Trafficking of U.S. Citizens and Legal Permanent Residents: The Forgotten Victims and Survivors

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1 Trafficking of U.S. Citizens and Legal Permanent Residents: The Forgotten Victims and Survivors Authors: Dr. Seri Irazola, ICF International Ms. Erin Williamson, ICF International Ms. Catherine Chen, ICF International Ms. Ashley Garrett, ICF International Dr. Heather J. Clawson, ICF International

2 Abstract Over the past decade, increased attention and resources have focused on the issue of human trafficking. While significant efforts have been taken to understand and combat transnational trafficking (i.e., trafficking between countries and across borders), little has been done to understand and combat the issue of domestic trafficking, especially domestic trafficking within the U.S. The trafficking and exploitation of U.S. citizens and legal permanent residents within their own borders is a serious crime that negatively impacts not only those who are victims/survivors, but also law enforcement officials, social service providers, and communities throughout the U.S. Despite the passage of the Trafficking Victims Protection Act (TVPA) in 2000, which was designed to protect the rights of these and other victims/survivors 1 of trafficking, insufficient effort has been made to more fully understand and combat the issue of domestic trafficking within the U.S. Human trafficking, also referred to as modern day slavery, is defined by the TVPA as the use of force, fraud, or coercion for the purposes of labor trafficking or sexual exploitation (8 U.S.C. 1101). 2 It is important to note that the definition of trafficking does not require the transportation and movement of an individual (Clawson, Salomon, Goldblatt Grace, Dutch, & Williamson, 2009), a common misconception about human trafficking that has resulted in much of the anti-trafficking efforts in the U.S. being focused on the trafficking of foreign nationals into the country. In an effort to amend this, in 2005, the reauthorization of the TVPA emphasized the need to address the trafficking of U.S. citizens and legal permanent residents. This amendment was effective in prompting increased attention to domestic trafficking within the U.S.; however, the majority of these efforts were limited to combating the sex trafficking of female minors (prostituted children). As a result of this focus, most of the research and literature examining domestic trafficking in the U.S. has also concentrated on this population with a primary focus on estimating the scale of domestic sex trafficking of minors, mapping routes, and reviewing policies and legal frameworks (Gozdziak & Collett, 2005), To date, service providers, activists, and government agencies continue to lack a clear understanding of domestic labor trafficking in the U.S.; the trafficking of adults, males, and transgender individuals; and the scope of these forms of trafficking. Additionally, little is known about the availability and effectiveness of service delivery to domestically trafficked populations in the U.S. Current research shows that domestic trafficking victims/survivors are served by a mix of service providers those with specialized knowledge and services for trafficking survivors, and those who serve the broader victim population who may have little understanding of this issue (Clawson et al., 2009). What is known about the few specialized services has largely been gleaned from assisting female minor victims/survivors of sex trafficking. Therefore, in order to ensure that efforts to address domestic human trafficking are both effective and efficient, additional research and evaluation is needed as well as targeted training and technical assistance to ensure proper understanding of the issue and implementation of best practices for serving this population through specialized and/or mainstream services and programs. 1 There is ongoing discussion within the anti-trafficking field about the use of the terms victim and survivor to describe individuals currently in or who have escaped a trafficking situation. This paper will use the term victim/survivor throughout to describe these individuals. 2 When commercial sexual acts involve a minor (an individual under the age of 18), there is no requirement for force, fraud, or coercion to have taken place ICF International, Inc. All Rights Reserved.

