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Fact Sheet
Office to Monitor and Combat Trafficking in Persons
Washington, DC
August 8, 2007

Health Consequences of Trafficking in Persons

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The U.S. Government estimates that approximately 800,000 people are trafficked internationally each year; millions more are enslaved in their own countries. Trafficking in persons has serious public health implications

such as spreading the HIV/AIDS epidemicbesides being a human rights and national security issue.including people in prostitution and victims of traffickingwith dignity and compassion.

Physical Trauma and Mental Health

By definition, human trafficking entails "force, fraud, or coercion" which typically includes confinement and, often, physical and psychological abuse. Research has demonstrated that violence and abuse are at the core of trafficking for prostitution. A study of women trafficked for prostitution into the European Union found that 95% of victims had been violently assaulted or coerced into a sexual act, and over 60% of victims reported fatigue, neurological symptoms, gastrointestinal problems, back pain, and gynecolopercgical infections.1

A nine-country assessment first published in the Journal of Trauma Practice concluded that 73% of women used in prostitution were physically assaulted, 89% wanted to escape, 63% were raped, and 68% met the criteria for post-traumatic stress disorder.2 Additional psychological consequences common among prostituted women include dissociative and personality disorders, anxiety, and depression.3 Another study (2001) revealed that 86% of women trafficked within their countries and 85% of women trafficked across international borders suffer from severe depression.4

As with sex trafficking, those who are trafficked for labor also suffer physical and mental health problems, such as post-traumatic stress disorder due to physical assaults and beatings, and depression that elevates the risk of suicide. Victims of labor servitude have limited ability to determine the conditions in which they work, which may put them at higher risk of physical and mental health damage. There is a need for more data on the health consequences of trafficking for forced labor.

The Link Between HIV/AIDS and Trafficking in Persons

Approximately 42 million people worldwide are living with HIV/AIDS, and sex trafficking plays a major role in spreading the epidemic. In 2005, the Joint United Nations Programme on HIV/AIDS reported, "Across Asia, the [HIV] epidemics are propelled by combinations of injecting drug use and commercial sex."5 Thus, both prostitution and sex trafficking contribute to the spread of HIV/AIDS.

Globally, people in prostitution have a high incidence of HIV. For example, HIV prevalence among women trafficked from Nepal and prostituted in India is 38%. The rate of HIV infection exceeded 60% among girls prostituted prior to 15 years of age.6 In South Africa, the number reaches 70.4%. According to the World Congress Against Commercial Sexual Exploitation of Children, between "50 and 90 percent of children rescued from brothels in Southeast Asia are infected with HIV."7

Experts believe that sex trafficking is contributing to the global dispersion of HIV subtypes and in the mutation of the HIV virus, as well as the development of drug-resistant strains of other sexually transmitted infections. In brothels in Indonesia, for example, 89% of prostituted women with gonorrhea were resistant to penicillin and 98% to tetracycline.8 The presence of some sexually transmitted infections (STIs) greatly increases the risk of HIV transmission.9

Sexual and Reproductive Health

Untreated sexually transmitted infections may lead to serious consequences for long-term health. One such implication, pelvic inflammatory disease, may result in "infertility, ectopic pregnancy, chronic pelvic pain, and an increased risk of hysterectomy."10

Research by Brian M. Willis and Barry Levy reveals that of the millions of women and girls forced into prostitution each year, approximately 45% are infected with the human papillomavirus (HPV).11 The National Cancer Institute has confirmed that HPV infection causes cervical cancer.12 Prostituted girls are left more susceptible to developing the disease since cervical cancer is associated with a high number of sexual partners and with young age at first intercourse.13

It is common for sex trafficking to result in pregnancy, a situation that frequently leads to forced abortions, according to a 2003 European Union study on the health consequences of human trafficking. Trafficked women are particularly vulnerable to post-abortion risks, such as incomplete abortion, sepsis (infections of the bloodstream), hemorrhaging, and intra-abdominal injury. These complications reportedly account for most maternal deaths.14 The study also found that many women exploited for commercial sex are given insufficient time to recuperate, thereby increasing the risk of post-abortion infection.15 The Christian Medical and Dental Association points out that these abortions are probably carried out by unqualified individuals with little regard to sanitation, resulting in infection, mutilation, or infertility.16

U.S. Government Policy

The Administration has implemented strong policies to combat HIV/AIDS and human trafficking. Recently, the President’s Interagency Task Force to Monitor and Combat Trafficking in Persons reaffirmed the Administration’s commitment to fighting both. The U.S. Government promotes the rescue and care of victims and seeks to ameliorate the harm suffered by men, women, and children used in prostitution. U.S. law encourages appropriate treatment and care for those trafficked into prostitution as well as those who escape servitude. Further, the U.S. Government is the largest funder in the world of vital HIV/AIDS prevention and treatment. We will continue to treat people infected and affected by HIV/AIDS

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1 Zimmerman, Cathy. "The Health Risks and Consequences of Trafficking in Women and Adolescents: Findings from a European Study." London School of Hygiene and Tropical Medicine. 28 Aug. 2006. http://www.lshtm.ac.uk/hpu/docs/traffickingfinal.pdf.
2 Farley, Melissa et al. 2003. "Prostitution and Trafficking in Nine Countries: An Update on Violence and Posttraumatic Stress Disorder." Journal of Trauma Practice 2 (2003): 33-74.
3 Ross, Colin A., Melissa Farley, and Harvey L. Schwartz. "Dissocation Among Women in Prostitution." Ed. Melissa Farley. Prostitution, Trafficking, and Traumatic Stress. Haworth Press: New York, 2003. 199-212.
4 Raymond, Janice G., Donna M. Hughes, and Carol J. Gomez. Sex Trafficking of Women in the United States: Links Between International and Domestic Sex Industries. Coalition Against Trafficking in Women (CATW): North Amherst, 2001.
5 AIDS Epidemic Update: December 2005. Joint United Nations Programme on HIV/AIDS (UNAIDS). 18 August 2006.
http://www.unaids.org/egi/2005.
6 "Silverman, Jay C., et al. "HIV Prevalence and Predictors of Infection in Sex-Trafficked Nepalese Girls and Women." The Journal of the American Medical Association 298 (2007): 536-542.
http://www.vitalvoices.org/files/docs/HIV%20Prevalence%20and%20Predictors%20of%20Infection%20in%20Sex-Trafficked%20Nepalese%20Girls%20and%20Women.pdf
7 World Congress Against Commercial Sexual Exploitation of Children. Impact statement. Stockholm: WCACSEC, 1996.
8 Joesoef M.R., et al. "Risk profile of female sex workers who participate in a routine penicillin prophylaxis programme in Surabaya, Indonesia." Int J STD AIDS 9 (1998) 756-60.
9 Sexually Transmitted Infections. UNAIDS,
http://www.unaids.org/en/Issues/Prevention_treatment/sexually_transmitted_infections.asp.
10 Willis, Brian M. and Barry S. Levy. "Child prostitution: global health burden, research needs, and interventions." The Lancet 359 (2002): 1419.
11 Ibid 1418.
12 "Human Papillomaviruses and Cancer: Q & A." National Cancer Institute. 21 Aug. 2006
http://www.nci.nih.gov/cancertopics/factsheet/Risk/HPV.
13 Willis and Levy 1419.
14 Zimmerman 51.
15 Ibid.
16 Barrows, Jeffrey. "Introduction to Human Trafficking: The Slavery of the 21st Century." Christian Medical and Dental Associations. 15 Aug. 2006
http://www.cmawashington.org/index.cgi?cat=100284&BISKIT=1244688284&CONTEXT=cat.



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