. Lead authors came together to present their first drafts and share their feedback on one another’s work; the resultant papers are all the stronger for the constructive criticism and vigorous debate that ensued. Overall, we are confident that this volume has much to offer for academics, policy-makers and practitioners interested in new perspectives on human trafficking. Below, we provide a short summary of each paper, followed by some brief concluding observations.

The special edition starts with a rare quantitative analysis of individual-level data on human trafficking, using data from the United Kingdom’s central system for identifying trafficking victims. For a sample of 2,630 confirmed victims, Cockbain and Bowers [ 38 ] systematically compare those trafficked for sexual exploitation, domestic servitude and (other) labour exploitation. They examine similarities and differences in terms of victim demographics, the trafficking process and official responses. They find both substantial and significant differences between types, demonstrating that human trafficking is a complex and diverse phenomenon. Although different forms of trafficking are routinely conflated in research, policy and interventions, this study highlights the value of a more nuanced approach that takes into account differences between – and indeed within – trafficking types.

Qiu, Zhang and Liu [ 39 ] provide a new perspective by focusing on trafficking for forced marriage – a particularly understudied issue – in the Chinese context. Women from poor neighbouring countries, such as Myanmar, frequently look for employment opportunities in China. Due to a severe imbalance in China’s sex ratio, a trafficking market has emerged to meet the demand for brides. The authors analyse 73 court cases involving 184 Myanmar women who were trafficked into China in the period 2003–2016. They find that most traffickers had limited education and were either unemployed or underemployed. The vast majority were Chinese nationals with good connections in both the cross-border trade and traditional matchmaking business. Most trafficking turned out to involve few formal organisational structures and occurred primarily under the guise of employment opportunities: it appeared that most victims were recruited within Myanmar in response to the offers of a job in interior China.

Wijkman and Kleemans [ 40 ] shed new light on female offenders involved in human trafficking, in particular trafficking for sexual exploitation. Analysing the court files of 150 women convicted for trafficking offences in the Netherlands, they conclude that popular conceptions of the role of women in trafficking are inaccurate and simplistic. Contrary to stereotypes of passive female victims/predatory male offenders, their analysis shows that female traffickers are neither rare nor unimportant. The roles they performed were not limited to low-ranking activities, nor were they exceptional: instead they could be similar to those of male offenders. Specific prior experiences of victimisation, such as a history of being sexually exploited, inadequately explained women’s involvement in the offending. Finally, the frequent presence of male co-offenders clearly shows that offending is embedded in social relationships, including intimate (romantic) relationships.

Brunovskis and Surtees [ 41 ] offer timely insights into the complexities of identifying trafficking victims in situations of massive and rapid transit movements. Their focus is on Europe’s so-called “refugee crisis” of 2015 and 2016. They draw on fieldwork in Serbia, where an extraordinarily high number of vulnerable migrants/refugees from different countries and cultural backgrounds passed through along the Balkan route over a short period of time. Opportunities to interact with these migrants/refugees in ways that would lead to victim identification and support proved heavily constrained. In such situations, the authors found it was difficult to set up appropriate and effective human trafficking screening mechanisms and to identify particular vulnerabilities. They conclude that the anti-trafficking framework can be difficult to apply in mass migration settings and does not always fit well with peoples’ experiences. Moreover, the protections on offer may not be suitable for or wanted by those who would be eligible.

Davies and Ollus [ 42 ] situate labour exploitation – including but not limited to trafficking at the extreme end of the spectrum – firmly within the context of developments in the economy, labour markets, and society at large. Breaking with dominant approaches to anti-trafficking that tend to centre individual offenders, they focus instead on how supply chains and business practices can enable and exacerbate the exploitation of vulnerable workers. Their analysis is based on qualitative, semi-structured interviews with both workers and supply chain stakeholders (e.g. employers, intermediaries and regulators) in the UK agri-food industry ( n  = 27) and the Finnish cleaning industry ( n  = 38). They identify industry dynamics, labour subcontracting and insufficient regulatory oversight as key factors in enabling exploitation in otherwise legitimate businesses. Given the significant role of corporate practices in facilitating exploitation, the authors argue in favour of framing labour exploitation as a form of corporate crime.

Van Meeteren and Wiering [ 43 ] take a fairly unusual approach in examining labour trafficking in the context of regular rather than irregular migration, specifically a labour migration scheme for the Chinese catering industry in the Netherlands. Through an in-depth qualitative analysis of investigative files from eight such cases identified as constituting labour trafficking, the authors explore various mechanisms through which exploitation is facilitated and sustained. They focus in particular on the impact of restrictions connected to regular migrant workers’ immigration status. The authors conclude that while employers and victims alike can manoeuvre within the space provided by immigration policies, these policies clearly shape relationships and dependencies in the labour market. They find, for example, that migrants’ reliance on their employers for work and residence permits makes them hesitant to disobey, run away and risk the large sums they have already invested in their migration ambitions. Tied residence and work permits emerge in this way as a particularly important contributor to vulnerability to labour exploitation.

De Vries, Nickerson, Farrell, Wittmer-Wolfe, and Bouché [ 44 ] extend research on the relationship between anti-immigration sentiment and criminal justice problems and solutions, by focusing on public support for anti-trafficking efforts in the United States. Using public opinion data from a nationally representative survey with 2,000 respondents, the authors find that anti-immigration sentiment is related to greater recognition that immigrants are vulnerable to human trafficking victimisation. While anti-immigration sentiment does not impact views on general governmental prioritization of counter-trafficking policies, it is associated with less public support for services for immigrant trafficking victims. These findings might explain why, according to the authors, public policies safeguarding migrant trafficked persons have been among the most difficult to pass in the United States, despite strong overall support for government prioritisation of anti-trafficking efforts.

Overall, this special edition covered a wide range of topics, geographies, datasets and methods. Despite the variety in the approaches, some common themes can be identified, which have important implications for research, policy and practice. First, many contributions underscore the complexity and diversity of both trafficking and counter-trafficking activity, including in terms of attributes and attitudes of victims, offenders and the general publics. Moving away from one-size-fits-all approaches is vital to become more effective at explaining and tackling this issue. Second, many papers highlight the importance of contextual factors in understanding how trafficking and exploitation are produced, sustained and exacerbated. Greater recognition of contextual factors - both at the individual- and systems-level - is crucial in supporting more nuanced responses and identifying a wider range of avenues for intervention. Third, the articles often challenge stereotypes, debunk myths and/or question assumptions about how trafficking and counter-trafficking function. With trafficking such a ‘hot’ topic, it is vital that rigorous empirical research continues to provide a measured and informed counter-balance to media and political treatments that are all too often simplistic and sensationalised.

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Acknowledgements

We are very grateful to the Economic and Social Research Council of the UK for funding the symposium in London via Dr. Ella Cockbain’s Future Research Leaders Fellowship (grant reference: ES/K008463/1). We thank the Department of Security and Crime Science at University College London for hosting the event and all who attended for their valuable contributions and feedback on others’ work. We thank all the anonymous reviewers for their generosity with their time and insightful comments. Our final thanks goes to the journal’s general editors, Professors Mary Dodge and Wim Huisman, for their support for this special edition and assistance throughout.

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Cockbain, E., Kleemans, E.R. Innovations in empirical research into human trafficking: introduction to the special edition. Crime Law Soc Change 72 , 1–7 (2019). https://doi.org/10.1007/s10611-019-09852-7

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Human trafficking risk factors, health impacts, and opportunities for intervention in Uganda: a qualitative analysis

• Robin E. Klabbers   ORCID: orcid.org/0000-0002-1462-0046 1 , 2 ,
• Andrea Hughes 3 ,
• Meredith Dank 4 ,
• Kelli N. O’Laughlin 1 , 2 ,
• Mutaawe Rogers 5 &
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Human trafficking is a global public health issue that is associated with serious short- and long-term morbidity. To address and prevent human trafficking, vulnerabilities to human trafficking and forces sustaining it need to be better understood among specific subpopulations. We aimed to explore risk and protective factors for human trafficking, the health impact of exploitation, and barriers and facilitators of seeking help throughout the human trafficking trajectory among forced labor and sex trafficking victims in Kampala, Uganda.

Between March and November 2020, in-depth, semi-structured qualitative interviews were conducted with 108 victims of forced labor and sex trafficking who had completed a human trafficking survey conducted by the Uganda Youth Development Link (UYDEL). Participants who experienced various forms of exploitation were purposively invited for qualitative interviews and a convenience sample was interviewed. Interviews explored personal history, trafficking recruitment, experiences of exploitation and abuse, and experiences seeking help. Interviews were analyzed using a combination of deductive and inductive thematic analysis. Themes and subthemes were organized using an adapted conceptual framework of human trafficking.

Poverty and an abusive home life, frequently triggered by the death of a caretaker, underpinned vulnerability to human trafficking recruitment. Limited education, lack of social support, and survival needs pushed victims into exploitative situations. Victims of human trafficking were systematically exploited and exposed to dangerous working conditions. Victims suffered from sexually transmitted diseases, incontinence, traumatic fistulae, musculoskeletal injuries, and mental health symptoms. Lack of awareness of resources, fear of negative consequences, restrictions on movement, and dependence on the trafficker and exploitation income prevented victims from seeking help. The police and healthcare workers were the few professionals that they interacted with, but these interactions were oftentimes negative experiences.

Conclusions

To address and prevent human trafficking, localized interventions are needed at all stages of the human trafficking trajectory. Health impacts of human trafficking are severe. As some of the few professionals trafficking victims interact with, police and healthcare workers are important targets for anti-trafficking training. Improved understanding of human trafficking drivers and barriers and facilitators to seeking help can inform the design of necessary interventions.

Human trafficking is defined by the United Nations Office on Drugs and Crime as the action of “ recruitment, transportation, transfer, harboring or receipt of people” using “ force, fraud or deception” to achieve the goal of “ exploiting them for profit” [ 1 ]. Human trafficking encompasses sexual exploitation, forced labor, slavery, servitude, and the removal of organs [ 2 ]. Recruiting, transporting, transferring, harboring or receiving a child under the age of 18 for the purpose of exploitation is always considered trafficking, even when force, fraud, or deception is not present [ 2 ]. An estimated 27.6 million people are exploited worldwide [ 3 ].

Human trafficking has historically been regarded as a criminal justice issue and has consequently been responded to through regulatory and law enforcement action. In recent years, however, there is increasing recognition of the importance of taking a public health approach to human trafficking [ 4 , 5 ]. Framing human trafficking as a global public health issue draws attention to its health impacts on victims and its preventable nature. Human trafficking victims suffer detrimental physical and mental health impacts in the short- and long-term as a result of the hazardous working conditions and spectrum of abuse that they are exposed to [ 6 ]. The first step to prevent human trafficking, and to reach Sustainable Development Target 8.7: to eradicate forced labor, modern slavery, and human trafficking by 2030, is to understand the complex interplay among risk and resilience factors.

Human trafficking has been presented by Zimmerman et al. as a series of sequential event-related stages: recruitment, travel and transit, exploitation, and integration (and in some cases re-trafficking/re-integration) [ 7 ]. Conceptualizing trafficking in this way, presenting it as a series of stages that victims may pass through, emphasizes the cumulative nature of health risks across this trajectory and highlights the different timepoints at which intervention could take place. In 2017, Zimmerman et al. published a second model that focuses on labor exploitation specifically. This model reiterated that exploitation and harm occur throughout all stages of the exploitation process, but added a focus on social and economic inequalities as structural drivers of exploitation [ 4 ]. Both models underscore the complexity of the human trafficking problem showing that it is influenced by multiple determinants which may vary across contexts and forms of exploitation.

Uganda is a source, transit, and destination country for human trafficking; 1,476 trafficked persons were identified in Uganda in 2020 [ 8 ]. The concealed nature of human trafficking and barriers to help-seeking make the identification of trafficked persons challenging, but estimates suggest that 2,057,000 children are involved in child labor and 7000–18,000 children are victims of sex trafficking in Uganda, with a lifetime sex trafficking prevalence as high as 11.9% in some Ugandan districts [ 9 , 10 , 11 ]. Given that school attendance in Uganda is only mandatory until the age of thirteen and the legal age of employment is sixteen years, children aged thirteen through fifteen are particularly vulnerable to human trafficking [ 8 , 12 ]. Children are often trafficked from their villages to more industrialized centers such as Kampala, the capital of Uganda [ 13 ]. Without access to shelter and other resources, many of these children, an estimated 2,600 children aged seven to seventeen in Kampala alone, end up living on the street where they are vulnerable to exploitation through forced begging, selling of goods, sexual exploitation, and illicit activities [ 14 , 15 ].

In this study, we aimed to qualitatively explore the lived experience of individuals exposed to forced labor and/or sex trafficking in Uganda using a public health conceptual model of human trafficking influenced by the 2011 Zimmerman et al. model to identify patterns in vulnerabilities to human trafficking. For each human trafficking stage, we strived to (1) identify risk factors and protective factors for human trafficking (2) assess the health impact of exploitation, and (3) explore barriers and facilitators of seeking help to leave exploitation. While there is a growing body of public health trafficking research and much is known on a general level about the risk factors for trafficking globally, a more nuanced understanding of the local modifiable drivers of human trafficking among specific subpopulations is necessary to guide the design of interventions to address it [ 5 ]. Using a public health framework to systematically explore these drivers for the unique context of human trafficking in Uganda is a novel generalizable approach that will yield locally relevant knowledge.

Study design

The Prevalence of Forced Begging and Sex Trafficking in Kampala, Uganda study took place in Kampala, Uganda between January 2020 and November 2020. It was funded by the Human Trafficking Institute and conducted by John Jay College of Criminal Justice of the City University of New York (CUNY) in collaboration with Uganda Youth Development Link (UYDEL), a non-governmental organization in Kampala focused on enhancing socioeconomic opportunities for disadvantaged youths. As part of this study, UYDEL field teams collected 1787 quantitative surveys and conducted 108 in-depth interviews with individuals aged ten years and older with lived experience of sex trafficking and minors under the age of 18 who were forced to beg and/or sell goods. Here, we report the findings from the analysis of the qualitative interview data. Quantitative survey findings were presented in a report to the Human Trafficking Institute and are available on UYDEL’s website [ 16 ].

Participant sampling and recruitment

Participants were recruited from all five divisions (Nakawa, Central, Rubuga, Makindye and Kawempe) of the greater Kampala district in Kampala, Uganda. A snowball sampling approach was taken in which youth who were in contact with UYDEL who had been forced to beg/sell goods or were engaged in commercial sex were approached by service providers for participation in a quantitative survey about their experiences of exploitation. Participants were compensated Ugandan Shilling (UGX) 5000 (approximately $1.34, €1.24) upon completion of the survey and received UGX 5000 for each additional participant (up to a maximum of three) that they recruited to the study. The survey covered demographic characteristics, migration decisions and debt situations, work conditions and earning experience, workplace abuse and help-seeking behavior. From the group of survey completers, participants were recruited for qualitative interviews with an emphasis on recruiting those participants who were trafficked and had experienced severe exploitation, i.e. participants who experienced various forms of exploitation across multiple survey indicators. Determination sex trafficking and adult forced labor was made in accordance with the United Nations trafficking definition [ 1 ]. A stricter definition of child forced labor was applied, requiring elements of force, fraud, or coercion in accordance with International Labor Organization guidance [ 17 ]. Interested participants were provided with dates and times that UYDEL field staff would be on site and available to conduct qualitative interviews to eliminate the need to record participant contact information. From this purposively sampled population, a convenience sample of ~ 50–60 participants who had experienced sex trafficking and forced begging or selling of goods, respectively, who were able to speak either Luganda or English, and were available at the times interviewers were present, were interviewed.

Data collection

Semi-structured interviews were conducted by six female UYDEL field staff fluent in Luganda and English with a background in social work (for a completed consolidated criteria for reporting qualitative research (COREQ) checklist see Additional file 1 : Appendix A). Participants were asked about their personal history, trafficking recruitment, experiences of exploitation and abuse, and experiences seeking help from justice and social agencies (interview guide included in Additional file 2 : Appendix B). Field teams were trained to recognize severe emotional distress and if distress indicators were present, participants were excluded from participation.

All interview participants provided consent (adults) or assent (children) prior to participation. To protect interview participants, a waiver of parental permission was obtained for children participating in the study as some had been placed into forced begging, selling of goods, or commercial sex work by their parents, and others were at risk of negative repercussions if their parents were to gain knowledge of their involvement in the commercial sex work industry. Age and literacy level appropriate consent/assent forms were read aloud to participants, and a hard or electronic copy was provided for participants to read along and keep.

