discussed, including the potential contributions of using a public health approach to examine and provide services to child and adolescent victims of commercial sexual exploitation and sex trafficking. Public health program models are described as examples of how health care providers and communities have taken such an approach. The chapter concludes with the committee’s findings and conclusions regarding the roles of health care providers in addressing commercial sexual exploitation and sex trafficking of minors in the United States.

Victims and survivors of commercial sexual exploitation and sex trafficking of minors may experience a variety of physical and mental health illnesses and injuries. Thus, they might be expected to present for treatment at some point during their victimization. If each of these encounters is viewed as a potential opportunity to assist victims, it would follow that health care providers must be prepared to identify victims and provide this assistance. Yet little is known about how often these opportunities arise and how health care providers can fulfill this role. To date, only two published studies have examined how often victims of human trafficking were taken to health care providers during their victimization. Both of these study samples included victims of all ages, of both domestic and international trafficking, and of all forms of human trafficking (including labor and sex trafficking). One study entailed interviews with 21 victims of trafficking aged 12-53 (FVPF, 2005). The authors found that 28 percent of victims had seen a health care provider at least once during their victimization. In the second study, a qualitative study of women aged 22-63, 6 of the 12 victims of sex trafficking interviewed reported a visit to some type of health care provider, including a curandera or traditional Latina healer (Baldwin et al., 2011), for treatment of sexually transmitted infections, testing for pregnancy, and abortion services. The findings of these two small, qualitative studies suggest that human trafficking victims may seek treatment by health care providers, but they reveal little about the role of the health care providers visited in identifying and assisting victims. Both studies also have limitations that underscore some of the inherent challenges entailed in research on vulnerable populations such as victims of human trafficking. First, the sample sizes were small, which is not unexpected when one is trying to recruit and study victims who may be unwilling to self-identify and volunteer. Also, it is reasonable to question whether youth who are victims of domestic sex trafficking would report different patterns of interaction with the health sector and providers from those of adults who are trafficked for other purposes, even though some factors associated with age and legal status might make accessing health care more difficult for them. Still, despite the lack of scientific data with which to fully appreciate the role of health care providers in identifying and assisting victims of commercial sexual exploitation and sex trafficking, there are lessons to be drawn from



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