Exploring the role of salon professionals in identifying sex trafficking and violence victims in Indiana.

BACKGROUND: Sex trafficking victims often have touchpoints with salons for waxing, styling, and other body modification services required by traffickers. Recently, some states have administered laws requiring salon professionals to receive intimate partner violence (IPV)-related training, with even fewer states mandating training on identifying sex trafficking. This study aimed to understand how salon professionals have witnessed evidence of violence, including IPV and sex trafficking, in the workplace and to explore the differences in their approach to each type of victim. METHODS: In-depth interviews were conducted with salon professionals (N = 10) and law enforcement professionals/policymakers (N = 5). Content and thematic analysis techniques were used. RESULTS: Salon professionals typically identified potential violence through signs such as bruises, odd behavior, and client disclosures, prompting them to engage in cautious conversations. Yet, few were trained to identify and intervene. Often, they responded to suspected violence by talking with the client, sharing concerns with salon leadership, directly intervening on the client's behalf, or contacting the police. Law enforcement and salon professionals had suggestions about improving salon professionals' recognition of and response to violence, including training on victim-focused resources, creating a safe environment, and building relationships with law enforcement. They also suggested strengthening community partnerships to increase resource advocacy and reporting. CONCLUSIONS: One-on-one salon services may provide a unique opportunity to intervene and identify victims of violence, especially when empowered through additional training and collaborative partnerships with community-oriented policing initiates. Implementing training and community-based initiatives could aid salon professionals in gaining greater confidence in knowing what to do when serving a client who is a victim of IPV or sex trafficking.

From not knowing, to knowing more needs to be done: health care providers describe the education they need to care for sex trafficked patients.

BACKGROUND: Sex trafficking is highly prevalent, pernicious, and under-recognized. When an individual is trafficked for the purpose of sexual exploitation within the borders of a single country, it is termed domestic sex trafficking. Sex trafficked persons can experience severe physical and mental health outcomes requiring medical attention and treatment. However, health care providers often fail to identify sex trafficked patients, missing opportunities to provide needed care and support. METHODS: In this qualitative study, we interviewed 31 health care providers (physicians, nurses, and social workers) working in Ontario, Canada to learn what they identified as their specific education and training needs to recognize and care for sex trafficked persons. Interviews were conducted over Zoom, recorded, and transcribed. Coding of the transcripts followed a standard framework for qualitative studies. Codes related to the education and training needs of providers were identified as a core issue suited to further analysis. RESULTS: Three themes related to providers' education and training needs emerged. These acknowledge basic (Foundational knowledge), as well as more specific learning needs (Navigating the encounter). The final theme, ("It just seems so much bigger than me") suggests that even with some knowledge of domestic sex trafficking, participants still experienced considerable distress and multiple challenges due to gaps in the broader system impacting the provision of appropriate care. CONCLUSIONS: Participants voiced their need for specialized sex trafficking education as well as role specific training to combat their sense of inadequacy and provide better care for their patients. Participants' education needs ranged from requiring the definition of domestic sex trafficking and the frequency of its occurrence, to the various circumstances associated with increased risk of recruitment into sex trafficking. In terms of desired training and specific skills, participants wanted to learn how to identify a person being sex trafficked, broach the subject with a patient, know what to do next including access to local resources and referrals, as well as connections to other critical services, such as legal and housing. The results can be used to inform the design and content of education and training on sex trafficking for health care providers.

Understanding Child Sexual Exploitation Dynamics: Development and Validation of a Taxonomy of Recruitment and Domination Strategies.

Child sexual exploitation is a form of interpersonal violence which involves the use of manipulation, control, and coercion strategies to recruit and dominate minors. This study aimed to develop and validate a taxonomy that identifies, defines, and classifies these abusive strategies. The taxonomy was developed from an extensive literature review and its contents were validated via expert evaluation through a two-round Delphi method with 31 participants. Experts also judged the frequency of each strategy's usage to recruit and dominate the victims in sex trade, sex trafficking, sex tourism, and online sexual exploitation. The taxonomy comprises 20 specific strategies, classified into five categories: isolation, control of personal life, emotional abuse, cognitive manipulation, and behavioral domination. According to the experts, the strategy most frequently used to recruit the minors is "affective enticement", and the strategy that contributes most to the maintenance of the exploitative situation is "instrumentalization of sexuality". Nevertheless, different patterns were found regarding the frequency with which each strategy is used when considering the four manifestations of sexual exploitation separately. Delimiting the abusive strategies commonly perpetrated in child sexual exploitation improves our understanding of this complex phenomenon and could contribute to the development of effective prevention and intervention approaches.