Following informed consent/assent, interviews were conducted in a private room at a community-based organization or in private spaces in the communities where the participants were recruited with no one but the interviewer and interviewee present. Based on the participant’s preference, interviews were conducted in either English or Luganda and audio recorded with permission to facilitate transcription. Interviews lasted 40 min on average. Participants completing qualitative interviews were compensated UGX 5000 for their time. All individuals approached for study participation were provided a resource card with information on where to access services. Interviews were transcribed and translated into English when necessary by multilingual transcribers. Any mention of potentially identifying information by participants in the interviews was redacted and deleted from transcripts.

Data analysis

Conceptual framework of human trafficking.

To guide the analysis, elements from the 2011 human trafficking conceptual model and the 2017 framework of the socioeconomic determinants of labor exploitation and harm by Zimmerman et al. were combined by the research team to conceptualize human trafficking in the Ugandan context (Fig.  1 ) [ 4 , 7 ]. The adapted conceptual framework characterized human trafficking as a multi-stage trajectory which starts with an individual’s life pre-trafficking (stage 1) in which risk and protective factors determine their vulnerability to being trafficked. At a certain point in time, individuals may be approached by an intermediary and recruited to a place of exploitation, or themselves travel to a new context where they are subsequently recruited. During this recruitment and travel/transit stage (stage 2), several risk and protective factors contribute to an individual’s vulnerability to progress to exploitation. During travel and transit, individuals may experience their first exposure to exploitative practices and harm and the associated health impacts. At this stage, barriers and facilitators influence the extent to which individuals are able to seek help. After initial recruitment, most individuals will continue to the exploitation stage (stage 3) in which they are exploited and harmed leading to negative health impacts. Various risk and protective factors influence how long individuals remain in the exploitation stage. Depending on the barriers and facilitators that are present, individuals may or may not be able to seek help during this stage to improve their circumstances. Help can take on many forms and can have an impact on the individual’s health. While for some individuals, exploitation ends and they can integrate back into society after being exploited (stage 4), many remain in exploitation or exit and are re-trafficked resulting in multiple cycles of exploitation.

Human trafficking framework adapted from Zimmerman et al. [ 7 ]

Interview transcripts were split into two groups by a human trafficking expert on the research team according to whether the type of exploitation described was forced labor or sex trafficking. If both exploitation types were experienced, the focus of the interview determined to which analysis group or groups the transcript was assigned. The two groups of interviews were analyzed using separate codebooks created through a combination of deductive and inductive thematic analysis. Open coding was applied to a random sample of 10 interviews by two researchers (AH, REK) independently to identify themes and subthemes. Identified themes and subthemes were subsequently organized using the adapted conceptual framework of human trafficking designed by the research team. Organized themes were compared between the two researchers and discussed until consensus on a preliminary codebook was reached. The codebook was then applied to the remaining interviews, which were divided equally between the two researchers (random assignment of first vs second half of the list of interviews). As new themes emerged from the interviews, the codebook was iteratively refined, and after every 10–20 interviews, codes were discussed between the two researchers, resolving unclarities and discrepancies by consensus. After coding all interviews, the findings were assessed for patterns in vulnerabilities to human trafficking throughout the human trafficking trajectory. Specifically, risk and protective factors for human trafficking were considered, health impacts of exploitation, and barriers and facilitators to seeking help. For each of these, differences between the lived experience of sex trafficking and forced labor victims were noted.

Demographic characteristics of the participants

Interviews were conducted in Kampala between March 2020 and November 2020 with a total of 108 participants. Of them, 72 participants had lived experience of sex trafficking, 31 participants had been subjected to forced labor, and 5 participants had been exposed to both types of exploitation (two analyzed as sex trafficking victims, one analyzed as a forced labor victim, and two analyzed in both groups). Most interview participants were female (80%) and the median age was 18 years (min 11, max 30 years). The interviews conducted with victims of forced labor focused on children under 18 years of age and consequently, interview participants exposed to forced labor were younger (median age 14 years versus 20 years) and had lower education levels than sex trafficking survivors (Table 1 ). Participants who were sex trafficking survivors were more frequently female than participants who were forced labor victims (97% vs 42%). Almost all interviews were conducted in Luganda.

Participants’ lived experience was explored through a public health lens. Various human trafficking risk factors, barriers to seeking help, and health impacts of exploitation and harm were identified (Fig.  2 ). Key findings are presented in Table 2 . Similarities and differences were observed between the experiences of victims of forced labor and victims of sex trafficking. Of note, participant quotes are presented to highlight experiences, risk and protective factors, and barriers and facilitators of interest, and therefore do not always contain all the data used to determine whether participants’ experiences met criteria for human trafficking.

Patterns in the lived experience of forced labor and sex trafficking victims

Warning: results section contains potentially disturbing content including graphic descriptions of violence, child abuse, sexual assault, and bestiality, which may be emotionally challenging to engage with . Reader discretion is advised.

Vulnerability resulting from life-circumstances pre-trafficking

Broadly, vulnerability could be split into two main categories, namely vulnerability resulting from financial hardship and vulnerability stemming from an abusive home situation. These vulnerabilities could co-occur. Participants described living in difficult circumstances in which there was insufficient money to meet basic survival needs including food, clothing, and medicine. Often, multiple family members were dependent on a single income. The need to repay a debt caused by medical costs, funeral costs or gambling addiction compounded financial hardship in some cases. One participant described, “ My mother has some debts in the village, however her debts are ever unending, school fees debts for my young siblings and also before the death of my father he left so many debts” (Forced labor, Female, age 11).

Financial difficulties repeatedly had a clearly identifiable trigger – the death of (one of the) the family breadwinner(s), usually a parent. Approximately half of all interview participants reported the death of a family member or caretaker. Causes of death varied and included disease, war, natural disasters, and suicide.

From primary one up to primary four, life was very easy because my dad was still there. I used to stay with my dad and my mum, and that is why life was very easy, but since my dad passed away, life became very hard. From primary five to primary six, up to primary seven, it was very hard because I was the one who was paying my [school] fees, struggling for it, and my mum didn’t have enough money. – Sex trafficking, Female, age 22

In situations of financial hardship, school fees were often an expense that could no longer be covered causing participants to drop out of school which explained the very limited education among interview participants. One participant regretted the consequences of her family’s economic circumstances for her schooling saying, “I stopped in primary six truthfully, because of school fees issues…I liked studying, but did not have the chance” (Sex trafficking, Female, age 18). In these dire circumstances of poverty, any work opportunity or offer to take the responsibility for a child or a child’s school fees off a parent’s hands, was considered very welcome. A participant described how her mother was presented with a financial opportunity saying, “So when she [participant’s mother] failed to get money, there was a friend of hers who told her that there was someone who wanted a maid this side of [medium size urban neighborhood in southern Kampala], so I came. But my mother was told that I was going to be a house girl, so I came thinking that too” (Sex trafficking, Female, age 17).

The second main determinant of vulnerability that could be identified in the interviews was an abusive home life. Interview participants gave accounts of beatings, neglect, mistreatment, withholding of food, sexual abuse, and being forced to carry out all the housework. Often, the abusive situation started when there was a new influence in the family, someone who was not a blood relative. One participant recounted how the abuse started when she moved in with her stepmother after her mother passed away:

My mother got sick and they took her to the hospital … When she died, my father took me to his mistress in [medium size urban neighborhood in Northern Kampala], that’s where we were staying, but she would mistreat me and I didn’t have any peace. … She would cook food and only give to her children, yet I was the one who would do all the work. – Sex trafficking, Female, age 18 My father gives a lot of attention to my stepmother. When she tells him something we had not done, he beats us, ties us on ropes, he starves us and [makes us] work all day. She doesn’t want to give us what to eat [something to eat]. When my father comes back, she tells him that we don’t want to work. There was a day I washed clothes. I washed three basins full of clothes. These big ones while she was beating me with a mingling stick [kitchen utensil] in the back. My back is paining! She could abuse my siblings telling them things like "Was I the one who killed your mother? You children don’t work!" While she treated her children like princesses, I even don’t know. They could also abuse us like that. – Forced labor, Male, age 15

Participants who did not feel safe or well-treated at home were often driven to run away and find alternative living arrangements. One participant described how he decided to leave the village and try his luck elsewhere saying, “I felt tired of the village… because in the village, it was pain and mistreatment. I was tired of being tortured and beaten in the village like a thief. I got fed up and decided to go to the city.” (Sex trafficking, Male, age 17).

The life-circumstances pre-trafficking that culminated in vulnerability to human trafficking were similar for participants who experienced sex trafficking and participants involved in forced labor.

Risk factors for recruitment and travel & transit

Among the interviewees, there was a general trend of movement from the village where participants grew up to the “big city,” Kampala. For some participants, recruitment into exploitation took place while they were still living in the village. Other participants traveled to the city first and were recruited from there. Participants were recruited by family members, friends, acquaintances and sometimes strangers.

Recruitment in the village

For participants who were trafficked from the village, an “opportunity” was often presented by traffickers that leveraged the vulnerability caused by financial hardship or an abusive home situation. For those who entered forced labor, it was often a family member or an acquaintance that offered to take participants in, cover their school fees, or provide them with work. In some interviews, the venue for recruitment was at the funeral of one of the participant’s caretakers at a time when it was unclear who would support the child. Others were approached during sports tournaments and dance performances.

When my father passed on … after the burial, there was a lady who was too, too close friend to my mother. She spent mourning for one or two weeks when she was around. She said she can help me get a job, telling my mother, because my mother had no capacity to take care of us. My siblings were so many yet I was the elder, so she said I should go and work. – Sex trafficking, Female, age 18

Another participant recalled how acquaintances had offered to take her in and cover her school fees after her father passed away saying, “ During father’s burial, there came his friends saying, ‘Am going to educate such a child. Give me this child'” (Sex trafficking, Female, age 16). The situation participants entered into, however, was rarely as promised. Instead of being sent to school, the children were put to work begging, selling, and collecting scrap. One participant described how her grandmother was deceived saying, “she said she would take me to school, so my grandmother accepted … because she didn't have money for my school fees. She just told me to go with her. When I reached there, it was only after one week and then she started giving me pancakes to sell” (Forced labor, sex unknown, age 11). Another participant spoke of false promises made by her uncle:

[I was] 5 years old when my uncle got me from the village and brought me here to Kampala in [small size urban location in the central business district of Kampala]. He told my parents that he was taking me to a certain school in Kampala that was offering full bursaries [scholarships] … My parents accepted because I was studying from the village and it was still hard for my parents to get school fees … I was so happy for the opportunity that I was offered, but to my surprise when I came to Kampala, things changed because after two days of my staying with them, the following day aunt decided to take me to the street so that we can beg together. I asked them, "What about the bursaries you told my father about?". My uncle told me not to question him but rather do as they say. – Forced labor and sex trafficking, Female, age 21

For participants that ended up in sex trafficking, the opportunity presented was usually a work opportunity in the city such as work in a house, hotel, or salon. Sometimes it was work that was already being done by a friend who appeared to be doing well. In many cases, the work opportunity turned out to be fictitious and what participants were actually being recruited for was commercial sex. One participant recalled how her friend visited and told her about her exciting life in Kampala saying,

One holiday, she came back to the village and told me that Kampala was so interesting. …I had a tough mother. One day, she [my mother] beat me and my heart ran to [I thought of] my friend. I said, "Why don’t I pick my things and I go?". When we came to the city, she [my friend] never told me anything. … When we arrived at [medium size urban neighborhood near the central business district of Kampala], she took me into a house but the house had only girls; I later discovered that the house was like a lodge. Men come in and use you and give you some money around five to ten thousand shillings. – Sex trafficking, Female, age 21

Once they started their new work opportunity, several participants were subjected to forced sex for the first time. These participants described a distinct initial trauma, typically rape by a customer or (a family member of) their employer. After going through this, they either chose to endure in their employment because they felt like there was no other option, or they left the work opportunity and found themselves living on the streets. After this initial gateway experience many resorted to engaging in commercial sex, and ultimately experienced sex trafficking.

When I was brought here, I was taken to her [the recruiter, a family friend’s] home. I studied for some little time while coming from her home. She was married and her husband raped me, so I left home. I met a friend who brought me here. – Sex trafficking, Female, age 23

Sometimes, participants were indebted to the trafficker who had recruited them from the village, making it difficult to leave their current situation. One participant recounted how she was not able to leave when she found out what she would be doing and said,

Yes, and that lady gave me a room and told me that I was going to start working from there, but I told her that I won’t be able to do it. But she said that I would work whether I liked it or not and that I didn’t know anyone in Kampala and that they also had to do that in order to survive. But I told her that I won’t manage and she assured me that I would manage. So when we reached, after two days, men started coming to me. The first one asked me, "Do you know this?" So, I asked him what he meant, but he just told me, "Set-up yourself quickly, I have other things to do and I have somewhere I am going". So, I also didn’t have a choice. So after five days had passed, I was getting used to it. I had nothing to do, nowhere to go, but in my mind I wanted to run. But I didn’t have a phone maybe to call my mother, had nothing on me that could help me go back home, so I just let it be. After two months I was used to everything. – Sex trafficking, Female, age 16

Recruitment in the city

The second group of interview participants reported coming to the city of their own volition, being abandoned in the city, or being put on a bus to the city by family members. Once on the streets, participants needed to find a means to survive. The lack of a place to go, not knowing anyone in the city, and lack of income put participants at risk of human trafficking. The limited educational background that most participants had left few options for a stable income. Many younger participants described finding safety in numbers by joining groups of street kids for survival. They then typically started doing the work that other street kids did such as collecting scrap metal, bottles, or selling soap. One participant shared his experience of first arriving in Kampala saying,

I stayed there in the city and started hustling. While I was there, I found people speaking our mother tongue. I joined them. They were home people, they understood me and I clung on them. They took me to their place. When we reached there, they told me that it was hustling throughout to sustain you. They told me that their bosses needed money therefore you had to go and look for it. I went into scrap; they took me to trenches, they have given me drugs to sell. There are those people we sell to. That is how I started living with them. – Forced labor, Male, age 15

For interview participants with lived experience of sex trafficking, who were typically older than the forced labor participants, having dependents, often children, added to the pressure to find work by any means. It was difficult to meet their own survival needs as well as those of their dependents, and they began engaging in commercial sex acts to provide for the family unit, which ultimately became a situation of sex trafficking.

I had two children! I have no job! I commenced from where I had ended. I had to look for money for both children. I could not even imagine the number of men I had to sleep with to get what to eat and yet I also had to look for money for rent. – Sex trafficking, Female, age 30 Sometimes a bad situation can drag you into something that you would not wish to do. ... First of all, I have to buy myself food, secondly I need rent, thirdly I needed school fees to educate my child. – Sex trafficking, Female, age 27

Human trafficking internationally

A minority of interview participants reported being trafficked internationally including to Malaysia and Dubai. One male participant described how a friend presented him with a work opportunity abroad that would allow him to pay back a debt he owed the friend,

[The friend] promised to take me to a money source so that we can work and earn. …The country he took me to was Malaysia. We arrived in a big house. We found some children, men, and girls going through torture and I asked my friend, "Is this the work you have brought me to do?" He said, "Don’t worry, this is where we get the money, and you yourself are the money." … Some of the boys would rape fellow boys. The girls were also raped. They would set cameras to record what we do and then take the recordings for sale to get money. – Sex trafficking, Male, age 19

The international setting compounded participants’ vulnerability to exploitation. Participants found themselves in a foreign country, often with no means of contacting their family, and frequently had their travel documents confiscated by the trafficker. One participant described, “ I was taken to a foreign country without my family knowing, and the contacts I had were just written on a paper. But after reaching Malaysia, they took everything we had. So, I had no way I could contact my family even if I got a chance of contacting them” (Sex trafficking and forced labor, Female, age 21).

Exploitation and its impacts on health

Once recruited, participants entered into a life of exploitation, which resulted in impacts on their health.

Forced labor exploitation

Participants who were exploited through forced labor described being made to collect different items such as scrap metal, bottles, and boxes from the street for their exploiter to sell. Others were forced to beg or steal. Participants often had to work long days, six or seven days a week, and were given almost no time off. One participant reported having no reprieve saying, “There is no resting day unless when there is scarcity of maize [if all the maize has been sold or if it has not been brought to the market yet]. That’s when we rest. However, if it’s seen on market, we go back to work.” (Forced labor, Male, age 14).