3 Recommendations In order to thoroughly understand and combat domestic trafficking in the U.S., significant efforts must be taken to document all stages of the trafficking process, assess existing services, identify and replicate best practices, and provide training and technical assistance to increase capacity to serve this population. Specific actions that will enhance these efforts include: 1. Conduct baseline research to document the stages of domestic trafficking and to improve understanding of domestic trafficking in the United States. Research that informs practitioners, law enforcement, and policymakers about the recruitment, exploitation, and rehabilitation of domestic trafficking victims/survivors and the demand for labor and sexual services that leads to trafficking is imperative to formulating policies targeted at combating domestic trafficking and creating new or adapting existing services to assist this population. Much is still unknown about the different populations of victims/survivors of domestic trafficking, particularly with regards to labor trafficking and the trafficking of adults, males, and transgender individuals. Furthermore, these different populations may have similar but also varying and unique needs that should be recognized. Effective strategies should be analyzed and assessed to further enhance ways to both protect those at risk and successfully reintegrate individuals with their families, communities, and the larger society. 2. Convene a group of experts to design specialized demonstration projects that would address the needs of the different sub-populations of domestic victims/survivors and subsequently fund the implementation of these projects. There are particular needs within the domestic trafficking victim/survivor population that may be best served through the development of specialized services. Currently, there are few specialized programs addressing the needs of domestic victims/survivors. Those that do exist target adolescent girls who are victims/survivors of sex trafficking and their effectiveness has not been evaluated. Convening a group of experts to design specialized demonstration and pilot projects that allow for targeted consideration of the unique needs of the different sub-populations of domestic victims/survivors (i.e. adults, males, labor trafficking victims/survivors) and subsequently funding the implementation of these project will result in enhanced capacity to successfully assist these individuals. 3. Assess effectiveness of existing specialized resources and programs targeted to meet the needs of domestic victims/survivors of trafficking. Identifying promising practices that meet the needs of these citizens and successfully reintegrate them into society is a crucial step to the provision of effective service delivery. For example, as of 2007, there were four residential facilities specifically serving victims/survivors of human trafficking in the U.S. To date, a comprehensive assessment of these programs has not been conducted to assess their effectiveness, document promising practices for trial and replication in other locations, or compare them to residential facilities that do not exclusively serve victims/survivors of trafficking but rather provide services to a variety of populations, i.e., juvenile detention facilities, domestic violence shelters, group homes, etc. 4. Assess effectiveness of mainstream systems and service providers whose programs are not exclusively targeted to meet the needs of trafficking victims/survivors but who nonetheless encounter and serve this population. It is important to recognize that this population is already served through a wide variety of systems (education, welfare, justice, etc.) and service providers (runaway/homeless shelters, domestic violence shelters, mental health/substance abuse treatment centers, etc.). Knowledge of this population ranges from comprehensive to nonexistent. Given limitations on ICF International, Inc. All Rights Reserved.

4 resources for the development of specialized programs and the reality that domestic trafficking victims/survivors will continue to seek assistance from, or be referred to, mainstream systems, assessments of the services and programs available from these providers is imperative to providing insight regarding their current ability to identify victims/survivors, their capacity to and effectiveness in serving this population, and their potential need for increased training and technical assistance on how to adapt their existing programs and services to better screen for and serve victims/survivors of domestic trafficking. 5. Provide training and technical assistance to mainstream systems and programs that serve or are likely to serve this population. As mentioned above, numerous systems and programs provide services to victims/survivors of domestic human trafficking, oftentimes without realizing they are serving this population. Targeted, needs-based training and technical assistance is needed for these providers to ensure the transfer of information on best practices and lessons learned, via specialized demonstrations, and to build capacity to better assist these them. Training and technical assistance that begins with an assessment of individual providers aptitudes to serve this population will ensure that the tailored training and technical assistance offered successfully meets the goals of building capacity and improving service delivery. 6. Provide training and technical assistance to improve identification of at-risk populations and early identification of victims/survivors. Numerous systems and first responders (doctors, social workers, law enforcement, etc.) come into contact with victims/survivors of domestic trafficking, with little preparation to identify and serve the needs of these individuals. For example, law enforcement, detention, and court personnel often arrest and incarcerate these individuals for perpetrating crimes, such as solicitation, without recognizing that they are, in fact, victims/survivors of trafficking. The systems and responders who are likely to come into contact with victims/survivors of domestic trafficking are in a position to identify individuals at risk of being trafficked and help prevent their future victimization. Yet, most are unaware and unprepared to effectively intervene. There is a real need for training and technical assistance to improve awareness, better educate, and better equip these individuals with the skills and tools they need to flag those at risk, properly identify victims/survivors, and refer them to or provide them with appropriate services. 7. Create educational programs aimed at preventing the victimization of the United States most vulnerable populations. In addition to serving those who have already been victimized by traffickers, more attention and resources are necessary to prevent more individuals from being trafficked. Our educational systems, juvenile justice system, and child welfare services provide unique outlets for the education and protection of those at risk for domestic trafficking. The development of programs, interventions, and materials that can be disseminated and implemented through these institutions is an important but missing step to providing the knowledge and skills necessary to guard vulnerable citizens against potential traffickers ICF International, Inc. All Rights Reserved.