Working With Youth Who Have Experienced Commercial Sexual Exploitation: Voices From the Field.

Little is known about the experiences of service providers working with youth who have experienced commercial sexual exploitation (CSE). In this qualitative study, 12 service providers shared their experiences working with youth who have experienced CSE. Thematic analysis was used to develop key themes that included the challenges posed by working with this population, including the breadth of necessary services and the type of support that is needed for this work. Participants shared the importance of being prepared to work with this population and learn from those with lived experience. The complexity of cases and the difficulty engaging youth who had experienced CSE were also themes. These results can inform service providers who work with youth about the common challenges in working with this population and prepare the next generation of service providers for this difficult work. Training service providers, managing their expectations, and getting them ready for their role will be critical for successful intervention with youth who have experienced CSE.

Closing the Educational Gap on Human Trafficking: There's No Better Time Than Now!

INTRODUCTION: Human trafficking is a heinous crime and violation of human rights affecting between 25 and 27 million adults and children globally each year. Current immigration and refugee policy could exacerbate the human trafficking public health crisis. Health care providers working in emergency department and urgent care settings interact with human trafficking victims and provide life-changing care. Research identifies a significant need for coordinated, consistent, and standardized education on human trafficking. The purpose of this study was to determine the effectiveness of online educational training in human trafficking on the knowledge and self-confidence of registered nurses and nurse practitioners working in the emergency department and urgent care settings in New York. METHODS: An asynchronous, online education module was designed for emergency department and urgent care registered nurses and nurse practitioners to address key components of human trafficking identification, assessment, and treatment. Using a 1-group pretest/posttest design, participants completed an existing published survey tool before and 6 weeks after education. RESULTS: Findings revealed statistically significant improvement (P < .05) in knowledge and confidence regarding components of identifying, assessing, and treating victims of human trafficking. Data demonstrated 63.8% of participants had never received human trafficking training, and 80% reported no history of contact with patients known or suspected of being trafficked. DISCUSSION: Results in this study demonstrate the need for increased standardized education regarding HT for frontline health care workers.

Onto the Next Generation: Exploring the Impact of Mother's Experiences of Child Abuse and Commercial Sex Industry Involvement on Child Custody Outcomes.

Women and girls remain substantially overrepresented in the commercial sex industry. While a number of outcomes have been linked to childhood abuse and involvement with the commercial sex industry, there exists a gap in understanding the unique impact of child abuse on child custody outcomes among adult women involved in the commercial sex industry. Drawing from data collected from 107 case files of adult women with a history of commercial sex industry involvement, the aim of the current study was to understand the link between child abuse history, commercial sex industry involvement, and child custody outcomes. Results indicated that among women who reported a history of child sex trafficking, 91.7% reported having endured child abuse. Further, 82.4% of women reported that their children were not under their custody. Dysfunctional family dynamics, substance abuse, and economic and structural barriers endured by these women are explored further, and intergenerational continuity of such traumagenic precarities is considered as a prolonged implication of such issues. Through a trauma-informed perspective, implications for prevention and intervention are discussed.

Current Trends in Sex Trafficking Research.

PURPOSE OF REVIEW: Sex trafficking is a significant global problem that results in millions of individuals being sexually exploited annually. This paper will provide an overview of recent research in the field of sex trafficking and evaluate findings to provide recommendations for future research and policy work. RECENT FINDINGS: In recent years, there has been an increase in research focused on understanding sex trafficking and how it can be prevented. Specifically, recent studies have explored characteristics of sex trafficking cases, risk factors for experiencing sex trafficking, recruitment and maintenance processes, identification and intervention techniques, and treatment approaches. While there have been significant strides to better understand sex trafficking across the globe, numerous areas require further exploration. Additional research conducted internationally and with adults who have experienced sex trafficking is needed to better understand methods that can identify individuals at risk for being trafficked, enhance early detection, and provide services to trafficked individuals.

Liberating more than light: Laser removal of branding tattoos is impactful in the recovery of sex trafficking survivors.