[I start work] at 06:00 or 05:00 in the morning....I work until 20:00, that's when I come back and of course I am always feeling tired, yet I actually have to figure out what to eat.....from the time I come back at 20:00, I eat well with what I have gotten from [medium size urban market in the central business district of Kampala] and then I go to beg ... I beg until midnight and then I come back ...I work six days in a week. – Forced labor, Female, age 17

The work frequently took place by the roadside exposing participants to the risk of road traffic accidents and environmental hazards.

Apart from that big accident, I got there some minor accidents. I get like a motorcycle knocking me, but causing minor injuries … Kampala Capital City Authority always chases us and we pass through big trenches where sewage passes, but remember we don't wear shoes because we don’t have them. – Forced labor, Male, age 13

Participants reported being harmed while carrying out their work. Most of the abuse forced labor victims were exposed to was physical. Participants described beatings from strangers, groups of older kids on the street, from customers that they sold their goods to, and from their trafficker/employers. Abuse that was mentioned included beatings with electrical cords, pouring of boiling water over them, being hit with heavy canes, being strangled, and being kicked. Psychological abuse also occurred, and participants reported being subjected to verbal abuse including insults and shaming, being threatened with beatings, not being allowed to leave without permission, and sometimes having food withheld as punishment.

Yes she forces me, when I don’t want to work. … she drags me and starts beating me severely and then she tells me to go and work. So when I come back at night, she tells me to do the housework while beating me and sometimes she ends up not giving me food. … She tells me to treat her well that she’s my mother and father...she ties me up and starts beating me and sometimes she undresses me which shames me in the presence of people. She brings my history that I am an orphan and how she got me from the rubbish pit. Then she strangles me. For sure, this situation treats me so bad and I hate myself. – Forced labor, Female, age 11

While most abuse among forced labor victims was physical, sexual abuse also occurred. Young age contributed to the vulnerability of forced labor victims. They were often dependent on others for their housing or dependent on older street children for safety while living on the street. Multiple participants provided accounts of rape and sometimes sexual exploitation by these individuals that they depended on.

So I decided to keep in the traffic jam selling such that by the time Uncle comes back he does not harass me. … I could come back home at around 10:00pm in the night and immediately he asks money from me and accompanying them with utterances like "You are coming from men". There, he forces you into the sexual acts telling me that "If you got no money, do not waste me, come over here or else I will chase you out of my home" and yet I had nowhere to go. There I bear with and I give in to him. – Forced labor, Female, age 16

For many forced labor victims, the trafficker was a family member. Victims lived with this family member and were dependent on them for food, housing and other essentials. They typically had to hand over all the money they earned and were extremely isolated.

Health impacts of forced labor

The abuse and dangerous exposures victims of forced labor faced in their work resulted in physical injuries that sometimes necessitated hospital admission. Reasons for consulting a healthcare professional described by forced labor victims included road traffic accidents, stepping on broken glass, and injuries from blunt and penetrating force trauma inflicted by others. The impact of their experiences on mental health was also significant and participants described how their life burdened them, how they felt sad and hated themselves.

Sexual exploitation

Interview participants with lived experience of sex trafficking described sexual exploitation with varying degrees of control by the exploiter. The most common situation described was that of commercial sex at a bar or lodge where the exploiter determined which customers participants saw and which types of services they provided them. Customers were seen on the lodge or bar property. Sex trafficking victims were exposed to physical, sexual, and psychological abuse during their work. Physical abuse was perpetrated by customers and employers. Participants described beatings, strangulation, being hit with a belt, cable, or brick, and being stabbed.

I have ever been hit with a bottle; customer came and we did what we had to do. Then he told me that he had no other money yet he wanted another round. So, I told him I was leaving and going somewhere else. When I was leaving, he hit me with a bottle....I don’t really know, that’s when I stopped understanding. – Sex trafficking, Female, age 16 Yes, she [exploiter] cut me with a knife here. I had refused to do what she wanted me to do. She had told me to go and sleep with a man and get money because the man had promised her 50,000 UGX so she told me to sleep with him. I said "No, I will not. What if the man is already infected with a disease and I die?". She said to me, "Haven’t you heard what I told you?". She instead beat me, got a knife which was on a table that she used it to cut me. She told me to go inside the house and stay there, I will not be given food, so I went. – Sex trafficking, Female, age 15

Common triggers for violence towards victims included participant refusal of sex without a condom and disputes over the price of services. There were many accounts of customers refusing condoms, or removing the condom before sex.

When I told him about wearing a condom, he pulled out a knife and put it on me. When he put the knife on me, I plead for mercy. I pleaded with him to have mercy on me. He had really put the knife and told me that I didn’t know the person I was playing with. "I can kill you and leave you here dead and then move away. Where will you find me?" He ignored my plea and still fucked me without putting on a condom. – Sex trafficking, Female, age 27 We always feared contracting it [human immunodeficiency virus (HIV)], but as you know men of nowadays, they come with condoms but leave them at the table. You try to quarrel a bit but they are strong and would tell your boss. We were at the mercies of God. – Sex trafficking, Female, age 21

Initiation into sex trafficking frequently happened through rape, sometimes by multiple people, and in some cases was preceded by drugging the participant. One female explained,

When they took me to a room, they used me. The man used me. After him using me, he was using my anus. When I was sobering up, I felt myself weak. I did not understand what was going on. When I started gaining my sight, I was seeing three men. I did not understand. They were big. I was nude. They had gotten their phone and were taking pictures of me while laughing. I felt my anus paining a lot. I think they took when I was not sober. When I gained my consciousness, I understood that these men had sex with me through my anus. They got out. – Sex trafficking, Female, age 23

Vaginal, anal, and oral rape occurred. In a number of interviews, participants described being subjected to bestiality with dogs and horses.

He brought his two men and caught both my legs and hands. Then he put his dog on me. That day it was not easy because even the dog scratched me in the ear at the beginning. … He then told me that, "It is you who caused it to do this, but if you come when you are calm, it doesn’t hurt in any way". I also started to learn the behaviour of the dog… They could dress it on a condom. He did not want his dog to get sick. – Sex trafficking, Female, age 16 In the morning, girls would be taken to kennels to sleep with dogs; the dogs would have sex with them. The medicine that was injected in us would make the girls seductive to themselves and they would be put to the kennels and let the dogs do all they want to them. The girls would cry, but they had no way out because they would be tied. The medicine injected in boys would enlarge our penises and they would send us to the horses. The horses also seemed to be used to this kind of treatment. You would have to have sex with the horse. – Sex trafficking, Male, age 19

Participants were frequently verbally abused and threatened verbally or with weapons. Their movement was often limited by their exploiter and sometimes food was withheld. Participants had to work when they did not want to and sometimes had to work even when sick. Money was paid either directly to the exploiter who later gave a small proportion to the participant, or participants received money from the customers directly but had to give most of it to their exploiter. It was a common occurrence that customers would not pay after sex or paid less than they had promised. When participants received money from their exploiters, sometimes unexpected fees were deducted such as the cost of the room they worked from or the cost of their meals at the bar.

Health impacts of sex trafficking

The health impacts of sex trafficking were significant. Health impacts could be grouped into three main categories, namely urogenital injuries (i.e., injuries of the urinary or genital organs), musculoskeletal injuries (i.e., injuries relating to bones, muscles, and soft tissues) and mental health consequences (i.e., disturbance in mood, cognition, and the ability to interact with others). Through their work, participants were at high risk of acquiring sexually transmitted infections (STIs) including HIV. One participant described the physical discomfort she felt saying, “I got sick; I first got these diseases that catch in the private parts. It would be hard for me to walk. I would feel pain. When I go to urinate, the urine wouldn’t come out properly, it would be hurting every time I urinated” (Sex trafficking, Female, age 18). Another participant reported contracting multiple STIs saying, “First of all, I contracted HIV/AIDS (acquired immunodeficiency syndrome). We get syphilis infections, candida and those others illnesses that is the second. The third illness that I see coming, if I don't fight for myself, is death.” (Sex trafficking, Female, age 21).

Rape and rough sex caused vaginal and anal injuries leading to the development of fistulas and incontinence problems. Participants described abdominal pain and localized genital pain impacting their ability to sit and to walk. One participant reported fecal incontinence saying, “I did not have brakes behind. Wherever I sat, stools would just flow out. I was treated badly. I could not even sit at times. I would feel a lot of heat at my bottom and pain.” (Sex trafficking, Male, age 17).

Multiple interview participants reported becoming pregnant through their work. Some participants kept the pregnancy and others sought an abortion.

I have only one child, she is 7 months old, but I was not ready to have a child because I was working on the streets and I got pregnant because I did not have safe sex … Yes, I was looking for clients and that is how I got pregnant. I could have aborted it, but I did not have money for abortion. And the little money that I had, I was using it for rent. – Sex trafficking, Female, age 20

Blunt and penetrating trauma inflicted by customers or exploiters resulted in bruises, wounds and fractures that sometimes required hospital care. A participant listed the different places where she had been wounded saying, “Some of us have scars. Like me, I have scars at my back. They cut me with a blade. I have scars in my face” (Sex trafficking, Female, age 20).

The experiences participants went through in their exploitation impacted their mental health. Multiple participants reported taking drugs or alcohol to be able to endure and described how others in their line of work had developed addiction. One participant explained how he used substances as a coping mechanism, saying “You still get some problems. Nowadays, if I am going to do it [sex work], I first sniff some fuel or take drugs to relieve the pain. They do it while I am high” (Sex trafficking, Male, age 17).

Some participants suffered from flashbacks and intrusive thoughts and displayed depressive symptoms. A minority of participants described times when they had suicidal thoughts and ideations. They told of feeling worthless.

Sometimes I pretend around so that they can pass and forget them, but am hurt inside. However much you see me eating and smiling, for sure I really don’t mean it. My heart is filled with something more than sorrow...You don’t know the sadness we have faced on this Earth! You don’t know what it means to sleep with a man you have just met on the street and then you have sex with him without you having feelings for him. – Sex trafficking, Female, age 30

Ongoing vulnerability

Lack of financial means was one of main factors contributing to ongoing vulnerability for both victims of sex trafficking and forced labor. While sex trafficking victims earned money through their work, after rent, food, and other basic necessities were deducted, there was usually little left to save. In many cases, the money participants earned was sent to help support dependents. Other lines of work usually earned less or required initial capital which participants did not have. Some participants reported being part of a savings club, or trying to put aside money themselves, but this was a slow process. For forced labor victims, there was the added complication that in many cases, the trafficker was a family member with whom they lived. This person was their source of housing, meals and all basic necessities. Participants had nowhere else to go, they were frequently underage, and because of their lack of education, had few other employment prospects. One participant explained the hopelessness of her situation saying, “No, l will stay with my stepmother [exploiter] because she’s the only family I have, however much she mistreats me. If I try to do it, she can call the chairman, people in the village, and also beat me to death” (Forced labor, Female, age 11).

Barriers to seeking help

While being exploited, participants experienced many barriers to seeking help. A major barrier was the lack of awareness of the organizations and resources available to them. Most participants were unable to list any organizations that could help them by name. Among participants that had sought help, the police and healthcare professionals were the most frequently approached. Participants recounted having reported stolen property, rape and in a few select cases, the trafficker, to the police. Physical injuries and STI symptoms were the most common reason medical staff were consulted. However, encounters with these professionals were not always positive experiences. One participant described how he was not believed when he reported sexual assault to the police,

At night, he wanted to sodomize me … While I was asleep, he started to remove my trouser. I ran away and went to the police. When I reached at police, I narrated my story, but they instead called me a mad person. They said that I didn’t wear my trouser properly and my words were false. – Forced labor, Male, age 13

The fact that many help services required money including services like filing a police report, receiving medication, and getting an abortion, acted as a deterrent to seeking help. In some cases, when participants did not have the required money, help services employees exploited participants’ vulnerability and requested sexual favors instead.

By the time you take there your case to him [police officer], and he is aware that you are a sex worker, he doesn’t take you as someone important … he wants to use you. Not once! Not twice! Many have been taken advantage of in the offices. You take there your case and the man says that, "If you want my help, first remove your underwear". Will you refuse? If you refuse, your case won’t be worked on. – Sex trafficking, Female, age 30

Fear also played a strong role in participants’ decision to not seek help. Participants reported feeling threatened by the trafficker who warned them that they or their family would be hurt or killed if they left or talked to anyone about the exploitation. Participants also feared the help services describing that sometimes help services were complicit in the abuse, worked together with the trafficker, or were the clients of their exploitation.

Going to the police … you might want to take there your issues and you find that they know her [exploiter]. So, there is nothing they are going to help with. Instead, you are the one who is considered to be in a mistake when you reach. I had a friend of mine sometime back who went there [the police], but it ended on her being imprisoned. She is the one who was taken to be having a criminal case. Like now the police that is nearby, they know our boss. So, even if went there, would be no help. – Sex trafficking, Female, age 23

Sometimes seeking help was made difficult by restrictions on freedom of movement and communication placed on participants by the trafficker.

Where would you report? There was nowhere to report. They could not even allow moving out of that house. …We were inside there as prisoners. At the gate, there was a security guard and he was commanded that anyone that dared to move out, bullet. There were even two of our friends that were killed when they tried to escape. – Sex trafficking, Female, age 24

Especially in those cases where the trafficker was a family member (mainly for those involved in forced labor) participants’ loyalty and personal ties to the trafficker caused them to be conflicted about seeking help. One participant described this dilemma saying, “I don’t want the police to arrest my mother, because [participant becomes emotional] I love her so much” (Forced labor, Female, age 12).

If the trafficker were to be arrested, participants would lose their source of income which caused some participants to be hesitant about seeking help.

Shame and fear of gossip also formed important barriers to seeking help. Participants were weary of confiding in others, and in many cases their family was unaware of the exploitation. A participant explained why she could not open up about her situation saying, “ Some people are not easy. You tell them your problems and they will tell them to anybody else. So it is better to stay quiet and live on.” (Sex trafficking, Female, age 15).

Facilitators of help-seeking

A minority of participants were aware of different non-governmental organizations (NGOs) that offered assistance to victims of human trafficking. These organizations offered services like legal counsel and sometimes vocational training. In those cases where participants sought help, this sometimes had a positive impact. Incidents were described in which seeking help from the police led to the recovery of stolen goods and the arrest of perpetrators. Similarly, seeking medical care contributed to resolution of physical symptoms. Multiple participants also reported receiving help from strangers. Usually, this help was a one-off and consisted of receiving a small amount of money, some food, or assistance with transport. Support was also offered by friends and co-workers. Participants reported appreciating the ability to confide in them and share their experiences. The advice they received from their social network, however, was often not very useful and was usually limited to encouragement to endure.

Interviews with victims of forced labor and sex trafficking in Kampala, Uganda, illustrate the complexity of human trafficking and reveal the substantial physical and psychological morbidity associated with it. Vulnerability to human trafficking can be traced back to financial hardship and abusive home situations in rural villages not uncommonly triggered by the death of a victim’s caretaker. These dire circumstances may cause children to drop out of school and accept work opportunities and promises of a better life that are offered to them. When these opportunities and promises prove false, their limited educational background coupled with the unfamiliar surroundings they find themselves in, where they lack a support system and the basic needs for survival, leave them vulnerable to being trafficked. Their lack of other employment prospects stemming from curtailed education, little to no vocational training, and reliance on income from trafficking for survival, sustain the cycle of exploitation. Victims are generally unaware of organizations that can offer assistance and help is rarely sought out of fear of retribution by the trafficker and other negative consequences. Negative accounts of what happened when participants did seek help, including not being believed, accusations of criminal activities, shaming, and exploitation of their vulnerability, illustrate that this mistrust is not always misplaced.