5 Discussion of the Problem While the issue of human trafficking has gained increased attention over the past decade, few efforts have taken place to understand and combat the issue of domestic trafficking within the U.S., and these efforts have largely concentrated on minor female victims/survivors of sex trafficking. In 2001, Estes and Weiner estimated that, each year in the U.S., between 244,000 and 325,000 minors are at risk for sexual exploitation. Because most measures used to estimate the scope of the problem, such as this one, do not account for adult trafficking victims/survivors or victims/survivors of labor trafficking, the actual prevalence of trafficking of U.S. citizens and legal permanent residents remains unknown. As a start, researchers have begun analyzing estimates of other related populations, such as prostitutes, runaway and throwaway youth, child laborers, as well as official data, such as arrest and prosecution data on juveniles and adults in trafficking-related crimes, to better understand issues related to and the extent of domestic trafficking in the U.S. Researchers have also begun studying these related populations and the programs serving them in order to identify effective programs and services that may be able to meet the needs of victims/survivors of human trafficking. Consequences of Trafficking 3 Much of what is known regarding the consequences of domestic trafficking has been extracted from research on populations that have experienced similar exploitation and trauma, such as victims/survivors of sexual abuse or domestic violence, sexually exploited women and children, victims/survivors of torture, and victims/survivors of transnational human trafficking. Some of the physical and mental health consequences found in these exploited populations are highlighted below. The potential physical health consequences of trafficking include, but are not limited to, broken bones, chronic pain, infectious diseases, sexually transmitted infections, memory loss, dental or oral problems, and gynecological problems (Alexander, Kellogg, & Thompson, 2005; Clawson & Goldblatt Grace, 2007; Family Violence Prevention Fund, 2005; Farley et al., 2003; Raymond et al., 2002). Additionally, due to lack of health care, children who were trafficked at a young age may have missed certain developmental milestones which have gone undetected. The mental health issues associated with this population are often complex and there is a high degree of comorbidity of mental health ailments (Alexander, Kellogg, & Thompson, 2005). Similar to victims/survivors of domestic violence and other traumatic experiences, many victims/survivors of human trafficking suffer from posttraumatic stress disorder (PTSD), depression, anxiety disorders, substance and alcohol abuse, and dissociative disorders (Alexander, Kellogg, & Thompson, 2005; Allen, 1980; Clawson & Goldblatt Grace, 2007; Clawson et al., 2009; Farley, 2003; Klain, 1999; Lloyd, 2005; Pico-Alfonso, 2005). In addition to health and mental health consequences, victims/survivors of domestic human trafficking often lack basic life skills. Research on the needs of homeless and runaway youth parallel the needs described for victims of domestic trafficking, such as gainful education and vocational skills necessary to function in our society (Aviles & Helfrich, 2004; Clawson & Dutch, 2008; DeRosa et al., 1999; Robinson & Toro, 1999). 3 Given the limited research which exclusively examines the consequences of domestic trafficking within the U.S., this section also contains references to studies which examine the consequences of transnational trafficking into the U.S ICF International, Inc. All Rights Reserved.

6 Challenges to Identifying Domestic Trafficking Victims/Survivors Numerous challenges continue to hinder our ability to understand and effectively combat domestic trafficking in the U.S. Human trafficking is a hidden crime. Victims/survivors of trafficking do not tend to self-identify for a variety of reasons including the fact that most victims/survivors have never heard of the term human trafficking and are unaware that laws exist that recognize them as victims and protect their rights. Paradoxically, this lack of knowledge leads many victims/survivors to assume that they are criminals who have broken the law by engaging in prostitution, a perception often reinforced by traffickers some of whom threaten to turn victims/survivors into the police themselves (Orhant, 2002). Minors, in particular, worry about being placed in the juvenile justice or foster care system or being forced to return to their dysfunctional or abusive families (Alexander, Kellogg, & Thompson, 2005). Additionally, community members, social service providers, law enforcement personnel, medical personnel, and other first responders who often come into contact with victims/survivors of trafficking often fail to accurately identify them because most of these people are unaware of the issue and definition of trafficking, in particular domestic trafficking (Clawson & Goldblatt Grace, 2007). Challenges with Accessing Services 4 Once victims/survivors are identified, they are in need of a wide variety of emergency, short-term, and long-term services. Unfortunately, obtaining access to these services is often difficult, if not impossible. Unlike international victims/survivors of human trafficking, there is no dedicated government funding for specialized services to aid domestic victims/survivors. Instead, domestic victims/survivors are assumed to have access to needed services offered by mainstream systems (e.g., medical, education, justice, welfare, etc.) by virtue of being a U.S. citizen or legal permanent resident (Clawson et al., 2009). However, these benefits often contain a number of stipulations with regard to participation. For example, most of these programs require proof of residency, a birth certificate, and a social security card which the majority of domestic victims/survivors are not in possession of immediately after escaping their trafficking situations. While victims/survivors can apply for new identification documents, this process can be both cumbersome and time consuming, resulting in a delay of service provision and leaving victims/survivors at high risk for re-victimization. Additionally, previous arrests, such as for solicitations, result in ineligibility for a number of these programs (Williamson, Dutch, & Clawson, 2009). As previously mentioned, victims/survivors of human trafficking experience a broad range of consequences as a result of their exploitation that require specific services to assist them in their recovery. Services often required by this population include health care, mental health counseling, legal representation, substance abuse treatment, life-skills training, and job training, to name just a few (Clawson & Dutch, 2008). When working with this population, it is imperative for service providers to have a comprehensive understanding of human trafficking (Clawson & Goldblatt Grace, 2007). Yet, professionals working within the mainstream systems that are frequently the only resource available for victims/survivors are often unfamiliar with the issue of domestic human trafficking and are ill prepared to address the unique needs of these individuals. Service providers who do not have this awareness risk misunderstanding their clients and/or not treating all of the conditions resulting from their exploitation. For example, a young female who reports her daddy raping her may be referring to her pimp as 4 Given the limited research regarding adult and minor male victims/survivors of domestic trafficking, the majority of information available on domestic trafficking is focused on female, minor victims/survivors ICF International, Inc. All Rights Reserved.