OBJECTIVES: Sex trafficking involves the use of force, fraud, or coercion to compel another person to engage in commercial sex acts. In 2020, 16,658 individuals were identified as sex trafficking victims in the United States, with thousands more not reported. Many victims are branded by their traffickers with tattoos conveying ownership, including names, symbols, and barcodes. We have partnered with local non-profits in Houston supporting sex trafficking survivors by providing pro bono laser tattoo removal, however we believe there is a greater need at a national level to support these survivors, allowing them to reclaim their bodies. METHODS: An online survey aimed at assessing the need and potential impact for pro bono branding tattoo laser removal services was distributed to United States organizations that support sex trafficking survivors. RESULTS: Forty organizations based in the Northeast (15%), Midwest (20%), South (45%), and West (20%) responded. Organizations support on average 81 survivors annually, ranging from 3 to 600 survivors, and estimate that 47% of survivors have branding tattoos. Among survivors with branding tattoos, approximately 67% were identified at an appropriate recovery stage to undergo laser removal. On a scale of 1-10 with 10 being the most impactful on recovery, removal of branding tattoos received an average impact score of 9.2. On a scale of 1-10, with 10 being the most need, pro bono services for laser removal received an average need score of 9.1. Qualitative responses provided several insights: laser removal may be associated with enhanced healing compared to tattoo cover-up, and survivors frequently move during their recovery process thus a successful removal campaign would require a nationwide network of partnering laser surgeons. CONCLUSIONS: Approximately 1 in 2 sex trafficking survivors are estimated to have branding tattoos and the removal of these tattoos is recognized as highly impactful on recovery. We propose a philanthropic campaign which involves the American Society for Laser Medicine and Surgery (ASLMS) establishing a national directory to connect sex trafficking survivors seeking removal of branding tattoos with interested ASLMS board-certified physician members.

Stigmatizing and inaccessible: The perspectives of female sex workers on barriers to reproductive healthcare utilization - A scoping review.

AIM: To systematically map the extent, range and nature of qualitative studies that explored female sex workers' own perspectives on barriers to accessing reproductive healthcare services. DESIGN: A scoping review of the literature utilizing Arksey and O'Malley's method. DATA SOURCES/REVIEW METHODS: A search of the electronic databases MEDLINE/ PubMed, PsycNET, Sociological Abstracts, ProQuest, ScienceDirect, HeinOnline, Scopus, Web of Science and Google Scholar was conducted for items published in English between 2001 and 2021. RESULTS: Twenty-one studies were included in the review, the majority of which were conducted in lower-middle-income countries. RHC themes studied were diverse, with a few more studies focusing on STI/HIV, contraceptive use and pregnancy than those focusing on childbirth and postnatal care. The findings indicate barriers in four main domains: socio-legal barriers, health services-related barriers, interpersonal barriers and personal history-related barriers. Stigma was a major multifaceted barrier. CONCLUSION: Female sex workers experience exclusion in utilizing reproductive healthcare services globally. As such, healthcare services are advised to adopt a nonjudgemental approach, to enhance physical accessibility and to train nurses and other healthcare professionals on reproductive health needs of female sex workers. Finally, knowledge production processes on the RHC of FSW should adopt a holistic view of FSW, by exploring their needs and barriers related to childbirth and maternity care and by including the perspectives of FSW in high-income countries. IMPACT: The review offered an in-depth understanding of female sex workers' own perspectives regarding needs and barriers in utilizing reproductive healthcare services. Findings indicated socio-legal barriers, health services-related barriers, interpersonal barriers and personal history-related barriers. The review could inform the training of nurses and other healthcare professionals in reproductive healthcare services globally. Researchers should adopt a holistic view of female sex workers, by exploring their family planning needs, including barriers related to childbirth, maternity and postpartum care. REPORTING METHOD: We adhered to the EQUATOR guidelines PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation.

Impacts of the COVID-19 Public Health Crisis on Caring for Sex-Trafficked Persons.

