Introduction
Sex trafficking (ST) has posed significant public health challenges to individuals across the globe. ST victims often witness an amplified risk of health-related problems, including harm emanating from rapes. For the ST offenders, the outcome of detention and sentence often leads to societal and economic costs resulting from imprisonment or public warning. The financial liability of ST includes such factors as increased mental health care, unemployment, and familial dysfunctions, thus negatively impacting the quality of life (Okeshola and Adenugba, 2018; Tsai, 2017; Dunkan and DeHart, 2019). Over the past years, considerable study has been performed to comprehend ST and its relationship to poverty better. Despite the numerous scientific struggles, few prime prevention strategies have been revealed to be active in averting the effects of ST. Therefore, stakeholders and government agencies should establish and device platforms that replicate the ethics of control and management for the known risk and causal factors. Arguably, no particular element causes ST, and it is improbable that government-mediated interventions, when effected alone, will have a comprehensive public health influence.
Poverty alienation has been shown to be directly useful with such prevention programs that are comprehensive in nature (Rai, R, and Rai, A.K, 2021). Questionably, addressing poverty as the leading cause of ST has been suggested to target various risk factors and integrate approaches across the public domain. There is a need for more research to illuminate the essential concerns central to prevention and control, risk reduction, and supportive mediation for survivors of ST. This study derives its data from service providers’ perspectives, sex offenders, and sex victims based on various qualitative and quantitative articles on ST. In this regard, to function as a source for scholars, the current qualitative analysis. encapsulates the risk and causal factors for ST that have been studied over the past couple of years.
Research Question and Objectives
The proposed research question is to learn how the phenomenon of poverty is connected to sex trafficking. The objectives to be explored are formulated as follows:
- To describe the meaning of sex trafficking.
- To analyze the root causes of sex trafficking.
- To investigate the relationship between the phenomenon of poverty and sex trafficking.
Rationale
ST is a global delinquent which touches the lives of many people all over the world and dispossesses them of their self-worth. As one of the common offenses globally, ST deceives and victimizes women and children as they are a target of daily exploitation (Twis, 2020; Tsai, 2017). This problem is rooted in many issues, but one of the most influential is poverty. Developing countries often lack the financial resources to provide adequate education to their populations, especially young girls, which significantly limit their opportunities (Franchino-Olsen, 2021). Children and women who live in developing countries face the most significant exploitation in the sex market. The reason women are most often exploited in sex trafficking is that they lack the access to food, employment, education, and health services. As a result, they often seek alternative means as a source of income that is not always legal or secure.
Theoretical Framework
Conceptual Framework
The methodology used is Subjective Legal Empowerment (SLE) theory as a tool to measure the impact of poverty on human trafficking. SLE describes the legal enablement based on distinct personal perceptions. This theory suggests that a perceived lack of power is a barrier to solving the existing legal problems. This measurement can be taken concerning the question of whether a person is at a heightened risk of sex trafficking. It is supposed that a lower SLE person is more likely to become a victim (Porter, 2016). The hypothesis formulated was that the causes of sex trafficking are more prevalent among poor people, prompting them to enter this chain at a higher rate. To test this research hypothesis, a qualitative approach is adopted. Qualitative analysis facilitates the understanding of how the causes of trafficking influence human behavior and its outcomes. The research methodology employs several types of data collection: surveys, in-depth interviews, and focus groups.
To understand the impact of poverty on ST using the model SLE, a comprehension of the risk factors is equally important. As a second objective of the study, the systematic researches sought to measure and understand the risk factors for both the minors and the adults’ ST and the consequences of the ST. In this regard, the study employed a second theoretical model driven by Reid and Jones (2011) known as structural modeling approach (SMA). The framework identifies direct and indirect ST causal factors by creating a structural equation risk pathway of ST victimization. For instance, domestic violence and inadequate access to healthcare facilities result in such factors as running away from home (homelessness), misuse of substances, and sexually oriented business. Furthermore, trauma because of unemployment directly influenced the susceptibility to victimization (Reid & Jones, 2011). Particularly, research by Reid and Jones (2011) established a statistically significant risk factor pathway from a child running away from home to minor ST victimization, childhood abuse, abandonment, and sexual exploitation. In this case, Reid (2011) created a model within the context of Sampson and Laub’s (1993) age-graded developmental theory of casual social control: a merger of life course and social control theory.
Methods Section
Search Engines Strategy
The EBSCOhost was used as the primary source of data in this review. Specifically, the PsychInfo electronic databases from 2017 to 2021 were searched as well as the online library of the University of Essex and Google Scholar. These were chosen because of the socio-economic focus that encompasses the psychosocial effects of sex trafficking. EBSCOhost database was essentially used for its comprehensive coverage of evidence-based nursing practices of qualitative research. However, the Google Scholar database was also used to provide a wide range of scientific journals for the study in question.
Table 1: Key Words Explored in the Literature Search
Table 2: Eligibility Criteria for Inclusion and Exclusion of Research Studies based on PEO
Journal articles and publications were rejected if it was understandable from the abstract (or their titles) that the research did not meet the inclusion criteria. Eighteen studies met the selection criteria and were considered useful for the review as shown in Table 3. All the used sources include academic and peer-reviewed studies that examine the relationship between poverty and sex trafficking.
Thematic Analysis
Critical appraisal of primary data is essential in the provision of ideal epidemiological characteristics to ascertain clarity in the synthesis of critical qualitative reviews. Based on these appraisals, the results of each study are easily reproducible, thus enabling thematic synthesis. For this part, inductive coding was used to produce descriptive themes, which were further analysed to produce analytical pieces. This was done by grouping similar codes together by inferring risks or causal factors for ST and its relation to poverty to form the themes as outline in the thematic synthesis Table 4.