7 opposed to her biological father. A misunderstanding of the vernacular often used by traffickers and victims/survivors can result in treating this young woman for incest as opposed to identifying her as a victim/survivor of trafficking who was raped by her pimp. Therefore, service providers who come into contact with this population require specialized training on the consequences of human trafficking, the specific needs of victims/survivors, and the most effective and appropriate services for addressing these needs. One crucial need of most victims/survivors is safe housing. Shelters and other residential facilities not only provide services to meet the basic needs of trafficking victims/survivors, they also provide the link to other needed services. Case managers and social workers operating as part of these facilities are often the first to identify these individuals as trafficking victims/survivors and subsequently coordinate and manage their service provision both within and outside of these facilities. As of September 2007, only four residential facilities specifically serving victims/survivors of human trafficking existed in the U.S., all of which exclusively serve female victims/survivors. While a comprehensive assessment comparing these facilities to other residential placement options has not yet been conducted, a qualitative review of these facilities found that across sites, street outreach workers, shelter providers, residential facility staff, law enforcement, and child protective services workers all felt that programs uniquely tailored to meet the needs of this population were an important priority for service delivery (Clawson & Goldblatt Grace, 2007). This sentiment was also expressed by Congress when it reauthorized the TVPA in 2005, calling for the implementation of a pilot program to establish residential treatment facilities in the U.S. for juveniles subjected to trafficking (PL ). The qualitative review of these facilities found that, by serving a homogeneous population of victims/survivors of human trafficking, they were able to develop targeted protocols and procedures to effectively meet the needs of this population. For example, these programs were able to reserve spaces for girls who ran away, as this population is prone to do. Not only did these program reserve the physical space for the girl to return but they also reported having specific protocols in place to work with running away as part of the girls treatment plans. These types of protocols are not possible in other residential programs that receive funding through child protective services and other sources that provide funding based on occupancy numbers (Clawson & Goldblatt Grace, 2007). Many shelters receive funding from sources that restrict the amount of time an individual may reside in the shelter, making it difficult if not impossible for case workers to build trust with the residents and begin meaningful treatment. Also, these placements are often not aware of or do not adequately recognize the prior abuse and sexual exploitation experienced by these individuals and, therefore, the trauma and other problems related to this exploitation frequently go untreated (Clawson & Goldblatt Grace, 2007). Additionally, the majority of runaway and homeless youth shelters and domestic violence shelters exclusively serve the female population resulting in a further limitation of housing options for male and transgender individuals. In addition to these alternative shelter facilities, many victims/survivors of domestic trafficking end up in juvenile and adult detention facilities, sometimes charged with prostitution related crimes but more often charged with other crimes such as curfew violations, truancy, runaway, or shoplifting. In juvenile and adult detention facilities, these individuals are frequently treated as offenders as opposed to victims/survivors and the treatment plans for them are often narrowly tailored to the criminal charges imposed on them (Clawson & Goldblatt Grace, 2007). The practice of placing victims/survivors of trafficking in detention centers often reinforces the idea that they are at fault for committing a crime as opposed to a victim/survivor of one. This message can lead to the re-traumatization of this population. Given the many challenges and limitations of alternative shelter facilities to serving victims/survivors of domestic trafficking, the reality is that mainstream systems do and will continue to come into contact with this population ICF International, Inc. All Rights Reserved.

