title: Identifying Health Experiences of Domestically Sex-Trafficked Women in the USA: A Qualitative Study in Rikers Island Jail.
abstract: While sex trafficking in the USA is a significant medical and public health issue, there is sparse data on the healthcare needs of and access for this population. This study was designed to identify experiences of domestically sex-trafficked women regarding healthcare access, reproductive health, and infectious diseases while trafficked. Trafficking survivors incarcerated in New York City's Rikers Island women's jail participated in audio-recorded interviews between July and September 2015. Recordings were transcribed, and a content analysis was completed to identify health-related themes. Twenty-one women ranging from 19 to 60 years old were included in this study. Reasons for accessing care included sexually transmitted infections (STIs) and HIV testing, unintended pregnancies, traumas, and chronic diseases. Emergency departments, Planned Parenthoods, and jails were common care sites. Traffickers and substance use impeded care and access to follow-up. Unintended pregnancy and STIs resulted in trafficker-perpetrated violence. Condoms, the most common form of contraception and HIV prevention, were inconsistently negotiated due to financial and violent consequences. These findings demonstrate that domestic sex trafficking survivors experienced chronic and acute health issues while trafficked and multiple barriers to care. Substance use and financial vulnerabilities furthered unintended pregnancy and infection risk. These findings can inform future research regarding healthcare access and practices for domestically trafficked women.
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA. ravia@alumni.upenn.edu.
authors.forename: Anita
authors.identifier: 0000-0002-9675-4362
authors.initials: A
authors.lastname: Ravi
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Megan Rose
authors.initials: MR
authors.lastname: Pfeiffer
authors.affiliation: NYC Health and Hospitals, Correctional Health Services, New York, NY, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Rosner
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D064410:Human Trafficking / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011329:Prisoners / Q000706:statistics & numerical data*; D036301:Qualitative Research; D016387:Women's Health / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Access to care; Condoms; HIV; Reproductive health; Sex trafficking; Women