Understanding Commercially Sexually Exploited Young Women's Access to, Utilization of, and Engagement in Health Care: “Work Around What I Need”

Barnert, Elizabeth S.; Kelly, Mikaela; Godoy, Sarah M.; Abrams, Laura S.; Rasch, Madeline; Bath, Eraka

doi:10.1016/j.whi.2019.02.002

Cited by 29 publications

(43 citation statements)

References 21 publications

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“…The continuum of harmful experiences endured in childhood and throughout the course of exploitation often results in complex trauma that leads to multifarious health care needs. Prior studies have confirmed survivors' significant health-related risks and needs, and documented frequency of using and barriers to accessing health care services (Barnert, Kelly, Ports, et al, 2019;Ijadi-Maghsoodi et al, 2018;Lederer & Wetzel, 2014;Ravi et al, 2017a;Varma et al, 2015). Though health care treatment may be available to youth and young adults affected by CSE, a multitude of structural, environmental, and internal barriers to utilization and engagement (i.e., "buy-in") into treatment remain .…”

Section: Introductionmentioning

confidence: 99%

Fierce Autonomy: How Girls and Young Women Impacted by Commercial Sexual Exploitation Perceive Health and Exercise Agency in Health Care Decision-Making

et al. 2020

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Prior research has examined the high health care needs and vulnerabilities faced by survivors of commercial sexual exploitation (CSE), yet their perspectives are frequently absent. We sought to understand the narratives and views of individuals affected by CSE on their bodies, health, and motivations to seek health care treatment. Twenty-one girls and young women ages 15 to 19 years with self-identified histories of CSE participated in the study. All participants had current or prior involvement in the juvenile justice and/or child welfare systems. Data collection included brief questionnaires, followed by semi-structured individual interviews. The interviews took place between March and July 2017 and were analyzed using iterative and inductive techniques, using the shared decision-making model as a guide. “Fierce Autonomy” emerged as a core theme, depicting how past traumas and absence of control led the girls and young women to exercise agency and reclaim autonomy over decisions affecting their health.

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confidence: 99%

Fierce Autonomy: How Girls and Young Women Impacted by Commercial Sexual Exploitation Perceive Health and Exercise Agency in Health Care Decision-Making

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“…Youth experiencing CSE are at increased risk for emergent health needs resulting from forced sexual activity, violence, and abuse, such as sexually transmitted infections or unintended pregnancies. [10][11][12][13][14] Additionally, these youth may also experience elevated behavioral health needs, such as depression, anxiety, and suicidality. 5,14 The literature shows that individuals experiencing CSE are known to access health care treatment at public and private health offices, emergency departments, urgent care centers, and family planning clinics.…”

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confidence: 99%

“…5,14 The literature shows that individuals experiencing CSE are known to access health care treatment at public and private health offices, emergency departments, urgent care centers, and family planning clinics. 12,[15][16][17][18][19] System involvement may also increase access to health care treatment or related services, as treatment is often court-referred or mandated. Yet, utilization or engagement in care can be challenging, often exacerbated by fragmented patterns of care delivery, 20 disrupting one's ability to obtain continuous and consistent care.…”

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“…9,18,19 The frequency of youth running away from care and back to exploitative circumstances or risky environments pose additional barriers to accessing or engaging in traditional health care services. 12,20,21 Further, youth have identified additional factors that create barriers to treatment engagement, such as long wait times, feeling judged by providers, staff changeover (forcing them to repeat reporting their history), not having accessible transportation, and fear of legal ramifications resulting from presenting for health care. 12,14,22 The general lack of agency afforded to youth when accessing health care treatment has shown to further compromise their willingness to engage in services, 20,22 creating an additional barrier to obtaining continuous care.…”

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confidence: 99%

“…12,20,21 Further, youth have identified additional factors that create barriers to treatment engagement, such as long wait times, feeling judged by providers, staff changeover (forcing them to repeat reporting their history), not having accessible transportation, and fear of legal ramifications resulting from presenting for health care. 12,14,22 The general lack of agency afforded to youth when accessing health care treatment has shown to further compromise their willingness to engage in services, 20,22 creating an additional barrier to obtaining continuous care. 23 These factors threaten continuity of care and lead to increased fragmentation of health-related treatment or mandated services.…”

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See 2 more Smart Citations

Perspectives of Girls and Young Women Affected by Commercial Sexual Exploitation: mHealth as a Tool to Increase Engagement in Care

Bath¹,

Godoy²,

Perris³

et al. 2021

Journal of Health Care for the Poor and Underserved

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Reimagining medical aftercare for sex‐trafficked youth

Raj

2022

Child Abuse Review

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To The Editor, In recent years, sex trafficking has been recognised as a human rights, child welfare and public health priority. The most commonly identified form in the US paediatric population has been termed domestic minor sex trafficking (DMST). DMST is defined as the exchange of a sex act for anything of value involving an American citizen or legal resident under 18 years of age within the borders of the United States (Greeson et al., 2019). Prominent international agreements, such as the United Nations Convention on the Rights of the Child, have explicitly advocated that minors involved in sex trafficking are considered survivors of crime and warrant specialised support services (Josenhans et al., 2020). Given the associated safety concerns and medicolegal implications, there has, to date, been an understandable emphasis on screening and identification within the healthcare system. However, generalisable aftercare guidelines on specific interventions should a youth screen positive remain elusive. Correspondingly, research has illuminated that only a minority of healthcare providers feel informed about the appropriate clinical response after encountering a trafficking victim (Einbond et al., 2020). Presently, no 'one size fits all' model of healthcare delivery for sex-trafficked youth has been ascertained. Nonetheless, clinical experience and a growing literature base have started to reveal recurring themes of which practices maximise opportunities for youth 'buy-in'. While it has become clear that the needs of trafficked youth are unique, as are the approaches required to address them, the tools necessary to secure a meaningful therapeutic alliance do not warrant a revolution but rather a thoughtful evolution in clinical practice.Although sex-trafficked youth constitute a largely heterogenous population, studies have consistently demonstrated that affected persons disproportionally come from historically marginalised communities, and often have personal experience with various forms of maltreatment (McCoy, 2019). While screening tools typically qualify these realities as biopsychosocial vulnerabilities linked to an individual, social-ecological research has determined that involvement in trafficking is inherently difficult to extricate from poverty, household dysfunction, and systematic oppression based on race, gender identity and sexual orientation (Judge, 2018). As can be seen with other disenfranchised groups, distrust of social services organisations and authority figures is not uncommon. For many youths, the very systems that society might lean on for child protection (e.g. child welfare and law enforcement), may be perceived as a threata threat to criminalise their current support networks and return them to the environments that may have contributed to their involvement in the sex industry in the first place (Gezinski, 2021). Consequently, it is not surprising that trafficked youth frequently voice fears related to the healthcare system given their concerns about confidentiality and mandated report...

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Understanding Commercially Sexually Exploited Young Women's Access to, Utilization of, and Engagement in Health Care: “Work Around What I Need”

Cited by 29 publications

References 21 publications

Fierce Autonomy: How Girls and Young Women Impacted by Commercial Sexual Exploitation Perceive Health and Exercise Agency in Health Care Decision-Making

Fierce Autonomy: How Girls and Young Women Impacted by Commercial Sexual Exploitation Perceive Health and Exercise Agency in Health Care Decision-Making

Perspectives of Girls and Young Women Affected by Commercial Sexual Exploitation: mHealth as a Tool to Increase Engagement in Care

Reimagining medical aftercare for sex‐trafficked youth

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