8 Additionally, while specialized residential facilities represent an ideal housing solution for victims/survivors of domestic trafficking, the limited number of these programs across the country and the shrinking resources for new programs necessitates that alternative facilities intervene on behalf of victims/survivors of domestic trafficking. Alternative facilities include runaway and homeless youth shelters, group homes, foster care placements, domestic violence shelters, substance abuse treatment facilities, and detention facilities. In order for these systems to effectively meet the needs of this population, it is important to learn through research and evaluation how existing policies, procedures, and programs need to be adapted or changed and to develop training and technical assistance to help systems make the necessary adjustments. Whether victims/survivors are able to access specialized or mainstream services tailored to their specific needs will depend greatly on how well these services are linked to and coordinated across the multiple service providing agencies. Since the passage of the TVPA in 2000, significant efforts have been taken to improve coordinated service delivery to this population. The U.S. Department of Justice funds 42 local task forces to help combat human trafficking (both domestic and transnational human trafficking) through the coordinated efforts of prosecutors, law enforcement, social service providers, and others in the anti-trafficking movement (G/TIP, 2008). While these and other collaborative efforts are an important step forward, there are a number of cities as well as suburban and rural communities that continue to lack coordinated task forces to assist in organizing service provision. Additionally, increased coordination is also needed across states, especially in cases where victims/survivors have crossed state borders as part of their exploitation. Therefore, coordinated efforts need to be expanded and built upon to better serve victims/survivors in all locations across the U.S. Call to Action and Conclusion Domestic trafficking of U.S. citizens and legal permanent residents is a serious crime which exploits the country s most vulnerable populations. While some efforts have been made to address the issue of human trafficking within the U.S., too often these efforts have fallen short and do not adequately address the needs of our own citizens who are victimized at the hands of traffickers. As more is learned about this population, special efforts must be taken to secure the resources necessary to rehabilitate and reintegrate these individuals into society. More research and targeted training and technical assistance offer two important tools to better identification, service provision, and future prevention of domestic trafficking. About the Authors This paper was written by Dr. Seri Irazola, Ms. Erin Williamson, Ms. Catherine Chen, Ms. Ashley Garrett, and Dr. Heather J. Clawson of ICF International s Human Services and Community Development practice. Dr. Irazola has more than eight years of applied research experience assisting with methodological designs, conducting field research, and engaging in data collection and statistical analysis; as part of this work, she served as the Principle Investigator for the Human Trafficking Reporting System funded by the Bureau of Justice Statistics. Ms. Williamson brings experience in analyzing policies, conducting research, and preparing complex reports on issues related to child welfare and human trafficking. Ms. Chen has spent the last seven years researching and implementing projects to combat child trafficking and exploitation around the world. In addition to her anti-trafficking work, she has a background in non-governmental management and capacity building. Ms. Garrett specializes in grant management, training, and technical assistance programs which build collaboration among diverse stakeholders at the community, national, and international levels on migration, gender, and crime victims with a specialized ICF International, Inc. All Rights Reserved.