BACKGROUND: Sex trafficking of persons, a pervasive public health issue disproportionately affecting the most marginalized within society, often leads to health as well as social consequences. Social service provision to meet the resulting needs is critical, however, little is known about the current pandemic's impact on providers' capacity to deliver requisite care. METHOD: To examine social service providers' perspectives of care provision for domestically sex-trafficked persons in Ontario, Canada, during the COVID-19 pandemic, we conducted semi-structured interviews with 15 providers and analyzed these using Braun and Clarke's analytic framework. RESULTS: Impacts of the COVID-19 pandemic on social service care provision were connected to individuals' increased vulnerability to trafficking, difficulties safely and effectively providing services to sex-trafficked persons amid pandemic restrictions, and reduction in in-person educational activities to improve providers' capacity to serve this client population. Securing safe shelter was particularly difficult and inappropriate placements could at times lead to further trafficking. CONCLUSION: The pandemic created novel barriers to supporting sex-trafficked persons; managing these sometimes led to new and complex issues. Future efforts should focus on developing constructive strategies to support sex-trafficked persons' unique needs during public health crises.

"Drugs Can Be a Great Coercion": Service Providers' Perspectives on the Relationship between Substance Use and Trauma Bonding among Survivors of Sex Trafficking.

While research has demonstrated a complex relationship between sex trafficking and substance use, the relationship between substance use and trauma bonding is not well understood. A trauma bond refers to an emotional attachment that can develop between victims and their abusers. This study aims to explore the relationship between substance use and trauma bonding among survivors of sex trafficking from the perspective of service providers working directly with survivors of sex trafficking. This qualitative study involved in-depth interviews with 10 participants. Purposeful sampling was employed among licensed social workers or counselors working directly with survivors of sex trafficking. Audio recordings of interviews were transcribed and coded using aspects of a grounded theory approach. Three themes emerged from the data regarding the relationship between substance use and trauma bonding among survivors of sex trafficking: substance use as a tactic, substance use as a risk factor, and substance use as a potential trauma bond. These findings support the need to treat substance use and mental health concerns concurrently among sex trafficking survivors. Additionally, these findings can inform legislators and policymakers as they consider the needs of survivors.

How Do Providers Assess Young People for Risk of Sex Trafficking? Observed Indicators, Follow-Up, and Assessment Questions from a Sample of Social Service Providers.

The extent to which service providers across systems identify and assess potentially sex trafficked youth is understudied. The purpose of this study is to determine whether and how providers observe relevant indicators and assess for sex trafficking risk among minors (ages 12-17), young adults (ages 18-29), and families of minors. A cross-sectional, web-based survey was disseminated to service providers, who represented child welfare, youth justice, and social services (e.g. runaway youth, sexual violence), in a region of a Midwestern state (United States). Participants (N=267) were asked whether they provided direct services to minors (ages 12-17, n=245), adults (ages 18-29, n=148), and/or families/foster families of minors (ages 12-17, n=163), resulting in three respective client groups. Survey items assessed the extent to which providers (1) identified possible sex trafficking indicators across 5 domains; (2) took follow up actions; and (3) asked risk assessment questions. T-tests were conducted to examine differences between those who reported receiving sex trafficking trainings, compared to those who did not. Results suggest that the most commonly identified indicators included depressive symptoms, shame and guilt, lack of social support. Least common indicators included torture, false IDs, hotel involvement. A third of minor-aged providers did not ask sex trafficking risk assessment questions. Providers reported asking fewer clients about online sex trading than in-person forms. There were statistically significant differences among providers who received training. Implications, including provider strategies for assessing online sex trading and organizational protocols to enhance sex trafficking identification, are discussed.

"Females are always dominated and disregarded by males, just because they are female": the continuation of patriarchal norms for young trafficked women in Nepal.

This article provides insights into the cultural aspects of sexual violence against young women trafficked into the sex industry in Nepal. Participant observation, participatory clay body mapping workshops and group interviews using photography were used to explore the reproductive body of six formerly trafficked women aged 14-22 years. Intimate partner violence against women, domestic violence and violence against women were important issues raised during the research process. Societal and familial patriarchal norms are the root causes of violence against women in Nepal and can be traced back to the Hindu legal code, the Muluki Ain of 1854, which was enforced for over 100 hundred years. Our findings indicate that tackling violence against women is complex for Nepali trafficked women because of its multiple forms and sources.

Midwives' experiences and perceptions in treating victims of sex trafficking: A qualitative study.