The victims of human trafficking who participated in this study reported being exploited, exposed to dangerous working conditions, and suffering a host of horrific forms of abuse. Physical abuse and hazardous working conditions led to injuries including lacerations, contusions, and fractures. Forced unsafe sex put forced labor and sex trafficking victims at risk of sexually transmitted diseases, unwanted pregnancy, and the debilitating sequalae of traumatic fistulae. Human trafficking victims in this study were systematically made to feel worthless and depressive symptoms, symptoms of post-traumatic stress disorder, and negative self-perception were common. Our findings are in line with data from other human trafficking studies in Africa which showed psychological, sexual, and physical violence against human trafficking victims at different stages of the trafficking cycle [ 18 , 19 , 20 , 21 ]. For example, in a mixed-methods study among human trafficking survivors in Nigeria and Uganda, sexual violence and hunger were reported during transit, and abusive working conditions, restricted freedom, and sexual and physical violence were reported during the exploitation phase [ 18 ]. A retrospective cohort study in Ethiopia among 671 trafficked women found prevalent sexual violence during predeparture, in transit, and the trafficking destination [ 19 ], and among 43 trafficked children in Ghana, maltreatment including starvation, sleep deprivation, denial of healthcare, and verbal and physical abuse was found [ 21 ].

The interviews make it clear that much of the vulnerability to trafficking in Uganda is rooted in structural factors like poverty. While the Government of Uganda has made strides in poverty eradication and has succeeded in lowering the proportion of the population living in monetary poverty from 56% in 1992 to 21% in 2017, a United Nations Children's Fund (UNICEF) report revealed that nearly half of Ugandan households (47%) continue to experience multidimensional poverty [ 22 ]. Poverty is not uniformly distributed in Uganda with a higher prevalence of multidimensional poverty found in rural (55%) compared to urban (23%) settings, which most of the interview participants originated form [ 22 ].

Despite the existence of the Universal Primary Education (UPE) program, under which primary education in Uganda is free, hidden costs associated with uniform purchase, school meals and examination fees are the motivation behind stopping education for six out of ten children who leave school [ 23 ]. Our interviews confirm this finding, illustrating how the additional costs associated with school attendance form a barrier to education for children from families facing financial hardship. Research shows that girls in Uganda in particular suffer from financial barriers to education as male children are often prioritized when funds are insufficient [ 23 ]. Discontinuation of education is problematic given the strong correlation between education levels and the likelihood of attaining stable employment for young people in Uganda [ 24 ]. The financial hardship described in our interviews was often triggered by the death of a caretaker, with almost half of interview participants reporting to have lost a family member. The apparent ubiquitousness of early death in this setting, also noted in other human trafficking research from Uganda and Nigeria, is a worrying public health finding in and of itself and raises questions about the cause of this mortality [ 18 ]. The HIV epidemic, armed conflict and natural hazards and disasters likely contribute to these untimely fatalities, once again underlining the need for holistic public health interventions. Research from other African settings shows limited human trafficking awareness, particularly in rural areas and among youth. This lack of awareness among potential victims and others in a position to protect them makes it unlikely that they will question opportunities offered to them, feeding into trafficking vulnerability [ 25 , 26 ].

We discovered that despite the substantial barriers victims faced to help-seeking, they succeeded in accessing health services for the somatic sequelae of exploitation. Services sought commonly included treatment for acute injuries and illnesses as well as reproductive health services. This highlights the unique position that healthcare workers are in as some of the few professionals that interact with this largely hidden and highly isolated group [ 27 , 28 , 29 ]. Health workers have successfully been leveraged in Uganda to improve access to care for other marginalized groups such as men who have sex with men and may be able to play a role in administering human trafficking interventions [ 30 ]. As a result of low awareness and gaps in knowledge among health professionals, however, human trafficking is often not recognized and opportunities to identify and help trafficking victims are missed [ 31 , 32 , 33 , 34 ]. Providers lack training on the issue of human trafficking and do not feel confident in their ability to identify victims [ 35 , 36 , 37 ]. Training for healthcare workers needs to be developed and woven into medical curricula or provided as continued medical education to ensure providers possess the skills necessary to identify trafficked persons and provide trauma-informed care [ 38 , 39 ]. Assessment tools to help providers recognize high-risk patients may be helpful in this regard, but few are validated for healthcare settings, especially in low- and middle-income countries.

Once victims are identified, it is imperative that health workers have the resources necessary to safely and appropriately respond to their complex needs. Health systems should have response plans in place which provide practical clinical guidance to health professionals and connect trafficking victims with available services [ 40 ]. More research directed towards contextualized and locally specific solutions needs to be funded to determine the best approaches. Interventions that are offered or assistance programs that survivors are linked to should go further than solely addressing medical complaints. Stakeholders involved in the response to human trafficking have emphasized the importance of offering integrated comprehensive interventions and advocate for a ‘one-stop-shop’ at which survivors of human trafficking can receive all the services they need [ 41 ]. In a qualitative needs assessment conducted in Ethiopia among key human trafficking stakeholders including service providers, academics, lawyers, and NGO workers, stakeholders underscored that an array of services including shelter, food, legal support, and vocational training should be provided that meets the complex needs of trafficking survivors [ 41 ]. Stakeholders highlighted that trafficking victims themselves often consider financial and employment needs to be of greater priority than their physical and mental complaints [ 41 ]. A qualitative analysis of in-depth interviews with 37 human trafficking survivors in Ghana who had completed a 9-month post-trafficking assistance program demonstrated that ensuring access to basic necessities including food, clothing, hygiene and sanitation allowed survivors to focus on developing the vocational skills they would need to start a micro-business after program completion [ 42 ]. Human trafficking survivors were found to often lack basic life and survival skills as a result of the young age that they left home. By assigning them roles and responsibilities, the program ensured that survivors were informally provided with critical skills including cooking, caring for a home, decision making, and effective communication [ 43 ].

The accounts collected in this study emphasize the public health burden associated with human trafficking and the need for interventions that interrupt the human trafficking trajectory. Possible interventions might be grouped into interventions aimed at decreasing vulnerability in villages pre-trafficking, services to support high-(trafficking)risk individuals surviving on city streets, and programs aimed at identifying those in exploitation to facilitate presentation of an exit strategy to reintegrate back into society. Multi-level interventions are necessary to prevent human trafficking [ 44 ].

Based on our study findings, we offer the following recommendations. Interventions are needed at all stages of the human trafficking trajectory (Fig.  1 ). In Uganda, pre-trafficking vulnerability can be addressed through poverty eradication, supporting families in financial need through covering school fees, strengthening health systems, and raising awareness about human trafficking in rural villages. The transition from recruitment to exploitation can be disrupted by advertising free resources to victims at transits centers and other entry points to the city, outreach activities for at risk-youth on the streets of Kampala, and the creation of drop-in centers. The unique position of healthcare workers can be leveraged to identify human trafficking victims and link them to available services. To achieve this, training in the recognition of human trafficking and the provision of trauma-informed care is needed, as well as the development of comprehensive after-care programs.

Our findings should be considered in the context of the study’s limitations. Snowball sampling was used to obtain the sampling frame that yielded the interview participants. Youth already working with UYDEL were asked to assist in study participant identification which may have led to the recruitment of individuals in their direct social circles, perhaps individuals less isolated than other trafficking victims. For the in-depth qualitative interviews, trafficking victims with severe forms of exploitation based on their survey answers were oversampled and their experience may not be representative of all human trafficking victims. Some of the study participants, mainly those with lived experience of forced labor, were as young as eleven years old at the time of participation. Considering their young age and limited educational experience, a different interviewing technique may have been more effective. Finally, the reported findings represent the experiences of the interview participants and may not be generalizable beyond the study population.

Human trafficking is an issue of serious global public health concern. In Uganda, structural determinants including poverty and dysfunctional family dynamics force children to drop out of school and drive them into a life of exploitation. Forced labor and sex trafficking victims suffer a host of physical, sexual and psychological abuse during exploitation which results in detrimental short- and long-term health impacts. Fear, lack of awareness, restrictions on movement, and a high degree of dependence on exploiters prevent victims from seeking help. Victims are extremely isolated and healthcare providers and the police are some of the few professionals with whom victims interact, but oftentimes with negative consequences. The improved localized understanding of the human trafficking trajectory in Uganda and its drivers gained through this study can inform the design of interventions to address and prevent human trafficking.

Availability of data and materials

The interview recordings and transcripts generated and analyzed as part of the current study are not publicly available due the sensitive nature of some of the topics covered and potential for identification of the participants, but will be made available by the corresponding author on reasonable request.

Abbreviations

Acquired immunodeficiency syndrome

City University of New York

Human immunodeficiency virus

Non-governmental organization

Sexually transmitted infection

Ugandan shilling

United Nations Children's Fund

Uganda Youth Development Link

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Acknowledgements

We are grateful to the survivors of sex trafficking and forced labor who were willing to gift their time and in some cases risk their safety to share their lived experiences. We appreciate the dedication and compassion of the UYDEL research assistants without whose efforts this study would not have been possible.

The Prevalence of Forced Begging and Sex Trafficking in Kampala, Uganda study was funded by the Human Trafficking Institute [grant number 7H270-00–01]. The Human Trafficking Institute was not involved in study design, data collection, analysis, and interpretation or in the writing of this manuscript.

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Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA

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AH and MD were involved in the study conceptualization and design, and MR was involved in data collection. AH, HS, KNO, MD and RK participated in qualitative analysis and codebook design. AH and REK read all interview transcripts and applied the agreed upon coding framework. REK drafted the study manuscript with input from HS. All authors provided feedback on the manuscript and approved the final version.

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Ethical approval for the Prevalence of Forced Begging and Sex Trafficking in Kampala, Uganda study was obtained from the John Jay College of Criminal Justice Institutional Review Board at City University of New York (IRB File #2019–0886) and Makerere University School of Social Sciences Research Ethics Committee (MAKSS REC 10.19.344). Additionally, final approval was obtained from Uganda National Council for Science and Technology (SS 5156) prior to the start of data collection.

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Supplementary Information

Additional file 1:.

Appendix A. Completed consolidated criteria for reporting qualitative research (COREQ) checklist.

Additional file 2:

Appendix B. Interview guide questions.

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Klabbers, R.E., Hughes, A., Dank, M. et al. Human trafficking risk factors, health impacts, and opportunities for intervention in Uganda: a qualitative analysis. glob health res policy 8 , 52 (2023). https://doi.org/10.1186/s41256-023-00332-z

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Research trends on human trafficking: a bibliometric analysis using Scopus database

• Waleed M. Sweileh 1  

Globalization and Health volume  14 , Article number:  106 ( 2018 ) Cite this article

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Human trafficking is a crime against humanity. It is also a serious threat to global health and security. Globalization has made human trafficking an easier task for the criminal organizations. No data are available on the volume, research trends, and key players in this field. Therefore, the aim of this study was to assess the research activity and research trends on human trafficking.

A bibliometric method was adopted. Literature published in academic journals indexed in Scopus database was retrieved. The study period was set from 2000 to 2017.

Two thousand forty-four documents were retrieved. The average number of authors per document was 1.9. Over one third ( n  = 771; 37.7%) of the retrieved documents were about sex trafficking, 616 (30.1%) were about labor trafficking/forced labor, 199 (9.7%) were about child trafficking, and 138 (6.8%) were about organ trafficking. One third ( n  = 707; 34.6%) of the documents were in health-related fields while 1526 (74.7%) were in social sciences and humanities. The USA ranked first ( n  = 735; 36.0%) regarding the number of published documents. Geographic distribution of the retrieved document showed that world regions with a high prevalence of human trafficking had the least research contribution. International research collaboration has a limited contribution to the retrieved literature. The Harvard University (USA) was the most active institution ( n  = 39; 1.9%). International Migration ( n  = 35; 1.7%) was the most active journal in publishing documents on HT. Documents published in Transplantation journal received the highest number of citations per document (25.5) and two of the most cited documents were about organ trafficking.

There was an under-representation of health-related literature on human trafficking. Literature on sex trafficking dominated the field of human trafficking. Research networks and research collaboration between the source and destination countries is important. Future research plans need to focus on health issues and on exploited/trafficked laborers.

Human trafficking (HT), or modern slavery, is an old problem [ 1 ]. However, in the past few decades, HT became a global concern [ 2 , 3 ]. The most accepted definition of HT is presented by the Trafficking Protocol [ 4 ]. Human trafficking was addressed by several international agreements and conferences such as the International Agreement for the Suppression of White Slave Traffic (1904) [ 5 ], International Agreement for the Suppression of Traffic in Women and Children (1927) [ 6 ], the Trafficking Protocol (2000), and the Protocol against Smuggling of Migrants by Land, Sea, and Air (2000) [ 4 ]. The last two protocols recognized HT as a transnational crime rather than just human rights or migration issue [ 7 ]. Different countries used the UN Trafficking Protocol to develop criminal codes for HT. As of 2016, over 150 countries had criminal laws for HT [ 8 ]. In the USA, the Office to Monitor and Combat Trafficking in Persons releases an annual report (TIP Report) about international efforts to combat trafficking. The European Union adopted the Brussels Declaration on Preventing and Combating Trafficking in Human Beings which aimed to fight HT in Europe [ 9 ]. Other non-European and non-American countries developed their own national policies and protocols to criminalize and fight HT [ 10 ].

Sex trafficking is one of the most common forms of HT with more than half a million women being trafficked every year [ 6 ]. Forced labor, child labor, child soldiers, debt bondage, involuntary domestic servitude, and organ/tissue removal for transplantation are other common forms of HT [ 11 ]. Forced prostitution represents the highest percentage of HT victims with the majority being women from Eastern Europe, Central Asia, and North and South America [ 8 , 12 , 13 ]. In contrast, the majority of victims of forced labor are men from Africa, the Middle East, and Asia [ 8 , 12 ]. International organizations distinguish between HT and smuggling. In smuggling, the actor takes part in the process while HT involves some deception or coercion [ 14 ]. Unlike HT, migration and smuggling are less often involved with a criminal organization [ 14 ].

Human trafficking has a global dimension despite that trafficking could occur within the same country [ 8 ]. Human trafficking affects people of all races, religions, social class, and education. It often results in mental health disorders and life-threatening infections [ 8 , 15 , 16 , 17 , 18 , 19 , 20 ]. For example, a study of 207 trafficked women from 14 countries reported that 95% of women had experienced physical and/or sexual violence [ 21 ]. A study on trafficked Nepalese girls and women found that 23% of them tested positive for HIV [ 22 ]. Despite its negative social, health, and legal consequences, HT is a growing business for criminal organizations [ 21 , 23 ]. Poverty, social injustice, disasters, substance abuse, family breakdown, and homelessness are major push factors for victims [ 24 , 25 , 26 ]. Globalization has created a larger gap between developing and developed countries with poverty and marginalization being major push factors for victims [ 1 ].

The International Labor Organization (ILO) reported 12.3 million trafficking victims in 2005, 21 million victims in 2012, and 40.3 million victims in 2016 [ 27 ]. The 2016 report of the ILO estimated that 40.3 million people in modern slavery, including 24.9 in forced labor and 15.4 million in the forced marriage [ 28 ]. Out of the 24.9 million people trapped in forced labor, 16 million people in the private sector such as domestic work, construction or agriculture; 4.8 million persons in forced sexual exploitation, and 4 million persons in forced labor imposed by state authorities [ 27 ]. The ILO considers the Asia-Pacific region to have the largest number of victims of HT followed by Africa and Latin America [ 28 ]. It was estimated that over 40% of trafficked victims were detected in their own countries and that 71% of the trafficked victims were women while 28% were children [ 8 ].

Bibliometric analysis is a research method used to shed light on research activity [ 29 , 30 , 31 ]. It differs from systematic reviews, which aim to answer a specific research question based on a selected group of articles [ 32 , 33 ]. It also differs from scoping reviews, which aim to identify the nature and extent of research evidence [ 34 , 35 ]. Bibliometric studies were carried out to provide a snapshot of national and international contribution to literature [ 36 ] and to advance information and science [ 37 ]. Bibliometric indicators assess national and international efforts carried out to achieve a particular goal. Several bibliometric studies on migrants and refugees have been published [ 38 , 39 , 40 ]. However, none was carried out on HT. Therefore, the aim of this study was to analyze published literature on HT. Such a study will shed light on the global research activity and discussed themes in literature on HT. Bibliometric analysis may be useful for health authorities and UN agencies interested in mapping and identifying research gaps within the HT research landscape, which is important for advancing an evidence-informed research agenda. Findings of a bibliometric analysis are difficult to obtain by other research methods such as systematic or scoping reviews. For example, a recent systematic review of research methods on HT and health concluded that despite the presence of various quantitative and qualitative data collection and analysis methods, the implemented methodological approaches have limitations that affect what is known about HT and health [ 41 ]. Most available literature on HT is based on emotional stories rather than on empirical research [ 42 ]. Bibliometric analysis would give an accurate quantitative analysis of literature on HT that would serve as a basis for future studies. The findings of a bibliometric study on HT will shed light on the evolution, volume, and scope of research on HT and will help identify countries and regions lagging behind in this field [ 5 ]. A bibliometric analysis of literature on HT will also give detailed information on the number of publication on each type of HT and therefore a direct academic and research effort as well as funding towards less-researched types of HT.

