More infrequently, traffickers rely on threats and use of force to ensure their power over victims and to guarantee their silence. Some reports of bar owners beating victims were received. In three identified cases, threats of violence were used to discourage reporting and participating in trial proceedings. One Colombian woman was cut on her face after complaining to authorities in Panama of her condition. Upon her return to Colombia, she was attacked, her assailants reportedly stating: "This is for what you did in Panama".
Forced Drug Use
On occasion, it was reported that bar owners used drugs to
control women and children and to make them more compliant. They
are also a means to induce dependence on the owner and to increase the
debt of the victim. Even at its most benign, women and children are
regularly expected to drink with clients. This daily high volume intake
of alcohol often has health consequences. Alcohol and drugs in many
instances become coping mechanisms for women and children.
Physical Health Implications
The health consequences to trafficked women and children in
the region are serious. Victims have reported physical and sexual
abuse by clients and law enforcement. Trafficked women and children
also appear to be at greater risk of HIV/AIDS and other sexually
transmitted diseases (STDs) due to a relative ignorance of sexual health
and contraception and the lack of access to health services. They are
also in less of a position to be able to negotiate with clients regarding
condom use. The occurrence of unwanted pregnancies and unsafe
abortions was also detected.
One NGO that counsels women in prostitution in Guatemala informed
researchers that their staff has found it necessary to introduce informal
classes on proper condom use, especially to trafficked women and
adolescents from El Salvador, Nicaragua, and Honduras, who neither
anticipated working in a brothel nor were familiar with how to use a
condom. A survey of 100 sexually exploited girls and boys in San Pedro Sula,
Honduras found that 68 had suffered an STD, 29 of whom had
contacted an STD more than once. One quarter of these children selftreated
their symptoms.
According to UNICEF, 67% of sexually exploited girls and boys in San
Pedro Sula, Honduras suffered some type of abuse that produced an
injury. The children identified clients and municipal/national police as
aggressors. A recent survey of 100 minors in Costa Rica in conditions of sexual
exploitation showed that 86% drank alcohol, 82% smoked tobacco,
80% used marijuana, and 34% and 41% consumed cocaine and crack,
respectively.
Due to the nature of their circumstances, trafficked women
and children are more likely to have these health conditions go
undetected and untreated. Despite the mandatory health revision
requirements for sex workers in the region, the establishment owner
usually controls access to health services. Even if available, not all
trafficked women are willing to participate in testing. In many cases,
trafficked women are undocumented and will evade such controls for
fear of deportation.
Similar fears keep women from seeking medical
treatment for injuries. In addition, the private organizations that
provide health screenings to sex workers report that they do not have
access to many establishments, especially private homes that are used
as brothels, and thus probably are not seeing the majority of trafficked
women. The situation of children is particularly acute. Since child
prostitution is illegal in all countries of the region, medical centers are
prohibited from registering children in sex worker health programs and
thus from providing regular health exams.
Mental Health Implications
Little information regarding the specific emotional health
consequences to trafficked women in the region was discovered. It can
be assumed that the violence, isolation, and dependence associated with
trafficking results in depression and lowered self esteem, among other
conditions. Groups working with sex workers in the region commented
on the low self worth and inability to participate in a healthy
partnership that many female sex workers exhibit. Damage to
adolescent and child victims is more pronounced, with effects of sexual
exploitation lasting into adulthood and interrupting full emotional
development.
Relatively limited information exists about the exit of
trafficked women and children from conditions of sexual exploitation.
Police, immigration, prosecutors and juvenile judges have facilitated a
small number of rescues of trafficked children through coordinated
raids. Immigration raids and counter smuggling activities have also
extricated women from trafficking situations, who in turn usually face
deportation. Some reports of independent escapes were received.
Finally, bar owners sometimes release victims if diagnosed with
disease or pregnancy (although many women have had children while
remaining in conditions of exploitation).