Trafficking in women. The health of women in post-trafficking services in Europe who were trafficked into prostitution or sexually abused as domestic labourers

Background. The trafficking of women and adolescents into exploitative and forced labour is a growing crime and a severe form of violence against women. Little theory or research-based evidence currently exists on the health risks and consequences associated with trafficking. Objectives. This thesis presents conceptual models and describes systematically collected data on the health risks and consequences of trafficked women and adolescents, and considers methodological implications of research with this vulnerable group. Methods. Two studies, one qualitative and one quantitative, were conducted with women trafficked predominantly for sexual exploitation. The formative research exploring trafficking-related health risks was carried out in five European states with a total of 28 women. The quantitative survey was conducted with a cohort of 207 attending post-trafficking services in seven European States. Semi-structured interviews were carried out over three time periods (0-14 days, 28-56 days and 90+ days) to document reported pre-trafficking and trafficking-related risk exposures and post-trafficking physical, sexual, reproductive and mental health symptoms. Results. Risk exposures included high levels of pre-departure and in-trafficking violence (physical and/or sexual). Perceived physical health symptoms were prevalent, especially at the first interview, with neurological symptoms (e.g., headaches) being the most prevalent and persistent. Most physical symptoms reduced between the first and second interviews. Symptoms suggestive of post-traumatic stress disorder were reported over the three interviews by 56%,12% and 7% of women, respectively. Depression levels remained extremely high throughout the study. Anxiety and hostility levels were also high, but decreased more than depression. Conclusions. These descriptive analyses offer theoretical models and new evidence on risk and health symptom patterns. Findings suggest the need for urgent and longterm comprehensive health care services, an adequate legal period of recovery and reflection, and research methods sensitive to the risks associated with studying this vulnerable population