Source of information

In the current study, SciVerse Scopus was selected to accomplish the objectives. Scopus is a bibliographic database created by Elsevier in November 2004 [ 43 ]. With 22,800 titles from over 5000 international publishers, Scopus delivers the most comprehensive view of the world’s research output in the fields of science, technology, medicine, social science and arts and humanities [ 43 ]. Scopus database includes all MEDLINE journals and allows for citation analysis [ 44 , 45 ]. Scopus database has several operating functions that facilitate bibliometric analysis. Such operating functions include journal name, type of document, year of publication, authors and their affiliations, the number of citations, and h -index metrics for documents [ 46 , 47 ].

Study design

A bibliometric method was implemented. The study period was set from 2000 to 2017. The study period was determined based on the assumption that HT has attracted a lot of public attention after the introducing the UN Trafficking Protocol ratified in December 2000.

Search strategy

In bibliometric analysis, selection of keywords is of utmost importance, as these keywords have a direct impact on the findings and results. In the current study, search strategy was based on title or title/abstract search with certain constraints to minimize false-positive results (Table  1 ) . Keywords were obtained from previously published literature on HT [ 20 , 48 , 49 , 50 , 51 ]. The search strategy was limited to documents published in academic journals but was not restricted to any language. The online search was performed on June 03, 2018.

Estimation of the number of health- and non-health-related documents

Using the function designated as “subject area”; it was possible to estimate the number of HT documents in health field, defined as documents in the following subject areas: medicine, nursing, psychology, pharmacology, neuroscience, general health, microbiology/immunology, biochemistry, and dentistry. The total number of health and non-health documents was greater than the total number of the retrieved documents because some journals are indexed in both medicine and social sciences; e.g. the Journal of Social Medicine which is categorized in both social science and medicine. Health-related documents were further divided into different domains such as mental health, health policy and systems, maternal and reproductive health, non-communicable diseases, and infectious diseases [ 38 ].

Bibliometric indicators, analytics, and mapping

In the current study, bibliometric indicators were presented as ten most active countries, institutions, journals, authors, and ten most cited documents. The choice of number ten as a threshold to list the results was an arbitrary selection that has been used in previously published bibliometric studies [ 40 , 52 , 53 , 54 ].

International collaboration

Research collaboration was assessed using author affiliation. For example, documents with authors having different country affiliations represent international research collaboration while documents with authors having the same country affiliation represent intra-country collaboration. Scopus allows for segregation of documents based on authoraffiliation. Therefore, for each country, the number of documents with international authors was calculated as a percentage of the total number of documents published by that country. Documents with international authors were referred to as multiple country publications (MCP) and represented the extent of international collaboration [ 55 , 56 , 57 , 58 ].

Bibliometric visualization maps

Co-authorship analysis, international collaboration, and keyword analysis were presented as network visualization maps using VOSviewer (Leiden University, Leiden, Netherlands) [ 59 , 60 ].The Statistical Package for Social Sciences (SPSS) (SPSS, Chicago, Illinois) was used to generate line presentation of the annual growth of publications. ArcGIS 10.1 software (Esri; USA) is a geographic information system used in bibliometric studies to map worldwide research contribution. The GIS map allows for a better understanding of regional contribution to a specific scientific topic.

Growth of publications and typology of documents

In total, 2044 documents were retrieved (Additional file  1 ). The retrieved documents were of eight different types: research articles (1553; 76.0%), reviews (280; 13.7%); notes (66; 3.2%); editorials (46; 2.3%), letters (30; 1.5%); short surveys (23; 1.1%), conference papers (22; 1.1%), and unclassified (24; 1.2%).

The number of retrieved documents have significantly increased during the study period (linear regression: β = .978, P  < .001, R 2  = .956; Figure  1 ). If this trend continues, it was estimated that 293 documents would be published in 2020.

Total number of published documents from 2000 to 2017

Mapping the most frequent keywords and typology of trafficking

Most frequent keywords were visualized (Fig.  2 ). The map showed five clusters: (1) organ trafficking; (2) child trafficking; (3) forced labor; (4) sex trafficking of women, and (5) slavery. Further analysis of the retrieved documents showed that 771 (37.7%) documents were about sex trafficking, 616 (30.1%) were about labor trafficking/forced labor, 199 (9.7%) were about child trafficking, and 138 (6.8%) were about organ trafficking. The remaining documents were general documents or ones that discussed multiple types of trafficking.

Mapping 10 most frequent keywords

Research domains

In total, 707 (34.6%) documents were in the health field while 1526 (74.7%) were in social sciences and humanities taking into consideration certain limited overlap between the health and health research domains. Analysis of the retrieved showed that 971 (47.5%) documents were about law and criminology, 238 (11.6%) were about health policy and systems, 200 (9.8%) were about social work, and 183 (9.0%) were about mental health (Fig.  3 ).

Research domains in the retrieved literature

Top 10 active countries

Authors from 91 different countries participated in publishing the retrieved documents. The top 10 active countries participated in publishing 1478 (72.3%) documents (Table  2 ). The United States ranked first (735; 36.0%) regarding the number of published documents. Five countries in the top 10 active list were in Western Europe, two were in Northern America, one in the Western Pacific region, one in Southeast Asia, and one in Latin America. The geographic distribution of the retrieved document showed that world regions with a high prevalence of HT, such as South East Asia, East Europe, Africa, and Latin America [ 8 ], had the least research contribution (Fig.  4 ).

Geographic distribution of publications based on the country affiliation of authors. The following is the color-coding for the map

Analysis of international research collaboration for the top 10 active countries showed that India had the highest percentage of documents (49%) with international research collaboration. In contrast, Brazil had the least percentage of documents (12%) with international research collaboration. For the US, which led in the number of publications, only 12.5% of documents with US authors included authors from other countries. Of the 1478 publications produced by the top 10 active countries, there were only 238 (16.1%) publications with international collaboration.

Top 10 active institutions

Harvard University (USA) ( n  = 39; 1.9%) was the most active institution in this field followed by University of British Columbia (Canada) and London School of Hygiene & Tropical Medicine (UK) (Table  3 ). The top 10 active list of institutions included four in the USA, three in Canada, and three in the UK.

Authorship analysis

In total, 3920 authors participated in publishing the retrieved documents, giving an average of 1.9 authors per document. Approximately 61% ( n  = 1250) documents were single-authored publications, 20.0% ( n  = 408) were two-authored publications, while the remaining 18.9% ( n  = 386) were multi-authored publications (≥ 3 authors per document). Professor Cathy Zimmerman (UK) was the most active author (22; 1.1%). Professor Jay Silverman (USA) ranked second (17; 0.8%) (Table  4 ).

Research networks

Mapping research networks for authors with a minimum research output of five documents showed only two research clusters (Fig.  5 ). The first cluster (red) included six authors with Zimmerman, C. as a member in this cluster. The second cluster (green) included five authors with Silverman, J as a member of this cluster.

Networks of active authors who published at least five publications and exist in a research network with a minimum of five authors

Preferred journals for publishing documents about HT

The retrieved documents were published in 998 different journals. The International Migration was the most active journal in this field. Top 10 active journals belonged to different fields including migration, criminology, medicine, social studies, gynecology, transplantation, violence, and human rights (Table  5 ). The majority of active journals were based in the USA. Documents published in Transplantation (25.5) journal received the highest number of citations per article followed by those published in International Migration (22.5).

Citation analysis

The retrieved documents received 15,505 citations giving a mean of 7.6 citations per document. The h -index of the retrieved documents was 48. The document that received the highest number of citations was published in 2007 in Politics and Society . Top ten cited documents discussed topics about organ trafficking, mental health, and HIV infections of HT victims. Table  6 showed the list of top 10 cited documents [ 22 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ].

Volume and growth of publications

The current study aimed to assess and analyze published literature on HT. Quantitative analysis of literature on HT is complicated by the lack of academic and legal consensus on the definition of HT as well as the unclear distinction between trafficked victims, exploited people, and vulnerable migrants [ 71 ]. For example, some researchers consider illegal migrants who end up in prostitution as victims of HT [ 72 , 73 ]. Despite these technical difficulties, the current study was the first to analyze volume, growth, research trends, and research domains of literature on HT published in academic journals.

The findings of the current study showed that the total number of retrieved documents on HT was low when compared to the size of literature on the 21 million people described as refugees [ 74 ]. The number of publications on HT could be attributed to the methodological, operational, criminal, and hidden nature of HT [ 20 ]. The limited research collaboration, as evident from the mean number of authors per document and the percentage of documents with international authors, is another potential reason for the limited number of publications on HT. The finding regarding international research collaboration is difficult to explain but could be attributed to lack of communications, motivation, funding, or lack of international conferences that could help gather experts in this field [ 75 , 76 ].

Health versus non-health related research

The current study showed that there was an underrepresentation of health-related research on HT despite the potential threat of HT to national health security [ 1 ]. Health is a subject that has been neglected in anti-trafficking work efforts compared to activities in the fields of immigration and law enforcement [ 77 , 78 ]. Many experts in health and HT agree that the health sector has had limited engagement in trafficking dialogues and research [ 78 ] despite that HT is being considered as a threat to global health security [ 79 ]. The presence of sexually transmitted diseases and tuberculosis among trafficked victims place the general population at risk [ 80 , 81 ].

The findings of the current study regarding the under-representation of labor trafficking relative to sex trafficking were in agreement several previously published studies [ 18 , 82 ]. Promotion and advancement of research on health aspects of HT require intensive involvement of public health experts in the global debate about HT. Public health experts and editors of medical and health journals need to create an international forum to encourage researchers from different parts of the world to get involved in health research about HT. This will benefit global public health agendas by shedding light on aspects related to HT such as labor exploitation and smuggling in Africa, Asia, and the Middle East where labor exploitation might not be considered illegal or a human right violation [ 83 ]. Establishing research networks that include scholars from destination and source countries will create a more detailed analysis of health aspects of HT.

The source versus destination countries

The current study showed that the bulk of the retrieved literature and the topics discussed represent the perspective of the destination rather than source countries. It is believed that the source countries are ones with no or minimum level of democracy, high levels of corruption, and poor economic growth, which make engagement in research and academic investigation an unaffordable luxury. The source countries might not have enough public health researchers or experts HT, which influence their contribution to literature in this field. It is recommended that the source countries place migration and trafficking in their national and foreign policy agendas. Healthcare professionals, social care specialists, and experts in global health diplomacy in source countries need to get engaged in developing evidence-based information about methods used by traffickers in recruiting their victims from source countries [ 84 ]. Legal and labor experts need to provide detailed information for migrants to increase their awareness of labor exploitation and trafficking [ 85 ]. Awareness of being a potential victim to traffickers is important in source countries, particularly those with a humanitarian crisis or armed conflict where young desperate men and women will take a quick decision regarding migration in hope of a better life and better wages [ 86 ]. For destination countries, healthcare professionals, and public health experts need to identify working conditions and occupational health hazards of migrant workers who might end up being victims of HT. Policymakers need to develop strict regulation to provide migrants with legal and health protection equivalent to that of domestic workers [ 87 ]. Health policymakers need to develop mechanisms to discover victims of HT once they attend a healthcare facility [ 88 ] and offer them appropriate health services and social as well as financial support and compensation. Experts in criminology need to develop detailed criminal codes based on international diplomatic cooperation to fight organizations involved in HT [ 89 , 90 ].

Types of trafficking

In the current study, published literature on sex trafficking dominated the field of HT. The over-representation of sex trafficking suggests that research related to other forms of trafficking, particularly labor trafficking is being under-researched. Trafficked laborers live and work in harsh and mostly unhealthy conditions that might involve confiscation of passports, low wages, sex slavery, and deprivation of basic health need [ 91 , 92 , 93 , 94 ]. Research domain in labor trafficking needs to be strengthened, supported, funded, and encouraged to generate more evidence-based data in this field.

Study limitations

The current study has a few limitations. Using Scopus database to retrieve literature on HT created a certain bias toward countries with a large number of journals indexed in Scopus. Scopus is biased toward academic journals in which documents are published in English. Therefore, documents in HT published in non-English were not retrieved. The current study, like all other bibliometric studies, did not include grey literature. The search strategy used in this study might have led to some false-negative or false-positive results. Therefore, interpretation of the results should take into consideration these limitations.

The current study is the first to assess research activity in the field of HT. The current study showed that health aspects of HT were under-represented compared to criminal, legal, and social aspects of HT. Similarly, research on labor trafficking was under-represented compared to sex trafficking and exploitation. The literature on HT represents the agendas of destination countries with limited contribution of countries in Asia, Latin America, Africa, the Middle East, and Eastern European. Future research plans should shed light on trafficking for non-sexual purposes. Furthermore, research networks need to be strengthened by including scholar from source and destination countries to investigate health conditions of trafficking survivors or exploited migrants. Greater investments in international research collaborations and research networks should be encouraged to help prioritize research on HT in various world regions.

Abbreviations

human trafficking

multiple country collaboration = international collaboration

single country collaboration = intra-country collaboration

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The author would like to thank An-Najah National University for facilitating this study. The author would like to thank Professors Adham abut aha and Ansam Sawalha for their language corrections

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• What is Human Trafficking? This paper will set out to define human trafficking and highlight some of the factors why it continues to occur today. The paper will discuss the effects of human trafficking.
• Human Trafficking and Illegal Immigration Human trafficking is a problem which seems to be concealed and even ignored in the United States’ society because of a lack of the appropriate discussion.
• Human Trafficking: Current State and Counteracts Human trafficking involves transportation of people inside their countries and abroad to be sexually exploited and become source of cheap unskilled labor in the developed states.
• Human Trafficking and Public Service Announcements Public Service Announcements project will attempt to educate youth, especially young females, about safety rules to reduct human trafficking on local and national levels.
• “The War on Human Trafficking: U.S. Policy Assessed” by Anthony M. DeStefano “The War on Human Trafficking: U.S. Policy Assessed” by Anthony M. DeStefano is an overview of American government’s efforts to combat the human trafficking.
• Women’s Rights Organizations and Human Trafficking
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• The Violent and Perverse System of Human Trafficking
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• The Differences and Similarities Between Human Trafficking and Slavery
• Human Trafficking From Latin America to Canada
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• Human Trafficking and the Trade of Human Sex Trafficking
• Medical Care for Human Trafficking Victims
• The Human Trafficking and the Saga of 53 Indian Nationals
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• The Horrors and Statistics on Human Trafficking in the United States
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• Human Trafficking Has Increased Greatly With Globalization
• What Are Five Warning Signs of Human Trafficking?
• Human Trafficking and Why Do They Call It Modern-Day Slavery?
• Human Trafficking vs. Prostitution: Is There a Difference?
• Who Is the Biggest Human Trafficking in the World?
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• Who Is Most at Risk for Human Trafficking?
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• What Happens to Human Trafficking Victims After?
• What Does the Blade Mean in Human Trafficking?
• What Is the Rate of Human Trafficking in the US?
• What Country Has the Highest Human Trafficking Rate?
• Where Does US Rank in Human Trafficking?
• Where Is Human Trafficking Most Common in Europe?
• What Are the Top Three Countries for Human Trafficking?
• How Many People Are Victims of Human Trafficking in Europe?
• What Are the Three Types of Human Trafficking?
• Is Human Trafficking Common in Africa?
• Why Does Human Trafficking Happen in Africa?
• What Country Has the Most Human Trafficking in 2021?
• Is Romania Known for Human Trafficking?
• Why Is There So Much Human Trafficking in Eastern Europe?
• How Do Human Traffickers Mark Their Victims?
• What Are the Statistics on Human Trafficking of Children?
• How Common Is Human Trafficking in Japan?
• Is There Human Trafficking in Tokyo?
• Where Is Human Trafficking Most Common in the Middle East?
• How Does War Contribute to Human Trafficking?
• How has globalization affected the prevalence of human trafficking?
• What are the most common recruitment tactics of traffickers?
• What population groups are the most vulnerable to human trafficking?
• How do different countries combat human trafficking?
• How do social networks facilitate human trafficking?
• What is the connection between human trafficking and other organized crime types?
• How does police corruption contribute to human trafficking?
• What are the challenges in prosecuting human trafficking cases?
• What social and cultural attitudes perpetuate human trafficking?
• How can education programs help prevent human trafficking?
• The impact of decriminalizing prostitution on human trafficking.
• Can temporary work visas be effective in reducing human trafficking?
• Should human trafficking victims be treated as criminals or supported?
• Human traffickers: do they deserve harsher punishment?
• Should human trafficking be considered a form of terrorism?
• Do public awareness campaigns help prevent human trafficking?
• Demand-side vs. supply-side interventions to combat human trafficking.
• Is the private sector responsible for addressing human trafficking?
• Is human trafficking a domestic or international issue?
• The role of immigration policies in human trafficking.

