Presented by Susan B. Spencer and Renee Jones Susan Spencer’s presentation was supported by contract #HHSP233200900774P from the Office on Woman’s Health. The content of this presentation is solely the responsibility of the presenter(s) and does not represent the official views of OWH. A pattern of coercive behaviors exerted by an intimate partner over another with the goal of establishing and maintaining power and control. No matter what gender or sexual orientation the victim or perpetrator may identify themselves as, control and abuse are the common characteristic that defines the relationship as violent 1 in 3 women experience some form of intimate partner violence in given year Human Trafficking Is… A form of modern-day slavery where people profit from the control and exploitation of others. As defined under U.S. federal law, victims of human trafficking include children involved in the sex trade, adults age 18 or over who are coerced or deceived into commercial sex acts, and anyone forced into different forms of "labor or services," such as domestic workers held in a home, or farm-workers forced to labor against their will. The factors that each of these situations have in common are elements of force, fraud, or coercion that are used to control people. Then, that control is tied to inducing someone into commercial sex acts, or labor or services. Using Male Privilege (relationship)  Making all the big decisions.  Acting like "Master of the Castle". Using Economic Abuse  Preventing you from getting or keeping a job.  Making you ask for money.  Being the one to define men's and women's roles.  Treating you like a servant.  Taking your money.  Not letting you know about or have access to family income. Giving you an allowance Using Coercion, Threats and Physical Violence   Making and/or carrying out threats to do something to hurt you.  Bruises, scars and other signs of physical abuse and torture  Sex-industry victims often beaten in areas that will not damage their outward appearance, like lower back •Threatening to "out" you.  Threatening to leave you, to commit suicide, to report you to Welfare authorities.  Making you do illegal things. HIV and DV/IPV  Black women are victims of DV at a rate 35% higher than white women  DV most common among those 16-24yo  High rate of poverty and homelessness amongst DV victims  AIDS is the leading cause of death for African American women in the US  Highest prevalence of new HIV infection is among youth 13-24yo  Highest prevalence of HIV/AIDS among low SES populations Abusive partners:  May use sexual assault as a form of control  May refuse birth control, condoms  Frequently engage in sex outside the relationship, putting themselves at high risk of STD’s, including HIV  Giving an STD to a partner intentionally is another form of power and control http://www.opdv.state.ny.us/health_humsvc/health/hiv.html Women who are abused:  Have difficulty accessing services, including health care and may have:  Worsened overall health  Results in immune system being stressed  Difficulty in getting STD and HIV testing  Diagnosed at advanced stages rather than early, so harder to treat  Difficulty assessing their own risk? New Diagnosis and Risks of Disclosure  Risk of violence directly after an HIV disclosure or increased severity over long period of time.  Partner may hide meds or keep victim from getting medical care.  Risk of partner “outing” victim for more power and control and increased isolation  Emotional abuse may increase likelihood that victim will stay. Ie: “No one else would ever want you now. A Positive Woman in a Violent Relationship  Many + women report that even though a partner is abusive, if they accept the HIV, then that makes the violence somehow more acceptable.  Risk of being outed if they leave is very real.  May feel guilt if they think they infected the abusive partner. Screening for Domestic Violence  “Do you ever feel unsafe at home?”  “Do you ever feel afraid of someone close to you?  “Have you ever been pushed, grabbed, slapped, choked or kicked by an intimate partner?  Have you or your children ever been threatened?  “Has anyone ever stalked, followed or monitored you?”  Have you ever been or are you currently concerned about harming your partner or someone close to you?” HIV Testing for Victims of Violence Pros of Testing  STD/HIV Testing is sometimes only way victims can protect themselves sexually  Knowing can alleviate some stress  Giving victims back power over their bodies Considerations in not testing  Isolation—lack of support if positive result  Emotional stability, access to victim if suicidal  Can make safe disclosure decisions Know Human Trafficking Human trafficking is code for slavery – involuntary servitude, debt bondage or peonage. Thousands of Northeast Ohio children, women and men are enslaved to commercial sex or forced labor annually. Trafficking violates human rights and is a stand-alone felony in Ohio. Founded in 2002, the Renee Jones Empowerment Center (RJEC) is the only Northeast Ohio 501(c)(3) agency committed to providing life coaching