Sexual Abuse Clinical Pathway — Emergency Department
Sex Trafficking
U.S. Federal Definition of Human Trafficking
The recruitment, harboring, transportation, provision, and/or obtaining of a person for:
- Labor or services, through the use of force, fraud, or coercion for the purpose of involuntary servitude, peonage, debt bondage or slavery
- Commercial sex act(s) through the use of force, fraud, or coercion
- Any commercial sex act if the person is under 18 yrs of age, regardless of whether any form of force, fraud, or coercion is involved
Victims of Trafficking and Violence Protection Act of 2000, aka TVPA
Red Flags/Risk Factors and Sex Trafficking Indicators
Patients may present for any number of chief complaints, not only for sexual assault concerns.
- Accompanied by an individual who shows a controlling or dominating relationship and/or
hostile behavior - History of running away or elopement, chronic truancy
- Lack of documentation, identification
- Experiencing homelessness, frequent relocation
- Unwilling or hesitant to answer questions about the injury or illness
- Demonstrates fearful or nervous behavior or avoids eye contact
- Resistant to assistance or demonstrates hostile behavior
- Tattoos or other forms of branding
- e.g., symbols of wealth, profanity, names esp. when used possessively
- Tattoos seen with BlueMaxx/alternative light
- Reports an unusually high number of sexual partners, or multiple STIs, pregnancies
- Does not have appropriate clothing for the weather or venue
- Uses language common in the commercial sex industry
- e.g., pimp, trick, quota, wifeys/wife-in-law/sister wife
- Prior child welfare agency involvement
- Drug/alcohol use, malnourishment
- Traumatic injuries