Abstract
Purpose
We sought to understand the perspectives of commercially sexually exploited (CSE)
young women regarding their health care needs, access, and use patterns.
Methods
Twenty-one CSE young women participated in this mixed methods study. Data collection
included brief surveys measuring health care use, followed by in-depth, semistructured
interviews to gain insight into CSE young women's health care needs, barriers and
facilitators to health care, use patterns, and recommendations for improving care.
Data analysis techniques included descriptive statistics for the quantitative survey
data and thematic analysis for the qualitative interviews.
Results
Survey data demonstrated relatively high health care use across health care types,
especially for reproductive and mental health treatment services. Barriers to care
included being “on the run,” fear of bad diagnoses, and trafficker control. The fierce
autonomy conceptual model emerged from the analyses to describe participants’ strong
desire for self-determination in their health care decision making, including when
to access care. Recommendations for improving care for CSE young women include preserving
autonomy in health care decisions while meeting their basic needs, such as safety
and shelter.
Conclusions
Overall, the CSE young women expressed high health care needs. Despite experiencing
significant barriers to accessing care, study participants frequently sought care
in a variety of settings. Furthermore, they shared insights about how to improve engagement
in health care among CSE young women. Improving CSE young women's engagement in care
requires health professionals and health systems that foster a sense of safety, trust,
and autonomy over health care decisions—a need intertwined with CSE young women's
experiences of abuse, survival, and sexual exploitation.
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Biography
Elizabeth Barnert, MD, MPH, is an Assistant Professor of Pediatrics at the UCLA David Geffen School of Medicine. Dr. Barnert's research focuses on vulnerable youth, particularly juvenile justice involved youth, commercially sexually exploited youth, and youth undergoing family separation and reunification.
Biography
Mikaela Kelly, BA, is a medical student at the UCLA David Geffen School of Medicine. Ms. Kelly is passionate about health equity and reproductive justice for marginalized adolescent girls.
Biography
Sarah Godoy, MSW, is a Staff Research Associate in the Department of Psychiatry and Biobehavioral Sciences at the UCLA David Geffen School of Medicine. Ms. Godoy's scholarship focuses on child sex trafficking and commercial sexual exploitation.
Biography
Laura Abrams, MSW, PhD, is Chair and Professor of Social Welfare at the UCLA Luskin School of Public Affairs. Professor Abrams' scholarship focuses on improving the well-being of youth and young adults with histories of incarceration.
Biography
Madeline Rasch, MSW, contributed as a graduate student of social welfare in the UCLA Luskin School of Public Affairs. Ms. Rasch strives to support, advocate for, and promote the well-being of families involved in the child welfare system.
Biography
Eraka Bath, MD, is an Associate Professor of Psychiatry and Biobehavioral Sciences at the UCLA David Geffen School of Medicine. Dr. Bath is board certified in child and adolescent, adult, and forensic psychiatry; she focuses on high-risk youth.
Article info
Publication history
Published online: April 05, 2019
Accepted:
February 19,
2019
Received in revised form:
February 9,
2019
Received:
July 1,
2018
Footnotes
This work was supported by the National Institutes of Health, United States (grant numbers UL1TR000124, K12DA000357) and the UCLA Children’s Discovery and Innovation Institute (grant number CDI-SGA-01012016).
Identification
Copyright
© 2019 Jacobs Institute of Women's Health. Published by Elsevier Inc.