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These essay examples and topics on Human Trafficking were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on June 23, 2024 .

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• v.28(2); 2021 Feb

Combatting human trafficking in the United States: how can medical informatics help?

Kim m unertl.

1 Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Colin G Walsh

2 Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA

3 Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Ellen Wright Clayton

4 Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA

5 Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA

6 School of Law, Vanderbilt University, Nashville, Tennessee, USA

7 Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Human trafficking is a global problem taking many forms, including sex and labor exploitation. Trafficking victims can be any age, although most trafficking begins when victims are adolescents. Many trafficking victims have contact with health-care providers across various health-care contexts, both for emergency and routine care.

Materials and Methods

We propose 4 specific areas where medical informatics can assist with combatting trafficking: screening, clinical decision support, community-facing tools, and analytics that are both descriptive and predictive. Efforts to implement health information technology interventions focused on trafficking must be carefully integrated into existing clinical work and connected to community resources to move beyond identification to provide assistance and to support trauma-informed care.

We lay forth a research and implementation agenda to integrate human trafficking identification and intervention into routine clinical practice, supported by health information technology.

Conclusions

A sociotechnical systems approach is recommended to ensure interventions address the complex issues involved in assisting victims of human trafficking.

introduction

Trafficking of children and adults for commercial and sexual exploitation is a far-reaching global problem, made worse by refugee crises, military conflicts, and multiple other causes. 1 While this may seem like an issue that only affects certain parts of the world, trafficking is an important problem in the United States. 2 From 2007-2018, the National Human Trafficking Hotline identified over 50 000 human trafficking cases in the United States, including instances of sex and labor trafficking. 3 Although the majority of trafficking survivors identified in 2018 through the hotline were adults, trafficking frequently began when individuals were under 18. 3 Estimates vary widely of the scope of trafficking in both the United States and globally for many reasons, including a lack of common databases, terminology differences, and law enforcement data variability. 2 , 4 , 5

The 3 core elements of human trafficking are action, means, and purpose. The United Nations defines trafficking in persons as:

The recruitment, transportation, transfer, harbouring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation. 6

Exploitation can take various formats, including prostitution, pornography, slavery, forced labor, and removal of organs. Trafficking occurs on a domestic level, where citizens of a country are victimized within that country, or transnationally, where victims are transported across national boundaries for purposes of exploitation, including transport of victims from other countries into the United States. 6

Responses to combat trafficking began with the establishment of international, national, and state laws defining trafficking as a crime. 7 , 8 Over the last 10 years, a potentially significant role for health-care providers to aid in combatting human trafficking has emerged. Many victims of trafficking seek health-care services, both to address routine health-care needs and to deal with trafficking-related trauma. 9–12 In a 2016 survey of survivors of trafficking, 68% of respondents indicated receiving health-care services from a variety of providers, with the largest categories being emergency/urgent, primary, dental, and obstetrics/gynecology care. 11 A 2014 report from the Institute of Medicine and the National Research Council on sex trafficking of minors reviewed the many barriers to identifying victims of trafficking in health-care settings and suggested opportunities for increased involvement of health providers in identifying and assisting victims. 2 Groups such as the American Academy of Pediatrics have developed guidelines to assist clinicians with identifying trafficking victims and create pathways for clinicians to assist victims. 13 Several educational resources about human trafficking have also been developed for health-care trainees and professionals. 14–17 There are multiple potential indicators that someone is being trafficked, but victims rarely self-identify and the lack of validated tools to assist health-care providers with victim identification hampers consistent screening across health-care contexts. 13 Despite existing efforts in health care, clinicians and health-care organizations remain ill equipped to identify victims and, if they have suspicions, to know what steps to take to provide meaningful assistance. This Perspectives article proposes that medical informatics can make substantial contributions in combatting human trafficking, and identifies definitive next steps specific to medical informatics research and implementation.

Materials and methods

Potential medical informatics contributions.

Human trafficking is a multi-factorial problem, and medical informatics contributions to date have faced multiple barriers. Even the most fundamental step of identifying trafficking victims during health-care encounters has proven challenging. Recent reviews of screening tools for the identification of trafficking victims noted significant variability in content, limited tools for use specifically in health-care contexts, and a lack of validity and reliability assessments for the majority of tools. 18 , 19 The variability of population characteristics (eg, age, gender, exploitation type, English-language fluency, sociocultural components) introduces additional complexity. 20 , 21 Compounding the challenges of identification are the many barriers victims face to reporting that they are being trafficked, including stigma and threats of retaliation. 22 , 23 Despite these challenges, we propose 4 specific areas where medical informatics could contribute: (1) screening, (2) clinical decision support, (3) community-facing tools, and (4) analytics, both descriptive and predictive.

The identification of potential trafficking victims during health-care encounters is a fundamental gap, and consistently implemented, validated screening tools are urgently needed. Protocols to assist health-care providers with consistently and reliably screening for trafficking characteristics have proven beneficial in small-scale studies. 24 However, the identification of trafficking victims in health-care settings is currently done in a piecemeal fashion, depending on clinician awareness, clinician knowledge of trafficking indicators, and whether a health-care organization has a screening protocol in place. 25 Although trafficking awareness is increasing among clinicians thanks to educational efforts, putting that knowledge into practice is an area where well-designed screening tools, integrated into electronic health record systems for both children and adults, could potentially increase identification.

Health-care settings face multiple, competing screening priorities, such as intimate partner violence, pain levels, immunizations, and depression. Introducing another screening into complex health-care workflows runs the risk of adding more noise in already busy clinical work. Moreover, victims of trafficking may interact with a wide variety of health-care contexts and providers. 9 Designing a technology-based screening intervention to fit all contexts is challenging. Efforts that target specific clinical contexts have shown promise, such as work to implement the Polaris Project Medical Assessment Tool in the emergency department at the University of Kansas Hospital. 26 Tools that allow confidential reporting, such as electronic questionnaires completed by the individual, might prove helpful, as was previously demonstrated for reporting intimate partner violence. 27 Developing validated screening instruments is critical, but development efforts also need to assess the implementation context, clinical processes, and technology infrastructures to ensure the feasibility of screening implementation.

Clinical decision support

Identifying potential trafficking victims is an important first step, but clinicians and health-care systems also need to know what to do once they have concerns that someone is a trafficking victim. 20 Medical informatics could contribute significantly to providing guidance on next steps through clinical decision support (CDS), similar to interventions that have been implemented for child abuse 28 , 29 and intimate partner violence. 30 Health information technology can assist with integrating screening and responses to trafficking into clinical work. Responses to trafficking typically have important local components, based on legal requirements 31 and the availability of social resources. 11 A trafficking CDS could link best practices for assisting trafficking victims across contexts while incorporating local contextual requirements. Developing CDS that is modular and transferable, using national standards, could support the widespread implementation of guidance on assistance for trafficking victims and help link victims to appropriate local resources.

Community-facing tools

Technology is not necessarily constrained by the walls of a medical center, and another area where medical informatics could contribute to combatting trafficking is through public health informatics and community-facing tools. Law enforcement agencies, social service providers, and community organizations are already using technology in multiple ways to combat trafficking and assist victims. 32 , 33 Medical informatics could add a health-care focus to these existing community-based efforts. For example, school nurses might interact with trafficking victims, 2 , 34 and screening tools in school health settings could help connect nurses to additional resources for further health-related assistance. Partnerships with community-based health-care providers, such as Federally Qualified Health Centers and Planned Parenthood, and with health-focused community groups could widen the reach of screening and intervention technology and also increase community awareness about trafficking. Outreach directly to marginalized, at-risk populations who have access to mobile technology, such as homeless youth 35–37 and victims of intimate partner violence, 38 , 39 is another area where medical informatics could potentially play a role. Such partnerships have already proven important in combatting crises that exist within and beyond medical centers, like the opioid crisis. 40 Approaches such as community-based participatory research could assist with the definition and design of tools for community health settings, and are crucial for engaging with existing community efforts and building collaboration with people directly involved in fighting trafficking. 41

Descriptive and predictive analytics

A longstanding challenge in the identification of trafficking victims is that people at risk or who are currently being trafficked are members of what sociologists have described as hidden populations: groups for whom no sampling frame exists and for whom privacy concerns create barriers to accurate data collection. 42 Researchers, non-profit organizations, and law enforcement agencies have begun exploring the use of data analytics to help with trafficking identification by tracing information trails left by traffickers on social media, online classified advertisements, and other online sites. 2 , 43 , 44 The growth of data analytics in health care presents a major opportunity to extend these analytic efforts into health-care settings. First, by more accurately describing the scope and scale of the problem, we can contribute to better awareness about human trafficking, and perhaps lead to improvements in screening. Could data analytics help identify defining characteristics of trafficking victims present in electronic health records? Data analytics could potentially be used to refine screening instruments for use in health-care settings and could contribute to the validation of screening instruments. Could predictive analytics be used to identify those individuals at risk for trafficking, inform the design of interventions, and capture the potential downstream health consequences of trafficking on victims? These types of analyses could then be used to connect people to resources and assistance programs. The tremendous fragmentation of health data across providers and organizations poses a major challenge to these types of large-scale data analyses, but also an opportunity for collaboration across organizational boundaries and with public health agencies.

The causes of the scourge of human trafficking are complex and multidimensional, and victims are not homogenous. Even perfect screening and decision support tools in health-care settings will fail to identify some victims and cannot aid those who do not have contact with health-care providers. There are also risks that technology interventions related to issues such as trafficking could lead to unintended, negative consequences that are difficult to predict: individuals may avoid or not be allowed to seek needed health-care services because of concerns about identification. Despite these limitations, issues such as trafficking challenge medical informatics as a field to take on ethical obligations, shared with health-care providers, 45 to address trafficking and other complex, painful societal problems, such as child abuse, infant mortality, self-harm, and addiction to prescribed painkillers. As the scope and reach of medical informatics continues to expand beyond the boundaries of health-care settings and into communities, homes, and schools and as approaches such as large-scale descriptive and predictive data analytics become well established, what steps should we as a field take to move forward?

To address the pressing need for medical informatics tools focused on human trafficking, we propose a research and implementation agenda ( Table 1 ), focusing on the highest priority and foundational efforts, with ideas for further development. The first area, Foundation, involves establishing the people/organizational, process, and technology components that are critical to begin moving forward. The second area, Evaluate and Expand, builds on the fundamental first steps in Foundation to create additional areas of focus and provide the sociotechnical components needed to expand interventions. The third area, Future Exploration, moves into additional contexts and more challenging areas where substantial additional work is needed to identify the paths forward.

Sociotechnical approach to trafficking research and implementation

The first context in which to focus efforts is pediatric and adult emergency department settings, since research indicates that a higher percentage of trafficking victims seek care in emergency departments. 11 , 13 Although multiple screening instruments exist, the validation of these screening instruments varies and has not been done on a large scale. To this end, using large-scale electronic health record databases may provide a window to retrospectively validate screening instruments, and may provide an opportunity to identify trafficking indicators in electronic health record data, much as has been done with indicators of homelessness. 46 , 47 Once a trafficking screening instrument is validated, the instrument can be translated into a transferable electronic tool that can be implemented and rigorously evaluated across organizations. Additionally, the development and integration of educational resources for medical students and health-care providers into existing technology-supported delivery approaches would provide a first step towards increasing awareness of this issue among providers. Although emergency department settings offer the highest immediate potential impact related to trafficking, screening and intervention approaches are also needed for primary-care settings, including walk-in and community clinics.

Technology is only a piece of the puzzle, however, as it is critical to have structures and resources in place to support ongoing, trauma-informed care delivery for trafficking victims. 48 Approaching the problem from a sociotechnical perspective, focusing on people/organizational, process, and technology components, would provide a firm foundation for further work in this area. The research and implementation agenda that we have identified faces multiple potential barriers, several of which we have already discussed (eg, alert fatigue, hidden sampling frame). Applying concepts from Implementation Science, such as rigorously assessing barriers of and facilitators to the widespread implementation of tools and processes, and the development and evaluation of implementation plans, could provide a way to categorize these barriers and potentially assist with the successful widespread dissemination of solutions. 49 , 50 The path forward includes research to identify effective, evidence-based approaches and technology to support the wide-scale, transferable implementation of human trafficking screening and intervention into routine clinical practice across contexts.

None declared.

AUTHOR CONTRIBUTorS

KMU developed an initial draft of the manuscript and incorporated feedback from the coauthors. CGW and EWC reviewed drafts, provided feedback, and suggested additional directions for consideration.

CONFLICT OF INTEREST

Human Trafficking Research

Combatting human trafficking through research and policy advocacy is one of the core areas of Center programming. This is evidenced by research projects, events programming, and affiliates of the Center for Human Rights and International Justice.

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20 Ways You Can Help Fight Human Trafficking

Office to Monitor and Combat Trafficking in Persons

Anyone can join in the fight against human trafficking. Here are 20 ideas to consider.

• Learn the  indicators of human trafficking  on the TIP Office’s website or by taking a training.  Human trafficking awareness training is available for individuals, businesses, first responders, law enforcement, educators, and federal employees, among others.
• If you are in the United States and believe someone may be a victim of human trafficking, call the 24-hour  National Human Trafficking Hotline    at 1-888-373-7888 or report an emergency to law enforcement by calling 911. Trafficking victims, whether or not U.S. citizens, are eligible for services and immigration assistance.
• Be a conscientious and informed consumer. Find out more about who may have picked your tomatoes or made your clothes at  ResponsibleSourcingTool.org   , or check out the Department of  Labor’s List of Goods Produced by Child Labor or Forced Labor   . Encourage companies to take steps to prevent human trafficking in their supply chains and publish the information, including supplier or factory lists, for consumer awareness.
• Volunteer and support anti-trafficking efforts  in your community   .
• Meet with and/or write to  your local, state, and federal elected officials    to let them know you care about combating human trafficking and ask what they are doing to address it.
• Be well-informed. Set up a web alert to receive current human trafficking news. Also, check out  CNN’s Freedom Project    for more stories on the different forms of human trafficking around the world.
• Host an awareness-raising event to watch and discuss films about human trafficking. For example, learn how modern slavery exists today; watch an investigative documentary about sex trafficking; or discover how forced labor can affect global food supply chains. Alternatively, contact your local library and ask for assistance identifying an appropriate book and ask them to host the event.
• Organize a fundraiser and donate the proceeds to  an anti-trafficking organization   .
• Encourage your local schools or school district to include human trafficking in their curricula and to  develop protocols    for identifying and reporting a suspected case of human trafficking or responding to a potential victim.
• Use your social media platforms to raise awareness about human trafficking, using the following hashtags: #endtrafficking, #freedomfirst.
• Think about whether your workplace is trauma-informed and reach out to management or the Human Resources team to urge  implementation of trauma-informed business practices   .
• Become a mentor to a young person or someone in need. Traffickers often target people who are going through a difficult time or who lack strong support systems. As a mentor, you can be involved in new and positive experiences in that person’s life during a formative time.
• Parents and Caregivers:  Learn how human traffickers often target and recruit youth    and who to turn to for help in potentially dangerous situations. Host community conversations with parent teacher associations, law enforcement, schools, and community members regarding safeguarding children in your community.
• Youth:  Learn how to recognize traffickers’ recruitment tactics   , how to safely navigate out of a suspicious or uncomfortable situations, and how to reach out for help at any time.
• Faith-Based Communities   : Host awareness events and community forums with anti-trafficking leaders or collectively support a local victim service provider.
• Businesses: Provide jobs, internships, skills training, and other opportunities to trafficking survivors. Take steps to investigate and prevent trafficking in your supply chains by consulting the Responsible Sourcing Tool and  Comply Chain    to develop effective management systems to detect, prevent, and combat human trafficking.
• College Students:  Take action    on your campus. Join or establish a university club to raise awareness about human trafficking and initiate action throughout your local community. Consider doing one of your research papers on a topic concerning human trafficking. Request that human trafficking be included in university curricula.
• Health Care Providers:  Learn    how to identify the indicators of human trafficking and assist victims. With assistance from local anti-trafficking organizations, extend low-cost or free services to human trafficking victims. Resources from the Department of Health and Human Services can be found on their website.
• Journalists: The media plays an enormous role in shaping perceptions and guiding the public conversation about human trafficking. Seek out some media best practices on how to effectively and responsibly report stories on human trafficking.
• Attorneys: Offer human trafficking victims legal services, including support for those seeking benefits or special immigration status.  Resources    are available for attorneys representing victims of human trafficking.