All the eighteen articles were coded using a standardized coding sheet for the articles that met our criteria. The coding sheet was established based on domains of risk factors or causal effects, which encompass the SLE Model, the SMA model, and the understanding of other shared risk factors. At the individual level, aspects associated with substance abuse, failing in schools, running away home, and sexual behaviors were captured. Moreover, the coding process also allowed us to identify any other cause via the open-ended sections.
Results
The final sample included 18 articles which are indicated in the PRISMA Flowchart (see Figure 1). The majority of studies used examples drawn from employed sex workers, women, children, and youth samples. However, other articles applied adjudicated models, which comprised of currently imprisoned individuals or archives and systematic reviews. The review yielded eleven summary effects or causal reasons for ST, which was classified into six main factors (see Table 4). Furthermore, the factors were subsequently categorized into two main domains: resources (four factors) and education (four factors) all at an individual level capacity.
Table 4: Thematic synthesis
Discussion and Implications
Resources
Homelessness/Statelessness
A significant amount of research has suggested the existence of homelessness and statelessness as a risk factor to influencing ST. For instance, such factor as running away from home due to family issues or individual life problems such as failing in school resulted in a majority of children getting involved in ST (Goldberg et al., 2017; Greenbaum, 2020; Baker, 2019; Fedina, Williamson and Perdue, 2019; Middleton et al., 2018; Rai and Rai, 2021). In this regard, the research articles concluded that child run away was a contributing factor to involvement in ST.
Although multivariate results show that domestic child ST victims were significantly more probable to have ever run away home, the researches were not without limitations. For instance, Greenbaum, 2020 used the public health approach to deduce the findings without noting the validity of such data. In addition, Baker (2019) applied narrative method used in 1970s to 1970s, a method that was prone to bias as most information during narrative may be based on feelings rather than the true picture of ST. The remaining research articles were exemplary for using primary data. However, the use of few number of participants as in 131 homeless youths (Middleton et al., 2018), 41 patients (Goldberg et al., 2017), and 115 participants (Fedina, Williamson and Perdue, 2019) reduces validity of such data because of low generalizability.
Poverty and lack of economic support
According to Tsai (2017), unemployment amongst the youths largely contributes towards the participation in ST. In support of these, such factors as participation in sexually oriented businesses and unsupportive communities result in increased ST cases (Herdiana et al., 2020; Mletzko, Summers and Arnio, 2018). Moreover, poor access to health care facilities, failing in schools, and distance from the local truck stop have been studied to closely relate to ST in resource-limited societies (Baker, 2019; Joshi et al., 2020; Mletzko, Summers and Arnio, 2018). Despite these, relatively few studies examined strategies on preventing poverty because of its association with ST. With the existing gap in research and mixed proof for the relationship between poverty and ST; there is limited but consistent support for ST prevention. Therefore, further study is required to elucidate and fortify the current empirical evidence for such association.
Education
Lack of Knowledge and Understanding
Although the majority of research does not directly link lack of knowledge and understanding as a contributing factor to the participation in ST, few types of research strongly suggest its existence. For instance, lack of knowledge and limited understanding of the indicators of ST leads to the involvement of the unknowing participants (Litam, 2017, Greenbaum, 2020). Furthermore, Litam (2017) suggests that the lack of knowledge by the ST counselors is also a key risk factor to ST. In support of these findings, Okeshola and Adenugba (2018) established that children who lacked an education found themselves in such activities as child labor, substance abuse, rape and kidnapping which increases their chances of being victims of ST (Fanchiro-Olsen, 2019; Durisin and Van der Meulen, 2020; Duncan and DeHart, 2019; Middleton et al., 2018; Greenbaum, 2020; Crawford , 2017). However, the pieces of evidence were not reliable, and outcomes may be sample dependent because majority of the research used few participants, thus reducing the generalizability of the evidence.
Lack of Awareness on ST
Across studies, as described in the Table 4, gender-based violence, racism, gender power, and social classification because of lack of awareness about human rights and limited information demonstrated an existence of a the link with ST. Remarkably, research by Greenbaum (2020) stood out because it scrutinized the collaboration of ST awareness and such factors as gender-based violence and social inequality amongst women of color, signifying elements work in concert to escalate the risk for ST. For instance, insolences supporting ferocity against women of color interrelate with such factors as lack of awareness to give rise to ST.
Conclusion and Recommendation
The identification and prosecution of perpetrators of ST are self-satisfying because it provides justice to the victims. However, such strategies do not offer a long-term solution to the effects of ST. To eliminate ST in underprivileged societies, primary prevention programs should be enacted at the multiple levels. For example, government agencies and public health professionals should engage in educating the individuals at risk of ST. Moreover, they may provide the needed resources and education through ST campaigns and awareness to address risk causes and susceptibilities and debate on harmful social, ethnic, and racial classifications that help drive ST. The stakeholders should also promote policies and laws that escalate the financing of the primary prevention research, which help address the determinants that contribute to trafficking exposure.
Limitation
The current systematic analysis was inadequate in numerous approaches: First, the inclusion measures produced for all qualitative designs did not prominent on the use of primary data, thus resulting in a select detachment of the ST risk factors that were not pertinent to crucial prevention strategies. For example, specific causal associations could not be associated with ST because of non-primary research. Second, the quality issues regarding the research methodologies applied in most research articles point towards the need for more investigations. For instance, most of the papers used few participants in providing their findings, suggesting that such conclusions cannot be heavily relied on because of the low generalizability. Lastly, whereas we derived on 20 articles for the systematic review, it is inevitable that particular quality articles were not included because of the use of narrow keywords and search terms and the use of only-English published articles.
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