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Using Survivors' Voices to Guide the Identification and Care of Trafficked Persons by U.S. Health Care Professionals

A Systematic Review

Armstrong, Stephanie PhD, RN, CNS; Greenbaum, V. Jordan MD

doi: 10.1097/TME.0000000000000257

Evidence suggests that trafficked persons in the United States frequently seek health care, yet little is known of their experiences, including reasons for seeking assistance, interactions with professionals, and barriers to obtaining care. To gain a better understanding, a search was conducted for empirical data collected directly from trafficked persons about their US health care experiences, published in peer-reviewed journals within the past 10 years, and in the English language. Four databases were searched and of the 1,605 articles initially identified, 8 met all inclusion criteria. Data from 420 participants demonstrated a wide range of physical and mental health complaints and 50%–98% reported seeking health care services in diverse medical settings during their exploitation. Barriers to care occurred at various levels, and although some are not modifiable, others are amendable by changes in the behaviors of professionals. A trauma-informed, rights-based approach to care would address many of these issues and create feasible treatment plans.

College of Nursing, Medical University of South Carolina, Charleston (Dr Armstrong); and Institute for Healthcare and Human Trafficking, Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Georgia (Dr Greenbaum).

Corresponding Author: Stephanie Armstrong, PhD, RN, CNS, College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC160, Charleston, SC 29425 (

This work was supported by the Robert Wood Johnson Foundation.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Disclosure: The authors report no conflicts of interest.

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