Human Trafficking
Providers and other clinical staff should be trained to recognize the indicators of human trafficking, often called “red flags;” be prepared to complete an evidencebased human trafficking screening tool; and be equipped to assist victims of trafficking in receiving additional information, support, and referral to care. Signs of human tracking include:
- Scripted or inconsistent history
- Signs of physical or sexual abuse, medical neglect, or torture
- Unwilling or hesitant to answer questions about an injury or illness
- Accompanied by an individual who does not let the patient speak for themselves, refuses to allow for privacy, or insists on interpreting for them
- Evidence of controlling or dominating relationships (excessive concerns about pleasing a family member, romantic partner, or employer)
- Fearful or nervous behavior or avoiding eye contact
- Resistance to assistance
- Hostile behavior
- Unable to provide an address
- Unaware of the location, the current date, or the time
- Person is not being paid or wages are withheld
- Does not have identification or other documents
- Is not in control of own money
The National Human Trafficking Prevention Framework, developed by the HHS Office on Trafficking in Persons, hosts SOAR to Health and Wellness, an online training for health care and social service providers. The SOAR training equips professionals with skills to identify, treat, and respond appropriately to human trafficking.
Assisting victims of human trafficking or someone at risk of trafficking requires thoughtful planning using a trauma-informed approach. This may include working with the patient to complete a safety plan or referring them via a warm handoff to an organization that provides safety planning services.207 Service sites should ensure they have a comprehensive human trafficking referral directory that includes anti-trafficking organizations and programs that offer emergency, transitional, and long-term services to victims and survivors.
Service sites should post the Federal Human Trafficking Hotline number in visible locations (Exhibit 16).
Exhibit 16. Commonly Used Screening Tools for Human Trafficking
| Tool | Demographic | Environment |
|---|---|---|
| Commercial Sexual Exploitation- Identification Tool (CSE-IT) | Ages 10+; sex trafficking only | Multiple settings, including child welfare and juvenile justice systems, schools, homeless youth shelters, health care, and mental health settings |
| Human Trafficking Interview and Assessment Measure (HTIAM-14) | Homeless youth; sex and labor trafficking | Service provider setting |
| Human Trafficking Screening Tool (HTST/ HTST-SF) | Ages 18–24; sex trafficking only | Runaway and homeless youth system settings |
| Quick Youth Indicators for Trafficking (QYIT) | Homeless youth; sex and labor trafficking | Service provider setting |
| Short Screen for Child Sex Trafficking | Ages 12–18; sex trafficking only | Health care setting |
| Vera Institute’s Trafficking Victim Identification Tool (TVIT) | Ages 13+; sex and labor trafficking | Not specified |
| Source: Tools listed from the National Human Trafficking Prevention Framework, developed by the HHS Office on Trafficking in Persons, and endorsed by the EWG. | ||