NCLIP

Human and Sex Trafficking

3 min read

Human and Sex Trafficking

Key Points

  • Human trafficking uses force, fraud, or coercion for exploitation and is a major public health and human-rights crisis.
  • Victims may present with physical injury, controlled communication, fear, and restricted autonomy.
  • Nurses are key in recognition, mandated reporting, trauma-informed care, and multidisciplinary referral.
  • Survivor-centered support must include safety, legal, social, mental health, and recovery pathways.

Pathophysiology

Trafficking causes cumulative trauma exposure, resulting in high rates of PTSD, depression, anxiety, substance-use disorders, and chronic medical sequelae. Ongoing coercion and fear conditioning can impair disclosure and help-seeking.

Psychological control tactics, isolation, and exploitation increase vulnerability to complex trauma and functional impairment.

Classification

  • Labor trafficking: Forced labor under coercive control.
  • Sex trafficking: Commercial sexual exploitation under force/fraud/coercion.
  • Child exploitation contexts: Includes trafficking patterns involving minors and dependency exploitation.

Nursing Assessment

NCLEX Focus

Prioritize private, trauma-informed assessment and immediate safety screening when trafficking indicators are present.

  • Assess injury patterns, malnutrition, untreated conditions, and signs of coercive control.
  • Assess behavioral indicators: fear, scripted responses, hypervigilance, restricted speech.
  • Assess identity/document possession, debt bondage indicators, and movement restrictions.
  • Assess immediate danger, suicidality risk, and potential retaliatory threats.
  • Assess legal mandates by jurisdiction and agency reporting requirements.

Nursing Interventions

  • Use trauma-informed, nonjudgmental interviewing that centers survivor autonomy and safety.
  • Activate mandated reporting pathways consistent with local law and institutional policy.
  • Coordinate urgent referral to trafficking hotlines, legal aid, shelter, and forensic services.
  • Provide crisis stabilization, medical care, and mental health linkage with survivor consent when feasible.
  • Develop safety planning and long-term recovery support in collaboration with multidisciplinary teams.

Retraumatization Risk

Confrontational questioning or loss of privacy can endanger survivors and reduce disclosure.

Pharmacology

Pharmacologic care is symptom-targeted and typically addresses trauma-related anxiety, depression, sleep disturbance, and co-occurring conditions. Medication plans should be integrated with trauma-informed psychotherapy and social stabilization supports.

Clinical Judgment Application

Clinical Scenario

A young client arrives with a controlling companion, inconsistent history, visible bruising, and fear of speaking alone.

Recognize Cues: Multiple high-risk trafficking indicators are present. Analyze Cues: Client safety and controlled communication suggest coercion. Prioritize Hypotheses: Immediate priorities are private assessment and danger mitigation. Generate Solutions: Initiate trauma-informed screening and mandated reporting pathway. Take Action: Coordinate emergency safety resources, social work, and law-guided reporting. Evaluate Outcomes: Survivor connected to protective services and trauma-informed follow-up care.

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