9 emphasis in working with victims of terrorism and human trafficking. Dr. Clawson, a principal at ICF, has more than 10 years of experience in the areas of victim services, criminal justice, and juvenile justice programs. He has assisted in the development and implementation of many assessments (needs assessments, evaluability assessments) and evaluation designs, developed and managed large databases, led data collection, and written well-received technical reports. The authors benefited from the input of staff across ICF who conduct work in juvenile and criminal justice, human services, and community development. The views expressed in this paper and any errors are those of the authors and not necessarily those of ICF International. About ICF International ICF International (NASDAQ:ICFI) partners with government and commercial clients to deliver consulting services and technology solutions in the energy, climate change, environment, transportation, social programs, health, defense, and emergency management markets. The firm combines passion for its work with industry expertise and innovative analytics to produce compelling results throughout the entire program life cycle, from analysis and design through implementation and improvement. Since 1969, ICF has been serving government at all levels, major corporations, and multilateral institutions. More than 3,000 employees serve these clients worldwide. ICF s Web site is References Alexander, M. P., Kellogg, N. D., & Thompson, P. (2005). Community and mental health support of juvenile victims of prostitution. In S. W. Cooper, R. J. Estes, A. P. Giardino, N. D. Kellogg, & V. I. Vieth (Eds.), Medical, legal and social science aspects of child sexual exploitation: Vol. 1 (pp ). St. Louis, MO: G. W. Medical Publishing, Inc. Allen, D. (1980). Young male prostitutes: A psychosocial study. Archives of Sexual Behavior, 9, Aviles, A., & Helfrich, C. (2004). Life skill service needs: Perspectives of homeless youth. Journal of Youth and Adolescence, 33(4), Clawson, H. J., & Dutch, N. (2008). Addressing the needs of victims of human trafficking: Challenges, barriers, and promising practices. Fairfax, VA: ICF International. Clawson, H. J., & Goldblatt Grace, L. G. (2007, September). Finding a path to recovery: Residential facilities for minor victims of domestic sex trafficking. Fairfax, VA: ICF International. Clawson, H. J., Salomon, A., Goldblatt Grace, L., Dutch, N., & Williamson, E. (2009). Human trafficking into and within the United States: A review of the literature. Submitted for publication. Fairfax, VA: ICF International. DeRosa, C. J., Montgomery, S. B., Kipke, M. D., Iverson, E., Ma, J. L., & Unger, J. B. (1999). Service utilization among homeless and runaway youth in Los Angeles, California: Rates and reasons. Journal of Adolescent Health, 24, Estes, R., & Weiner, N. (2001). The commercial sexual exploitation of children in the U.S., Canada, and Mexico. Philadelphia: University of Pennsylvania ICF International, Inc. All Rights Reserved.

10 Family Violence Prevention Fund. (2005). Turning pain into power: Trafficking survivors perspectives on early intervention strategies. San Francisco, CA: Author. Farley, M. (Ed.). (2003). Prostitution, Trafficking, and Traumatic Stress. Haworth Press, New York. Farley, M., Cotton, A., Lynne, J., Zumbeck, S., Spiwak, F., Reyes, M.E., et al. (2003). Prostitution and Trafficking in Nine Countries: An Update on Violence and Posttraumatic Stress Disorder. Journal of Trauma Practice, 2(3/4), Gozdziak, E. M., & Collett, E. A. (2005). Research on human trafficking in North America: A review of literature. In F. Laczko & E. Gozdziak (Eds.), Data and Research on Human Trafficking: A Global Survey (pp ). Switzerland: International Organization for Migration. Klain, E. (1999). Prostitution of children and child-sex tourism: An analysis of domestic and international responses. Alexandria, VA: National Center for Missing and Exploited Children. Lloyd, R. (2005). Acceptable victims? Sexually exploited youth in the U.S. Encounter: Education for Meaning and Social Justice, 18(3). Orhant, M. (2002). Article 1: Trafficking in persons. In E. Murphy & A. Hendrix-Jenkins (Eds.), Reproductive health and rights: Reaching the hardly reached (pp. 1 12). Retrieved July 23, 2008, from Pico-Alfonso, M. A. (2005). Psychological intimate partner violence: The major predictor of posttraumatic stress disorder in abused women. Neuroscience and Biobehavioral Reviews, 29, Raymond, J. G., D Cunha, J., Dzuhayatin, S. R., Hynes, H. P., Rodriguez, Z. R., & Santos, A. (2002). A comparative study of women trafficked in the migration process: Patterns, profiles, and health consequences of sexual exploitation in five countries (Indonesia, the Philippines, Thailand, Venezuela, and the United States). Coalition Against Trafficking Women International. Robertson, M. J., & Toro, P. A. (1999). Homeless youth: Research, intervention, and policy. In L. B. Fosburg, & D. L. Dennis (Eds.), Practical lessons: the 1998 national symposium on homelessness research ( ). Washington, DC: US Department of Housing and Urban Development and US Department of Health and Human Services. Trafficking Victim Protection Reauthorization Act of Pub. L. No , 7101, 119 STAT 3558 (2006). U.S. Department of State, Office to Monitor and Combat Trafficking in Persons (G/TIP). (2008, July 11). The President's interagency task force to combat trafficking in persons declaration of achievements: Retrieved March 2, 2009 from Victims of Trafficking and Violence Protection Act of Pub. L. No , 8 U.S.C. 1101, 7101, 114 STAT 1464 (2000). Williamson, E., Dutch, N., & Clawson, H. (2009). National symposium on the health needs of human trafficking victims/survivors: Post-symposium brief. Submitted for publication. Fairfax, VA: ICF International ICF International, Inc. All Rights Reserved.

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