Survivors of Commercial Sexual Exploitation Involved in the Justice System: Mental Health Outcomes, HIV/STI Risks, and Perceived Needs to Exit Exploitation and Facilitate Recovery

This exploratory retrospective study analyzes the emotional and mental processes, risk behavior for HIV/STIs, and needed services to exit commercial sexual exploitation. Participants were court-referred to the local survivor-led program, Freedom from Exploitation, in southern California. Data were collected (N = 168) using an intake assessment form for a period of five years (2015-2020). Two groups were identified in the data, self-identified survivors of sex trafficking (SST) and non-self-identified survivors of sex trafficking (NSST). Bivariate and multivariate logistic regressions examined the associations of HIV/STI risks and emotional and mental processes with these two subgroups. Findings demonstrated that both groups experienced gender-based violence and similar emotional and mental processes as well as HIV/STIs risks. However, in adjusted models, the SST group had three times the odds of experiencing abuse by a sex buyer when asked to use a condom and eight times the odds of feeling hopeless or desperate and experiencing nightmares/flashbacks among other negative mental health outcomes. Both SST and NSST said they needed assistance to obtain legal services and complete a high school equivalency credential, among other services. Findings may be used by social service and law enforcement agencies to better assist survivors of sex trafficking and similar groups in supporting their rehabilitation and protection.