U.S. Department of State

The lessons of 1989: freedom and our future.

Human Trafficking Essay Topics, Outline, & Example [2024]

“People for sale” is a phrase that describes exactly what human trafficking is. It also makes for an attention-grabbing title for an essay on this subject. You are going to talk about a severe problem, so it’s crucial to hook the reader from the get-go.

A human trafficking essay is an assignment where you discuss causes, effects, or potential solutions to the problem of modern slavery. A well-written essay can help raise awareness of this complicated issue.

In this article by our custom writing experts, you will find:

• 220 human trafficking essay topics;
• a writing guide;
• an essay sample;
• helpful info on human trafficking.
• 🔝 Top 10 Topics
• ❓ What Is Human Trafficking?
• ✍️ Topics for Any Essay Type
• 📝 Essay Outline
• 📑 Essay Sample
• ✏️ Frequent Questions

🔝 Top 10 Human Trafficking Essay Topics

• History of slavery.
• Slavery in literature.
• Human trafficking awareness.
• Modern slavery: legislation.
• Cultural background of traffickers.
• Globalization and human trafficking.
• Human trafficking vs. human rights.
• Modern slavery and kidnapping.
• Human trafficking rates by country.
• Human trafficking effects on the economy.

❓ What Is Human Trafficking?

The United Nations Convention against Transnational Organized Crime determines human trafficking as the recruitment, transportation, harboring, or receipt of persons for the purpose of sexual slavery, exploitation, forced labor, organs removal, etc.

According to the recent reports of the Council of Europe,  human trafficking rates have reached epidemic proportions . Millions of people are being trafficked for different reasons, primarily for sexual exploitation and forced labor. Women and children are the primary victims of human trafficking , which makes the problem especially acute.

One of the most worrying factors that directly impact the increase in trafficking rates is the growing number of refugees and migrants. It’s the largest seen since WWII, and it has intensified during the last years.

Types of Human Trafficking

Before you start writing your essay, it’s essential to review the forms of human trafficking. Knowing them will help you see the bigger picture. Here are the most common ones.

Additionally, victims of human smuggling and child trafficking are often involved in various kinds of labor. While sexual exploitation is one of the major reasons for trafficking, it’s not the only one. These are also serious problems that you can focus on in your essay.

According to Polaris Project, there are 25 types of modern slavery . Among them are:

• Manufacturing in sweatshops;
• Agricultural work;
• Food and cleaning services;
• Beauty and massage salons.

Note that each of these practices has unique traits. It means there are specific methods of recruitment and control associated with them. Make sure to take all essential features of human trafficking into account when writing your essay.

The History of Human Trafficking

If we go back in time, we can see that human trafficking has a long history. Here are some of its milestones:

As you now know, human trafficking is inextricably linked to other crimes against human rights. And the eradication of this phenomenon depends on both governments and ordinary citizens.

What Is Being Done to Stop Human Trafficking

In recent decades, a lot has been done to curb slavery. The United Nations General Assembly has established the World Day against Trafficking in Persons on July 30 . It was done to raise awareness of the situation and promote and protect victims’ rights.

One of the essential frameworks used to combat human trafficking is the 3P: prosecution, protection, and prevention .

Sometimes “ partnership ” is added as the fourth P. Since human trafficking became a pandemic, it requires a combined effort of people working together to overcome this problem. You can learn more about the 3P paradigm from this article by the US Department of State .

You may ask, “What can I do?” Here are some ways in which anyone can help fight human trafficking:

• In each country, there is a hotline where you can report on a known case of human trafficking or an attempt at recruiting.
• Be attentive to various kinds of controversial proposals and promises of a better life.
• Try to avoid bad company.

These recommendations may seem simple, but they can help you stay away from danger, spread awareness, and even save lives.

Before you start writing a human trafficking essay, you need to find a compelling topic. Check out the following list of topics and prompts and choose a subject that interests you.

✍️ Human Trafficking Topics for Any Essay Type

Human Trafficking Argumentative Essay Topics

• We should let survivors inform the public about the dangers of trafficking.
• State laws should protect the rights of trafficking survivors.
• Victim behavior is not the reason for the actions of criminals.
• Present medical facts about the ability of humans to survive a trauma.
• What psychological techniques do criminals use to lure victims?
• School is a safe haven for children from disadvantaged families.
• High social status is not a guarantee of protection against traffickers.
• Deception as a tool for controlling victims of modern slavery.
• Family can provide significant support to a victim of human trafficking.
• Physical violence and threats are the chief tools for controlling traffickers.
• Health workers should follow safety rules when rescuing trafficking victims .
• Countries providing financial advantages for anonymous economic activities should be held accountable.
• Psychologists should comply with ethical standards when assisting victims of trafficking.
• Countries with high trafficking rates should develop maps showing hotspots.
• Victims of modern slavery are not to blame: justification from the criminal perspective.
• Whom should we hold responsible for what happens to the victims in captivity?
• Will economic support for vulnerable groups help reduce the level of human trafficking?
• Prolonged captivity reduces the chances of adaptation after release.
• Exercise and physical activity help victims of trafficking to overcome trauma.
• Medication alone is ineffective in combating PTSD among trafficking victims.

Human Trafficking Argumentative Essay Prompts & Tips

• Who is responsible for human trafficking—the government, police, or society? There is no sufficient progress in stopping human trafficking. This is mainly due to the absence of an unequivocal opinion about who is responsible for the situation. Give your own ideas in this essay.
• The need to inform the public about human trafficking. Demonstrate the necessity to convey this information to the masses. You can also suggest ways of doing it.
• Immediate assistance for the victims of modern slavery. Show why it is important to provide psychological aid to rescued victims. What is the role of nurses and community organizations in it?
• Psychological help to victims of human trafficking: group therapy. Group therapy is based on awareness and acceptance of trauma. These actions are the basis of PTSD treatment. Decide whether it’s the optimal solution for victims’ psychological rehabilitation.
• Countries with widespread human trafficking should develop appropriate laws. Legislation changes are a crucial element of an integrated approach. In this essay, provide a list of existing laws and possible new regulations.
• The devastating impact of modern slavery. Describe the disastrous consequences that victims of human trafficking face. Find stories describing their lives in various media. How did they become victims? What happened to them after release from captivity?
• Tightening police measures as a way to stop human trafficking. Women and children are especially vulnerable targets for traffickers. Demonstrate the need to enable the police to protect them better.
• The high rate of trafficking indicates a high crime rate in a country. Determine which countries have the highest human trafficking rates. What are the related crimes observed there? Is there a correlation?
• The use of technology to catch criminals and traffickers. In this essay, discuss technologies that can help officials stop traffickers. For instance, satellite imagery allows identifying places of victims’ detention.
• International financial law is one of the best ways to stop human trafficking. Would the right to disclose anonymous bank accounts help reduce such crimes? What new laws and agreements are required to allow this?

For an argumentative essay, you need to conduct extensive research and present evidence to support your claim (check out our argumentative essay guide to learn more.) Here are the main steps:

Human Trafficking Persuasive Essay Topics

• An anti-trafficking tax will help decrease the modern slavery rates.
• Is preventing new cases of slavery more critical than saving victims?
• Modern slavery is a serious problem that the CIA should address.
• Ignoring human trafficking is the same as neglecting Nazism.
• Forced labor is an economic problem as it is caused by poverty.
• Border control no longer solves the problem of forced labor.
• Should producers of weapons pay an anti-trafficking tax?
• Imprisonment for paying for escort services will stop human trafficking.
• Will stricter gun control laws help stop human trafficking?
• Victims of human trafficking should receive lifetime financial compensation.
• Human trafficking is a national problem that requires coordination of efforts.
• Treatment of human trafficking victims is a responsibility of society as well as psychologists.
• Two-year state-funded hospital treatment will help survivors to cope with the trauma.
• Are social networks a determining factor in the spread of human trafficking?
• Assess gender disparity in using the labor of human trafficking victims.
• Did the political polarization of society lead to an increase in people smuggling?
• Immigration laws are an effective means of combating modern slavery.
• Human traffickers’ family members capable of domestic violence should share responsibility with criminals.
• Civil and human rights protection laws do not sufficiently address human trafficking.
• People smuggling is not a crime from the criminals’ perspective: is this statement true?

Tips & Persuasive Essay Prompts Related to Human Trafficking

• The President must take personal responsibility. The problem of human trafficking is more acute than ever. It requires the immediate intervention of the President and Vice President. For example, they can declare the upcoming year the year of the fight against human trafficking.
• Criminals guilty of human trafficking should be kept in special prisons. The government should create special jails for rapists and human traffickers with a stricter regime. Moreover, we should prevent these criminals from becoming part of society again. Is this proposal fair?
• Trafficking should be punished with life imprisonment . Today, life imprisonment is mainly reserved for murder. Should human trafficking be penalized to the fullest extent?
• Can self-defense lessons help to avoid the risk of being captured by traffickers? Do you agree that schools should introduce a martial arts training system?
• State laws should permit surveillance in regions with high trafficking rates. Debate whether security is more important than the right to anonymity. Should the government allow the police to access people’s data?
• Public organizations that help the survivors should take official responsibility. If non-governmental associations take it, they can receive financial support. It will help them cooperate more effectively with the police. Do you agree?
• The existence of human trafficking in a country: deontology, utilitarianism and egoism. The United States is officially a democracy. However, the human trafficking rates show that America is close to a feudal society. Criminal ties among the upper class also enforce it.
• Fines as a way to motivate social workers and patrol officers to fight human trafficking. Many activists and police officers work in areas with high human trafficking rates. Do you agree that governments should fine them? Would a system of moderate fines motivate them to be more responsible?
• People who cannot pay rent are easy targets for traffickers. The government should prevent homelessness to combat human trafficking. For instance, it can compensate for the rent of vulnerable demographics.
• Homelessness as the main reason for being captured by traffickers. Homelessness deprives a person of protection. States with the highest human trafficking rates should start building shelters for the homeless. The state should provide them with food, clothing, jobs, and education. This way, traffickers won’t capture them into slavery.

A persuasive essay aims to convince the reader to share your opinion. You can do it by citing facts and statistics (check out our persuasive essay guide for more info.) Here’s how to write it:

Human Trafficking Informative Essay Topics

• How do international organizations fight modern slavery?
• Human trafficking in developed African countries.
• Outline the demography of human trafficking in the US .
• How does society stigmatize trafficking survivors?
• Fair trade as a way to combat modern slavery.
• Sex trafficking from a feminist perspective.
• The role of photography in the fight against forced labor.
• Fighting human trafficking on the dark web.
• Media coverage of human trafficking: ethical aspects.
• Review how anyone can help combat human trafficking.
• Association of human trafficking with social insecurity.
• How can medical institutions provide safety to victims of trafficking?
• Review the political and economic effects of human trafficking in the US.
• What lessons can the US learn from the trafficking situation in Eastern Europe?
• Forced labor and higher education in the US: programs for survivors.
• What US laws protect victims of slavery and define criminal activities?
• Review government statistics on forced labor in the US over the last five years.
• Which American states have the highest human trafficking rates?
• Modern slavery in the Arab world: from ancient times to modern days.
• Using technology to combat forced labor: the latest solutions.

Tips & Informative Writing Prompts for Human Trafficking Essays

• Measures that governments can take to reduce human trafficking. Review legal and informative measures to combat modern slavery. You can base this essay on reports from official government agencies.
• Human trafficking: types, symptoms , and effects. For this essay, present the kinds of trafficking according to the official categorization. It includes divisions according to age, gender, and type of forced labor. You can also describe the symptoms commonly found in victims.
• The history of human trafficking: from ancient times to the 21 st century. Start by describing ancient cultures that used forced labor. Alternatively, you may focus on the history of slavery in the US. Include the latest statistics on reported cases of human trafficking.
• Human trafficking and fundamental humanistic values. Outline humanistic values that are violated by forced labor. Back it up with arguments drawn from the works of famous humanists.
• What are the consequences of human trafficking for victims? Describe the trauma that people develop while in captivity. Use reports from national and global organizations. What physiological symptoms are associated with adaptation after release?
• How does the US deal with the problem of reporting on forced labor? Present ways of communicating the risks of human trafficking. Base this essay on government anti-trafficking reports. Include a list of trafficker indicators and other red flags.
• Environments that put a person in danger of becoming a victim of human trafficking. These include unemployment , homelessness, and the absence of immigration status. You can base this essay on data from governmental reports.
• Informing the population as means of reducing human trafficking rates. Does informing people actually reduce the number of potential victims? Review the best informing strategies used by community organizations.
• Why are migrants the most vulnerable population group in terms of human trafficking? In this essay, provide information on migrants’ life circumstances. Mention the aspects that make them the most vulnerable demographic. Examples include unemployment and insecurity before the law. You can also present the most common schemes by which traffickers capture migrants.
• New approaches to mitigating the effects of modern slavery in psychotherapy. Describe what methods therapists use to help slavery victims. You can present a list of optimal practices for restoring the integrity of survivors’ personalities. For this essay on human trafficking, use scientific articles and reports from practicing therapists.

An informative essay should educate the reader on something they didn’t know before. Have a look at this outline:

Topics for an Expository Essay on Human Trafficking

• Assess social adaptation methods for victims of sexual slavery.
• Social adaptation of men who worked for traffickers in captivity.
• Police memo: evidence sufficient to detain a trafficker.
• Describe how to identify a trafficker based on 7 criteria.
• Power of the image: photo reports on human trafficking.
• Anonymous story of a sexual slavery survivor.
• Present a psychological and demographic portrait of a trafficker.
• Describe the conditions of human traffickers’ detention.
• Dealing with trauma in children who have been in labor slavery.
• Human trafficking in the Southern and Northern states.
• How to restore citizenship and documents after release from captivity.
• How can human trafficking survivors get free medical care?
• Who is more effective in stopping human trafficking: government agencies or community organizations?
• Being in captivity during the war, in forced labor, or sexual slavery: psychological consequences.
• Gender differences in human trafficking victims’ labor.
• Modern slavery’s connection to the criminal underworld in the Northern states.
• Enumerate the reasons why homeless people can end up in captivity.
• How many years does adaptation take for human trafficking survivors?
• Explore the modern meaning of the word “slavery.”
• Discuss ways of psychological support for the families of slavery victims.

Modern Day Slavery Writing Prompts & Tips for Expository Essays

• Human trafficking and modern slavery: real stories told by the media. Review several articles about falling into slavery. You can focus on press coverage from the 2010s. The stories of survivors will speak for themselves.
• Non-governmental organizations of the USA assisting victims: the power of community . Present five influential organizations from California, Texas, Florida, Ohio, and Nevada. Assess the personal contributions of staff. What is the role of local communities?
• How to help a friend if they’ve become a victim of human trafficking. In this essay, list tactics and strategies for assisting forced labor victims. Pay particular attention to compliance with safety regulations.
• What is it like to be a forced labor victim? A more creative task is to describe the situation from the inside. Can victims try to escape and free themselves from slavery? What is the role of psychological pressure from traffickers? How can an ordinary person cope with such a monstrous challenge?
• Prostitution, forced labor, and organ trafficking: a comparison. In addition, describe what forms of modern slavery prevail in different countries.
• Therapy methods in human trafficking survivors. Review what therapy practices are the most suitable for working with the survivors.
• An overview of common human trafficking schemes. These often involve vulnerable demographics, including illegal immigrants and adolescents from underprivileged communities.
• In what conditions do human trafficking victims live? In this paper, explain how life in captivity affects one’s mental health. Determine the connections between trauma and the body’s response to it.
• Ways of integration of human trafficking survivors. Review the best strategies for their adaptation to everyday life. Give examples of social adaptation that include education and employment.
• Human trafficking in the Southern and Border States. Study the situation in Texas, California, Florida, Georgia, and Arizona. Then, describe how to solve the problem. Don’t forget to emphasize the role of social work with illegal migrants.

