Signs and Indicators When Taking Medical History and In Medical Exam
It is important to have protocols in place that are helpful in identifying victims of trafficking. For example, have a general rule about the exam room. One key “best practice” is to examine the patient alone. Providers should aim to examine the patient without another person present, by citing client confidentiality or privacy. However, if the client insists, and especially if he/she might leave otherwise, it may be necessary to allow the other person to be in the room.
Red Flags – During the exam, there are may red flags that may be revealed while going over the client’s medical history. For example, the client may have had repeated STIs, UTIs, pregnancies, miscarriages, or abortions. During the exam other indicators may be injuries (old and new), specific tattoo markings, self harm such as cutting. Some may have needle tracks as a result of addiction.
Provider Tips – It is critical for providers to demonstrate care, compassion, and consistency. Use a trauma informed approach that recognizes that a trafficking victim may have complex trauma, and even a simple exam could trigger fear, flashbacks, or other trauma reaction. Use simple language as many victims have had disruptions in their formal education. Ask clear and concise questions that may help uncover trafficking. For example, survivors have said that they often do not know exactly how many sexual partners they have had. A better way to frame that question might be to use a threshold (e.g., have you had more than six sexual partners in the past week/month)?
Goal – The goal in the exam room is to build trust so that the victim feels safe enough to disclose exactly what is happening to them.