AIM: To explore the experiences and perceptions of midwives in the treatment of sex trafficking victims. DESIGN: The study was qualitative with a hermeneutic-phenomenological approach, using semi-structured interviews and focus groups. METHODS: Two focus groups and six interviews were carried out on 14 midwives in primary care, delivery and emergency rooms. Data were collected in three hospitals in Spain in June 2021. ATLAS.ti 9 software was used to conduct a content analysis of the focus group and interview data. RESULTS: The results revealed two primary themes and six subthemes. The two primary themes were (i) sex trafficking: a camouflaged reality on the invisible spectrum, and (ii) a thirst for attention in the aftermath of violence. Representative quotations were used to illustrate both the main themes and the subthemes. CONCLUSIONS: This study provides new insight into midwives' experiences treating sex trafficking victims. Professionals view this type of violence as a silent issue that negatively impacts victims' health and livelihood. However, a number of different factors stand in the way of correctly identifying and treating victims. Therefore, healthcare workers must be provided with practical tools and continuous professional development on this topic. IMPACT: This study indicates the importance of the midwives' key role in identifying and assisting victims of sex. Not only do measures in the healthcare setting, such as on-going specific-related content training or up-to-date protocols, need to be implemented to ensure proper care for those affected by sexual exploitation, but also focusing on suspicious characteristics and reducing obstacles to patient communication will help bring the true situation to light and better respond to patients' priority needs.

Healthcare providers' perspectives on the relevance and utility of recommended sex trafficking indicators: A qualitative study.

AIMS: The aims of this study were to (1) explore the barriers and challenges of sex trafficking identification and (2) understand how sex trafficking indicators are perceived (i.e. relevance and utility) by healthcare providers at five sites of a large sexual health care organization in a Midwestern state within the United States. DESIGN: A qualitative, collective case study was conducted. METHOD: In-depth, semi-structured interviews were conducted with 23 healthcare staff (e.g. medical assistants, nurse practitioners) who provided sexual and reproductive healthcare between fall 2018 and spring 2020. RESULTS: Findings suggest that providers perceived behavioural and verbal sex trafficking indicators (e.g. patients appearing nervous or being unable to answer questions) as relevant, particularly with a female patient accompanied by a 'controlling' male. Medical and physical indicators (e.g. repeat STIs, bruises and tattoos) were perceived as generally lacking clinical utility or irrelevant. Some indicators were only perceived as relevant when combined or only later, upon reflection (e.g. older, female adult accompanying one or more female patients). CONCLUSION: Healthcare providers may be aware of sex trafficking indicators conducive to identifying female patients, in relationships with older men, who are at risk of sex trafficking. Our study finds that healthcare providers may not be aware of all recommended sex trafficking indicators and the nuances of how patients present. IMPACT: Provider trainings on sex trafficking dynamics and nuanced clinical presentations should include observing ST indicators in simulated interviews, assessing and safety planning (including using harm reduction strategies) with seemingly ambiguous cases. In addition, we recommend that trainings emphasize the relationship between the continuum of agency and victimization in sex trafficking and patient presentations.

Exploring the Impact of Trauma History on the Mental Health Presentations of Youth who have Experienced Commercial Sexual Exploitation and Trafficking.

This study explores the types and extent of potentially traumatic events that youth who have experienced commercial sexual exploitation and trafficking (CSE/T) report, and how these experiences influence mental health. CSE/T youth (N = 110, 11-19 years old) referred to Trauma-Focused Cognitive Behavioral therapists affiliated with Project Intersect provided self-report data between August 2013 and March 2020 at the start (baseline), mid-point, and completion of therapeutic services. This study focuses on the baseline data collected. Bivariate relationships were analyzed, and where bivariate associations were statistically significant, associations were assessed in adjusted regression models. Two logistic regressions were performed: one for the adjusted associations between types of potentially traumatic events reported by CSE/T youth and the outcome PTSD, and a second for the outcome emotional distress. Results indicated that polytrauma was significantly associated with PTSD diagnosis among CSE/T youth. Direct violence victimization and polytrauma were significantly associated with CSE/T youth emotional distress. Results inform behavioral medicine practitioner considerations for how to appropriately assess the potentially traumatic experiences of CSE/T youth, and how these experiences may differentially impact the mental health presentations of youth in clinical treatment. Effective treatment may include precision-based customization of evidence-based practices to ensure that the diverse traumatic experiences and related symptomatology of CSE/T youth are effectively addressed.

Youth survivor perspectives on healthcare and sex trafficking.