An expository essay includes a thesis statement, evidence, and a logical conclusion. You can also use elements of creative writing in your paper (feel free to read our expository essay guide for more info.) Here are the main steps:

Human Trafficking Research Paper Topics

• Survival in an unfamiliar city: is an escape from slavery possible?
• What prevents citizens from recognizing victims of human trafficking?
• Are monthly payments for human trafficking survivors justified?
• Dietary adaptation for malnourished forced labor survivors.
• How do the police investigate slavery markets?
• Economic levers to combat human trafficking: practical approaches.
• Describe global criminal connections that lead to modern slavery.
• Being in captivity leads to psychological trauma inherited by victims’ children.
• The use of figureheads on social media is a successful tactic against traffickers.
• Five app projects that will help avoid becoming a human trafficking victim.
• We should ban goods produced by forced labor worldwide.
• Human trafficking transportation problems as an opportunity to catch criminals.
• Research the use of symbolic language in informing victims of human trafficking.
• Funding for the installation of video surveillance systems to catch traffickers.
• People from what socio-economic background are the most vulnerable to child labour and exploitation?
• How can we combat human trafficking during a pandemic?
• Ethics of business and economic relations as a way to combat slavery.
• Informing vulnerable groups about human trafficking and attracting them to cooperation.
• Coordinated interaction of police departments is the key to success in combating people smuggling.

Human Trafficking Research Paper Prompts & Tips

• Deficiencies in US law determine success or failure in the fight against human trafficking. US legislation on human trafficking includes several rules. International acts and agreements also guide it. Nonetheless, the US laws, especially in the leading states, require urgent revision.
• Human trafficking as modern slavery: history repeating itself. Draw analogies between the trends and schemes from the past and the present. What historical practices can be effective in combating slavery? In particular, this concerns the anti-slavery movement and public awareness.
• Domestic human trafficking in the US shows increasing tendencies. Here, analyze the growth of domestic human trafficking cases. Demonstrate the need to create new approaches to catch criminals.
• Technology companies can stop human trafficking. The luring of victims often occurs on social media. Should social networking companies be penalized for failing to act against criminals?
• Can social media campaigns help protect potential victims? It’s necessary to create a program that will inform users about the dangers of trafficking. This method of targeted communication can be very effective.
• City officials should be ready to engage in the fight against modern slavery. Provide examples of American cities that are actively fighting human trafficking. What approaches and practices can be adopted throughout the US?
• Medical institutions are the main asset in combating human trafficking. More than three-quarters of victims receive medical care while in captivity. Health workers have the legal right to place a patient in a hospital and protect them from contact with criminals. This approach has been successful in many states.
• The police have insufficient funding to combat human trafficking. The police are conducting successful investigations, and there are many cases of solved human trafficking crimes. The state can grant more money to the police to uncover more trafficking schemes. It will allow using more advanced technologies in search of criminals.

• Hotlines should be more accessible to victims of trafficking. Hotlines are highly effective in combating human trafficking. They are easy to find on the Internet, but captive victims rarely have access to the network. How can we improve this situation?
• Families of trafficking victims and their participation in the search. Demonstrate the need to establish a format for families’ closer cooperation with the police. Would it help to conduct police investigations more effectively? Should we allow families to conduct their own investigations?
• The US is responsible for the success of international cooperation against human trafficking.

To write a research paper, you study the available information, analyze it, and make conclusions. Here’s a human trafficking research paper outline:

Causes of Human Trafficking Essay Topics

• Discuss psychological factors of human trafficking.
• What personal reasons make people become traffickers?
• Greed as a major reason for human trafficking.
• What are the major causes of sex trafficking?
• Substantial profit as one of the human trafficking root causes.
• Explore the reasons for forced marriages.
• How does social media promote people trafficking?
• Commercialized sex and its contribution to human trafficking.
• Does authoritarianism promote human trafficking?
• Compare the cases of human trafficking in the United States and Thailand.
• Explore the court cases of traffickers. Does the judicial system cope with its duties?
• Why are weak anti-trafficking policies the primary cause of people’s exploitation?
• Discuss the role of government in human trafficking.
• Investigate the reforms on human trafficking. How effective are these measures?
• Lack of relevant laws leads to more trafficking cases. Do you agree?
• Should legal punishments apply to victims as well as traffickers?
• Why is ethnicity one of the main factors of people trafficking?
• Explore the connection between drug addiction and slavery.
• Violent force and threats as major leverages of traffickers.
• Naivety leads to becoming a victim of traffickers. Provide your arguments.

Causes of Human Trafficking Essay Prompts & Tips

• What are the leading causes of human trafficking? Your essay may start with the definition of people trafficking. Think about social and economic factors. Dig into history to find the reasons. Most importantly, look at this issue from various angles.
• Explore poverty as one of the reasons for human trafficking. How does poverty influence people? Can it force them to behave illegally? What are people ready to do for money?
• Migration: is it a cause or a consequence of human trafficking? Some people are so eager to immigrate to developed countries that they can do anything. They are even ready to sell their children to get money or sell themselves into slavery. At the same time, others become traffickers to move to another country.
• Discuss the connection between human trafficking and education. Think about the following: If a person lacks education, they lack knowledge about their rights. They can be deluded more easily. Following this logic, these individuals can become desired prey for traffickers.
• What is the role of war in human trafficking? Do armed conflicts provoke or prevent the spread of slavery? How do they facilitate the development of this problem? Is smuggling flourishing in countries that are at war? These are excellent questions to start with.
• What are the effects of cheap labor demand? Supply and demand are two pillars of economics. If there were no need for a cheap working force, traffickers wouldn’t exploit people so easily. They force their victims to work almost for free while selling the goods at a high price.
• Investigate institutional racism as a root cause of people trafficking. Who is the most vulnerable social class? Naturally, these are marginalized groups. They lack protection at a constitutional level. That’s why they can become victims of traffickers.
• Cultural and social causes of human trafficking. For some nations, selling children, slavery, smuggling, and bonded labor are commonplace. In some countries, such as Uzbekistan, people are forced to work in the cotton fields by the authorities. If you do research, you will see many similar examples worldwide.
• How do natural disasters facilitate human trafficking? The consequences of some natural disasters force people to migrate and find alternative ways to earn money. Some of them have no other option but to let themselves be exploited. 
• How does the absence of safe migration conditions assist people trafficking?  Many people from developing countries want to move to the United States to achieve their American Dream. Traffickers delude fortune seekers, promising well-paid jobs and help in crossing the border.

Discussing human trafficking in a cause-and-effect essay is an excellent way to investigate this issue in detail. You can learn how to write it from our article on cause-and-effect essays . Here’s a recap:

Solutions to Human Trafficking Essay Topics

• How can employers help stop human trafficking?
• Producing films about slavery : is it a problem solution?
• How can we stop human trafficking by learning the indicators?
• How can people protect themselves from traffickers when going abroad?
• Why should employers stop using cheap labor?
• Compare and contrast solutions to labor and sex trafficking.
• The role of parents and caregivers in preventing forced labor.
• How can civic awareness stop human trafficking?
• What is more important: to persecute traffickers or to protect victims?
• In what ways can attorneys help stop people smuggling? 
• Can creating a reliable online platform for job searching help reduce slavery?
• Educational curriculum : should students be taught how to indicate and prevent human trafficking?
• Investigate the list of goods produced by child exploitation as a form of human trafficking. How does this information influence people’s choices?
• Forewarned is forearmed: discuss the effectiveness of anti-trafficking non-profit websites.
• How can stricter validity checks on job-searching websites solve the issue of modern slavery?
• Can the implementation of severe punishments for human trafficking help to curb the problem?
• Legalization of prostitution as a way of preventing sex trafficking.
• How can timely identification of human trafficking indicators save the lives of the victims?
• Fighting against poverty and unemployment as a means of preventing people smuggling.
• Watching documentaries about modern slavery as a problem solution.

Solutions to Human Trafficking Essay Prompts & Tips

• What are the primary solutions to human trafficking? Think about the following: How can this problem be solved on personal and national levels? It’s crucial to mention self-awareness , education, volunteering, and the role of charity organizations. You may also address the necessity to change the law.
• Human trafficking: an international approach. The issue of modern slavery is a global problem. That’s why it should be dealt with at the international level. The authorities all over the world should unite to fight against people trafficking.
• Compare and contrast the effectiveness of volunteering and adopting new policies. On the one hand, volunteers attract public attention to the issue of human trafficking. On the other hand, we should protect marginalized groups at the constitutional level. Otherwise, human trafficking will remain flourishing in the future.
• Coverage of human trafficking cases in social media. Is it a good idea for the victims to share their stories on Instagram, Twitter, or Facebook? How can it help prevent this issue? Could it lead to the stigmatization of these people by others? You can start by brainstorming these ideas.
• Discuss whether fundraising is an effective solution to human trafficking. Ponder on how holding a fundraiser helps bring awareness to the problem of modern slavery. What are some other benefits of fundraising, such as financial assistance?
• Donations help prevent human trafficking. Do you agree? Every person can donate some money, clothes, or even shelter for the victims of human trafficking. Business owners may ensure employment opportunities, giving these people a chance for a better future. Focus on the importance of psychological and legal assistance.
• How does the media help prevent human trafficking? The media attracts people’s attention to the problem. They become more aware and careful. The cases of victims are widely discussed, leading to more fundraising and volunteering .
• Explore the anti-trafficking legislation in the United States. Discuss its strengths and drawbacks. What could be changed or done better? Is it effective? How are the rights of marginalized groups protected? These ideas are only the tip of the iceberg.
• Education opportunities for disadvantaged groups as a way of preventing human trafficking. Should the government provide marginalized people with free education? How can it affect human trafficking? Discuss it in your essay.  
• Why is a boycott an effective way of preventing human trafficking? If others start rejecting the goods produced by the victims of human trafficking, traffickers won’t get such huge profits. Everyone can make their contribution to the fight against this issue.

A problem-solution essay is particularly suitable for discussing modern slavery. Explore the facts and suggest how to stop this inhumane practice. Here’s how to write about problems and their solutions:

If you haven’t found a suitable topic, feel free to use our topic generator .

📝 Human Trafficking Essay Outline

Before you start writing, let’s have a look at some aspects to consider in your college essay on human trafficking. Here’s the basic template:

Human Trafficking Essay Introduction: How to Write

The most important part of an essay introduction is a hook. A perfect attention grabber for a human trafficking paper would demonstrate the seriousness of the problem right away. It, in turn, would make your audience eager to read on.

Have a look at some of the ideas for your essay’s hook:

• Cite statistical data related to the current situation with human trafficking.
• Start with a stirring quote to appeal to readers’ emotions.
• Pose a question related to your essay’s topic. Make the reader want to learn the answer.

Besides the hook, it’s logical to start your essay with some background information. This way, even an unprepared reader will understand your essay’s thesis. Think of what your audience may not know about your topic. It will help you determine what to include in this part of the introduction.

Here are some strategies:

• Tell about the countries and regions with the highest trafficking rates—for example, Thailand, the Philippines, India, South Africa, and Eastern Europe.
• Mention reasons behind this problem: unemployment, social discrimination, political instability, armed conflicts, etc.
• Give a solid definition of human trafficking or its specific type. It’s better to formulate your own one rather than take it from a dictionary.

It’s important to notice that your hook and background information should be relevant to your topic. Make sure these elements help to further the understanding of your essay’s main point.

Human Trafficking Essay Thesis

A thesis statement is your essay’s main point formulated in one sentence. It outlines the paper’s direction and provides an answer to the problem stated in the title. You place it at the end of the introduction.

A good thesis statement for a human trafficking essay usually presents the solution to a problem. However, the thesis’ contents depend on your essay’s type. For example, in an informative essay, you don’t need to prove or suggest anything. Instead, you say what you’re going to explain and how you’ll do it.

Once you’ve written the thesis statement, how do you determine whether it’s strong? Well, one way is to answer the questions from the following checklist.

If your answer to all three questions is “yes,” you can be sure of your thesis’s effectiveness.

Finally, don’t forget that the rest of your essay should support your thesis. If necessary, you can rework your statement to better suit the body paragraphs, or vice versa.

Human Trafficking Essay: Main Body

How do you make your essay on human trafficking credible and persuasive? Naturally, you want to add evidence. Here’s how to incorporate it into your paper:

• It’s better to start collecting your evidence before you start writing. Once you’ve found all the necessary information, it will be easier for you to structure the paragraphs. The point is to focus each section on a single aspect.
• Start each paragraph with a topic sentence. It should present the main idea that you will then support with evidence. Ideally, your audience should be able to follow your logic by reading the topic sentences alone.
• Finally, add your evidence. It can be statistics, facts from scholarly articles, quotes, or even anecdotes. Follow it with your explanation of this information. Say how it relates to the topic and supports your thesis.

Human Trafficking Essay Conclusion: Dos & Don’ts

A strong conclusion is a crucial part of any writing. In this final part, you synthesize your essay in a few sentences while adding a twist to it. If a conclusion is done right, it can leave a lasting impression on your readers.

This dos and don’ts list will help you write a perfect conclusion for a human trafficking essay. Check it out:

Don’t forget to introduce statistics in your essay on human trafficking. It’s available on numerous websites of governmental and non-governmental organizations dealing with the problem. You can find more ideas for your paper in our article about writing a child labor essay.

📑 Human Trafficking Essay Examples

We’ve prepared an outstanding sample essay on human trafficking that you can use as inspiration. You’re welcome to download the PDF file below:

Human trafficking is a global problem. It deprives millions worldwide of their freedom and dignity. Traffickers use various tactics to lure children, men, and women into the trap. For that reason, precaution measures should be taken. It is crucial to educate as many people as possible on the issue to ensure everyone’s safety.

Share your thoughts about human trafficking with us! Why do you think slavery is still in demand? If you were a politician, what would you do to prevent it? Tell us your suggestion in comments below!

Learn more on this topic:

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• Nationalism Essay: An Ultimate Guide and Topics
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✏️  Human Trafficking Essay FAQ

Human trafficking is a topical issue in society because it’s an inhumane practice that affects millions of people worldwide. Writing on that topic helps understand why it is happening and what can be done about it.

Human trafficking is a very complex phenomenon driven by various economic, social, cultural, and other causes. Factors of a high human trafficking risk are poverty, social instability, exclusion, and lack of education and awareness (e.g., in South Africa.)

Pretty much every fact connected with human trafficking is horrifying. Nearly everything about this phenomenon can be considered a danger. As human trafficking is a form of slavery, it would be naive to presume there are any positive effects whatsoever.

Human trafficking is a serious problem, and you should be able to express your opinion on it. For example, it can be done in the form of an argumentative essay. It is vital to avoid using too many emotionally charged words. Remember to stay objective and provide facts and examples.

🔗 References

• Tips for Organizing an Argumentative Essay: Judith L. Beumer Writing Center
• Human Trafficking Essay: Bartleby
• Post Traumatic Stress Disorder Treatment: NHS
• Embrace AI, Technology to Beat Human Traffickers: Reuters
• Essay Writing: Purdue University
• What Is Human Trafficking: Anti-Slavery International
• Human Trafficking: Encyclopedia Britannica
• End Human Trafficking: United Way
• Human Trafficking Facts: CRS
• OSCE Resource Police Training Guide: Trafficking in Human Beings: OSCE
• Study on the Economic, Social and Human Costs of Trafficking in Human Beings Within the EU: Europa.eu
• Writing a Research Paper: University of Wisconsin-Madison
• Human Trafficking: FBI
• Human Trafficking: Causes and Implications: Research Gate
• Writing a Persuasive Essay: Hamilton College
• Parts of an Informative Essay: Pen and the Pad
• Expository Essay Outline: Columbus City Schools
• Introductions & Conclusions: University of Arizona
• Writing the Introduction: Monash University
• How to Write a Thesis Statement: Indiana University Bloomington
• Writing a Thesis Statement: Piedmont University
• 4 Ways Anyone Can Fight Human Trafficking: The Muse
• What Fuels Human Trafficking?: UNISEF USA
• What Is Human Trafficking?: Homeland Security
• Psychological Tactics Used by Human Traffickers: Psychology Today
• Psychological Coercion in Human Trafficking: An Application of Biderman’s Framework: NIH
• Warning Signs of Human Trafficking: State of Nevada
• Human Trafficking: US Immigration and Customs Enforcement
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