Human trafficking, especially of women and girls, is a major human rights violation. One report estimated that about 150,000 women and girls across South Asia are trafficked for sex annually (Miko and Park 2002). However, precise estimates of the number of women and girls currently being exploited within and outside of the subregion are not available and are always subject to question especially given the comparative complexity and ease with which international borders on the sub-continent can be crossed (Mehta 2003).
Gushulak and MacPherson (2000) reviewed and summarized health issues associated with trafficking. They demonstrated that despite the paucity of data, the levels of morbidity and mortality among trafficked persons are substantial throughout the migration process due to physical, sexual and psychological abuse, poor living and working conditions, social isolation, forced use of drugs and alcohol and lack of access to health and social services.
The exploitative and abusive nature of the human trafficking process poses health risks for trafficked persons. Among the health-related consequences of trafficking are reproductive health problems, psychological reactions, infectious conditions and physical trauma (IOM and others 2009).
Studies on survivors of human trafficking have documented sex workers’ higher vulnerability to STIs, including HIV, and tuberculosis. Qualitative work in India indicates that the vulnerability of ex-trafficked women and girls to HIV infection is exacerbated by several mechanisms, including forced unprotected sex, mobility restrictions that preclude access to health care and other services, violence upon sex work initiation and limited autonomy (Gupta and others 2009). Sex workers who entered the industry as a result of being trafficked were more likely than other female sex workers to report various increased vulnerabilities to HIV (Jhumka and others 2011). Similarly, studies among repatriated Nepalese sex-trafficked women and girls showed high HIV rates, with those under 15 years at higher risk for infection (Silverman and others 2007).
Regarding psychological risks, studies indicate the significant impact of trafficking for sexual exploitation on general mental health. A 2008 study in Nepal found that victims of sexual exploitation tended to have more anxiety symptoms and prevalence to depression and Post Traumatic Stress Disorder (PTSD) than those subject to labour exploitation (Tsutsumi and others 2008). Female drug users with a lifetime involvement in prostitution had a significantly higher prevalence of lifetime suicidal attempts and depressive ideas than those without (Gilchrist and others 2005). Findings suggested that efforts to assist trafficked populations must pay attention to the work performed during the trafficking process and explicitly focus on mental health and psychosocial support (Tsutsumi and others 2008).