PURPOSE: This study aimed to assess the perspectives of youth survivors of sex trafficking on healthcare to improve care for this vulnerable and often unrecognized population. DESIGN AND METHODS: Semi-structured focus groups were conducted with eight survivors in Southern California who interacted with the healthcare system while being sex trafficked. Interviews were audio- and/or video-recorded and transcribed verbatim. The analysis utilized a grounded theory approach, where researchers reviewed the data collected, then inductively generated codes and themes based on the findings from the interviews. RESULTS: The focus group interviews revealed the following themes: unequal treatment, barriers to patient care, risk identifiers, support, and survivor recommendations. CONCLUSIONS: Youth survivors seeking healthcare reported multiple barriers based on their interaction with healthcare providers, such as the lack of provider awareness, education, training, feelings of shame, judgment, fear, racial biases, and lack of empathy. Improving patient outcomes relies on understanding the complexities of human trafficking and implementing an approach to decrease barriers to care. PRACTICE IMPLICATIONS: This study resulted in invaluable survivor recommendations with practical solutions on addressing human trafficking and exploitation in the healthcare system. The solutions proposed by participants included strengthening relationships and experiences with healthcare providers by increasing awareness, establishing rapport, creating a safe space, asking questions about their safety and situation, using a non-judgmental approach, and providing resources.

Exploring Sexual Grooming in Female Perpetrated Child Sexual Abuse.

According to official statistics, two percent of those who commit sex crimes are women, most of which involve child victims. However, victimization surveys suggest the true rate of female-perpetrated child sexual abuse is significantly higher than official statistics, and that it is under-detected and under-reported. Compared to men, relatively little is known about the behaviors and tactics that females employ to perpetrate child sexual abuse. While as many as half of male-perpetrated child sexual abuse involves sexual grooming, sexual grooming has not been empirically studied as it pertains to women. Existing literature, case studies, and media reports describe behaviors and strategies of women who abuse minors which may be suggestive of sexual grooming, particularly in cases of child sexual abuse perpetrated by female educators and child sex traffickers. This article explores what is known about female sexual offending, integrating it with the research on sexual grooming to provide a framework for understanding female sexual grooming behaviors. Implications for prevention, policy, and practice will be examined.

Pushing for the same thing on the same set of tracks: a qualitative study exploring the anti-trafficking response in Bihar and Uttar Pradesh.

BACKGROUND: Human trafficking is a critical public health issue particularly pervasive in the Indian states of Bihar and Uttar Pradesh (UP), which share a border with Nepal. Many NGOs are participating in prevention, protection, prosecution, and capacity building initiatives. The aim of this study was to identify factors hindering and enhancing the efficacy of anti-trafficking programs in the region. METHODS: A qualitative study was conducted using semi-structured interviews and focus groups with key stakeholders in Bihar, Uttar Pradesh, and Nepal. RESULTS: Thematic analysis revealed that the barriers hindering the anti-trafficking movement include police corruption, insufficient enforcement of national law, discrimination toward trafficking victims, inadequate funding, and lack of government involvement. Recommendations for overcoming these barriers were through empowering survivors and increasing cooperation, coordination, and communications between NGOs and the government. CONCLUSIONS: In mitigating these barriers and increasing survivor autonomy, anti-trafficking interventions have the opportunity to create individualized environments for those with an experience of trafficking to thrive. Ultimately, elevating community accountability, honoring individual autonomy, and recognizing the value of the persons with a lived experience of trafficking are critical as we continue to use a public health lens in the fight against human trafficking and for human rights.

Functional Isolation: Understanding Isolation in Trafficking Survivors.

The study of sexual exploitation of trafficked victims cannot be done without understanding their enforced isolation. To better understand the dynamics of isolation, this study examined how traffickers used different elements of isolation and how such tactics may have contributed to the traffickers' success in maintaining control over the victim(s). We examined in-depth narratives from 14 women between the ages of 20 to 53, primarily immigrants, who were recruited from an agency serving victims of sex trafficking in a large metropolitan city. The tactics used by traffickers varied and included not only the commonly defined structural isolation in which victims are restricted physically and socially, but also included a shrinking of safe social space and an elimination of privacy and social support. The latter, which we label as functional isolation, refers to instances when survivors are surrounded by peers who are either unreliable or aligned with the trafficker and thus are unable to give true social support. Survivors reported a combination of isolation tactics (i.e., both structural isolation and functional isolation). The different interwoven types and patterns of isolation reported by former victims of trafficking help address a dearth in the coercive control and abuse literature, providing a richer understanding of isolation in trafficking survivors.