and aftercare services to those with the courage to break the human trafficking cycle. RJEC shines light on the dark side of humankind and offers a comprehensive approach to getting lives back on track. Characteristics and Traits of Traffickers •Traffickers can be men or women. •Recruiters are often selected for their ability to quickly establish trust. •Female traffickers are often used to recruit victims who would quickly perceive them as trustworthy and credible. •Some traffickers are victims themselves. •Traffickers can be of any nationality, especially now that it has become a global problem •Traffickers can be any one from a child to an elderly person. •Some traffickers are willing to victimize their own families. •Extreme poverty can create a trafficker. •They can be educated or not. •Some traffickers have professional occupations. A doctor or a lawyer and so on. Who Might be a Trafficker? Some examples of those involved in trafficking include: •Pimps •Intimate partners/family members •Gangs and criminal network •Brothel and massage parlor owners and managers •Growers and crew-leaders in agriculture •Labor brokers •Employers of domestic servants •Small business owners and managers •Large factory owners and corporations Screening For Victims of Human Trafficking  As with domestic violence victims, if you think a patient is a victim of trafficking, you do not want to begin by asking directly if the person has been beaten or held against his/her will. Instead, you want to start at the edges of his/her experience.  And if possible, you should enlist the help of a staff member who speaks the patient’s language and understands the patient’s culture, keeping in mind that any questioning should be done confidentially.  You should screen interpreters to ensure they do not know the victim or the traffickers and do not otherwise have a conflict of interest.  Before you ask the person any sensitive questions, try to get the person alone if they came to you accompanied by someone who could be a trafficker posing as a spouse, other family member or employer. However, when requesting time alone, you should do so in a manner that does not raise suspicions. Suggested Screening Questions: •Can you leave your job or situation if you want? •Can you come and go as you please? •Have you been threatened if you try to leave? •Have you been physically harmed in any way? •What are your working or living conditions like? •Where do you sleep and eat? •Do you sleep in a bed, on a cot or on the floor? •Have you ever been deprived of food, water, sleep or medical care? •Do you have to ask permission to eat, sleep or go to the bathroom? •Are there locks on your doors and windows so you cannot get out? •Has anyone threatened your family? •Has your identification or documentation been taken from you? •Is anyone forcing you to do anything that you do not want to •Do not collect more information than you need! In depth interviews with the potential victim should be conducted by mental health professionals, law enforcement professionals or legal experts. Multiple interviews may confuse and/or re-traumatize victims and may put you, as a service provider, at risk of being subpoenaed as a witness. •If you think you have come in contact with a victim of human trafficking, call the National Human Trafficking Resource Center at 1.888.3737.888. This hotline will help you determine if you have encountered victims of human trafficking, will identify local resources available in your community to help victims, and will help you coordinate with local social service organizations to help protect and serve victims so they can begin the process of restoring their lives. Street Outreach Model Street Outreach:  In an effort to reach out to sex trafficking victims, The RJEC Project Red Cord Response Team conducts bi- weekly outreach with women who are being sexually exploited on the streets of Cleveland. A dedicated team of trained volunteers and staff venture out to the street to meet women being prostituted. We offer these women love, encouragement, and a source of hope by distributing Red Bags of Hope, filled with handwritten notes of hope, hygiene products, snacks, and other gifts, as well as emergency hotline cards and information about our support programs & services.  Access to emergency shelter  Basic survival tools (clothing, food, hygiene supplies)  Advocacy  Referrals to needed medical services  Referrals to sexual assault and crisis rape relief counseling  Referrals to drug and alcohol counseling  Individual assessments and case       managements Relationship building with trustworthy adults Coordination with community partners and law enforcement Assistance in finding housing and employment Referrals to family counseling Educational and skill-building opportunities Follow-up support QUESTIONS? Susan B. Spencer, LCSW Consultant Susan B. Spencer, Inc. 8016 Flourtown Ave Wyndmoor, PA 19038 215-233-5373 [email protected] Renee Jones, President & CEO Renee Jones Empowerment Center 1340 West 65th Street Front Cleveland, OH 44102 216-651-9601 www.rjecempower.org