How do I detect if my patient is a victim of human trafficking?

By | 2018-12-10T15:42:38-05:00 December 10th, 2018|6 Comments

Know the signs to help some of your most vulnerable patients.

What you might imagine human trafficking victims to look like can be a completely different picture than the reality of the patient in front of you.

Although human trafficking often brings to mind sex workers, did you know 68% involves the exploitation of forced labor, according to the International Labour Organization?nurse salary - Woman is taking out money from wallet

Although in the U.S. human trafficking is outlawed under The Trafficking Victims Protection Act, 75% to 80% of trafficking victims in America are involved in the sex trade.

Recognizing the warning signs a patient is a victim of trafficking is crucial in the ED and other healthcare settings.

For many victims, the opportunity to escape and receive help comes when they visit a healthcare provider, according to our recent continuing education webinar on human trafficking.

10 facts that could help you treat a patient victimized by human trafficking

  1. Patients who are victims of sex trafficking might exhibit a reluctance or inability to speak, with the possibility of a companion present who does all the talking or refuses to leave. The patient might provide answers to questions that seem scripted or rehearsed.

  2. Sex trafficking indicators include frequent pregnancies and/or forced abortions, frequent sexually transmitted diseases, an excessive number of sex partners. For underage victims, it also could be a history of truancy or running away.

  3. Most labor trafficking in the U.S. involves foreign nationals. More than 71% entered the U.S. on lawful visas.

  4. Many labor trafficking victims are indebted to someone who charged the victims “finding fees” for jobs or charged fees for transport. The fees and interest continue to accrue and the workers are unable to retire the debt and escape. One study showed 31% of Spanish-speaking laborers in Southern California had been victims of human trafficking.

  5. Some trafficking victims might not be aware they are victims. Traffickers use charm and coercion tactics — preying upon vulnerable, at-risk people. Tactics can involve promises of stability.

  6. Human trafficking victims under U.S. law could include children younger than 18 induced into commercial sex; adults 18 years or older; adults 18 years or older induced into commercial sex through force, fraud or coercion; and children and adults induced to perform labor or services through force, fraud or coercion.

  7. Human trafficking is low risk, high reward for perpetrators, with more than 20 million victims worldwide and an economic impact globally of more than $150 billion.

  8. Of the 67% of forced labor victims, 25% are children. Labor traffickers can include recruiters, contractors and employers.

  9. Victims are moved often to prevent friendships, and communication with family and friends is restricted or prohibited. Some do not understand English, may be unfamiliar with cultural and legal norms and are afraid to ask for help.

  10. Traffickers often target runaway and homeless youth, as well as victims of domestic violence, sexual assault, war or conflict, or social discrimination. Patients involved in trafficking may not even be aware they are victims.

What can you do to help?

Medical histories of victims are admissible in court. Document your patient’s medical history in an unbiased manner and make sure findings of “suspected human trafficking” are noted, along with unaltered direct quotes from the patient.

If you suspect human trafficking, questions you could ask include: “Did anyone you worked for or lived with trick or force you into doing anything you did not want to do?” for sex trafficking. “Have you ever worked without getting the payment you thought you would get?” for labor trafficking.

Should a patient disclose he or she is a victim of human trafficking, contact and consult with a forensic nurse and/or social worker/mental health professional.

Try to build a rapport with the patient. Offer victims information and support through the process of connecting with service providers when they are ready to report what’s happened to them.

Not all victims will be ready to seek assistance. Try to partner with the patient in making the decision to contact law enforcement.

Hospitals and health systems should have a plan in place for assessing trafficking victims, with a response process among ED residents, attending physicians, triage staff, nurses, forensic nurses and social workers to work together to care for and assist suspected trafficking victims.

Watch our continuing education Human Trafficking webinar.

human trafficking


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About the Author:

Sallie Jimenez
Sallie Jimenez is content manager for healthcare for from Relias. She develops and edits content for the blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Digital Editions. She has more than 25 years of healthcare journalism, content marketing and editing experience.


  1. Avatar
    Megan Rivera December 30, 2018 at 7:25 pm - Reply

    I didn’t know this was something people in health care discussed. I just know that there was a nurse working triage who recognised something wasn’t right about me when I came in one day. (I had escaped from two men trying to drug me and hold me against my wishes only 2days prior and was being followed, I didn’t know where to go for safety and I ended up in the er afraid) She saw that I was afraid to talk because there was a couple who followed me in, who I kept looking at as she she assessed me. She asked me the words I’ll never forget “Do you feel safe” I shook my head no and she brought me to a secure part of the hospital where I believe a social worker came to my aid. As she escorted me away I seen the couple walking out, the male was visibly angry and cursing under his breath ordering the woman to “come on”.

  2. Avatar
    Gregory Knapik January 14, 2019 at 3:46 am - Reply

    Thanks so much for this very helpful discussion and information. The more awareness the better. We in healthcare are often the persons the victims go to for help, though perhaps not forthcoming due to threats and fear.
    Blessings for 2019

  3. Avatar
    Nancy M. January 14, 2019 at 9:42 am - Reply

    What U.S. states have the highest number of human traffickers?

  4. Avatar
    Michaela Murrieta July 5, 2020 at 9:32 pm - Reply

    I would like to know more about forensic professionals who deal with human trafficking. I’d like to date it as far back where familia trafficking started in my life. I’d like the best to be able to investigate. Kinda hard to believe but still the statistic is there. But it’s stemmed from my family to the widespread community. I would like contact info please and thank u. I live in Blackfoot, Idaho.

    • Sallie Jimenez
      Sallie Jimenez July 7, 2020 at 11:34 am - Reply

      Hello Michaela,

      Here’s some information that might be helpful:
      1) National Human Trafficking Hotline: Tel #: (888) 373-7888. Also, here’s the website:
      2) Here’s the website for the Idaho Anti-Trafficking Coalition –

      Hopefully, one of these resources can help you find what you’re looking for. Best wishes to you and your family.

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