Health and Traficking in East and Southern Africa

• Very few health practitioners see women who have been trafficked
• Non-medical experts in the field of trafficking do not generally take into consideration the health consequences of human trafficking
• Most Thai and Mozambique women trafficked to South Africa for prostitution
• HIV rate in 15 brothels with trafficked women varied between 60-80%
• Trafficked Thai women in brothels in South Africa reported that healthcare providers visited and tested them for STI’s, but due to language barriers, they were unable to tell them they were trafficked
• Whenever trafficked Thai women visited healthcare facilities, they were accompanied by an interpreter to prevent them from asking for help
• If a male interpreter is used, victims of TIP are less likely to discuss matters relating to their sexual health
• All service providers interviewed in this study were unsure how to find trafficking victims
• If they did know how to identify these women, they didn’t know how to help them.
• Experience of Ethiopian women trafficked to Middle Eastern Countries
o Majority held in detention centers with minimal healthcare
o Often end up victims of TIP again on return because of lack of jobs
o Most TIP victims are reluctant to identify themselves
• Mozambican women trafficked into South Africa
o Only 20 women have been assisted recently
o More difficult to identify them than Thai women

IOM “Breaking the Cycle of Vulnerability-Responding to the health needs of trafficked women in East and Southern Africa.” Available online at: http://www.iom.int/jahia/Jahia/cache/bypass/pid/8;jsessionid=DBDD486BD4BD2D9ACD1546969EBC1CC9.worker02?entryId=12684

Emergency Room personnel knowledge about TIP

• Personnel in 2 emergency departments surveyed
• 110 responses obtained
o 28% attendings
o 34% residents
o 6% PA’s
o 23% nurses
• 76% knew what trafficking was
• 29% thought it was a problem in their ED population
• 55% were unsure it was a problem
• 9% did not think it was a problem in their ED population
• 6% had knowingly treated a TIP victim in the ED!
• 13% felt confident or very confident that they could identify a TIP victim in their ED
• 22% were confident in their ability to treat a TIP victim
• <3% had ever had any training on recognizing a TIP victim

Chisolm-Strike, M. and Richardson, L. “Assessment of Emergency Department Provider Knowledge about Human Trafficking Victims in the ED.” Acad Emerg Med 2007;14(5), Supplement 1: 134.

Sex Trafficking and HIV in South Asia

• 225,000 of the men, women and children trafficked each year are from South Asia
• Sex trafficking has direct cause and effect linkages to the spread and mutation of the AIDS virus
• Sex trafficking is helping the global dispersion of HIV/AIDS
• Women and child victims of sex trafficking have a high incidence of HIV/AIDS and other STI’s.

Huda, S. “Sex Trafficking in South Asia.” Int J Gynaecol Obstet. 2006 Sep;94(3):374-81. Epub 2006 Jul 17.

Sex Trafficking and HIV in India

• Found 175 trafficked women and girls
o 22.9% tested + for HIV
• Risk factors
o Time within the brothel
o Increase of 3-4%/ month in the brothel
o Younger age
o Found that the younger girls had to stay longer in the brothel
• Reasons for greater risk of HIV in younger girls
o May be preferred by men with HIV with thought of cure
o Less able to negotiate condom use
o More vulnerable to violence
o Cervical ectopy may predispose young girls to higher HIV acquisition rate

Silverman, J.G. et. al. HIV Prevalence and Predictors Among Rescued Sex-Trafficked Women and Girls in Mumbai, India. J Acquir Immune Defic Syndr. 2006 Dec 15;43(5):588-93.

The Association of Sex Trafficking and HIV in Nepal:

• 287 women and girls repatriated to Nepal between 1997 and 2005 were tested for HIV
o 38% tested +
o 60.6% who were trafficked when < 15 tested +
• Those trafficked to Mumbai were more likely to be +
• Those who lived in the trafficking scenario longer were more likely to be +

Sex Trafficking drives the spread of HIV

Silverman, J.G., Decker, M.R., Gupta, J. et. Al. “HIV Prevalence and Predictors of Infection in Sex-Trafficked Nepalese Girls and Women.” JAMA 2007; 298:536-542.