Although policies are sympathetic to undocumented persons working in the sex industry, cultural stigma against illegal immigrants and prostitutions are realities for trafficking victims, both in the United States and in their home countries (Stuckman, 2006). Despite current emphasis on victim protection as opposed to old “victim blaming” policies and practices, there is evidence that reality falls short of ideology. Trafficking victims, given their limited education, work options, and historical trauma, may be vulnerable to “secondary trafficking” (Chuang, 2004). Trafficking victims may be among the most vulnerable and disadvantaged persons in society, likely to have experienced poverty, trauma, and desperation prior to trafficking (Bales, 2005; Coonan, 2004; Schuckman, 2006). Previous experiences, limited education, lack of fluency in host language and culture may cause victims to avoid seeking or utilizing help. Some researchers have noted correlations and similarities to victims of domestic violence including self blame, shame, lack of emotional and social support as factors (Gavagan & Brodyaga, 1998; Hopper, 2004). Because most victims are in the United States illegally, fear of deportation may be valid concern. Even for victims who are willing to come forward and cooperate with law enforcement, the process of applying for benefits and protections can be very long, stressful, and potentially risky. Despite protections, victims may be charged with crimes, including prostitution, and face incarceration or deportation (Bales & Lize, 2005; Pendleton, 2004; Webber & Shirk, 2005). Despite the high amounts of money provided to combat the problem of human trafficking, little change has occurred in terms of prosecutions of traffickers or protections for victims(Chuang, 2004).

An Unsuccessful Intervention
Marisol was identified as a potential “trafficking victim” by a trusted health care worker. The worker convinced Marisol that she might be able to obtain legal immigration status, public benefits, and even be reunified with her daughter, Serena, under the TVPA policies. Marisol reluctantly agreed to cooperate with law enforcement against “Uncle Ned,” resulting in greater alienation from her family of origin, as well as the local community. “Uncle Ned” was highly respected by Marisol’s family and peers. Her willingness to work with U.S. law enforcement was perceived by many as a betrayal. Programs, shelters, and legal resources specific to trafficking victims were limited or non-existent in the small rural community where Marisol and Sergio had been residing. Marisol’s worker made arrangements for Marisol to and Sergio to be placed in a shelter/advocacy program for victims of domestic violence. Life in the shelter failed to provide Marisol and Sergio with support and security. Once again perceived as an “other,” Marisol was shunned by the other residents. Few spoke her language, and many labeled her a “whore.” Separated from what she had perceived as support and special treatment from “Uncle Ned,” Marisol became increasingly lonely and afraid. She felt little in common with her housemates, many of whom had mental health and substance abuse problems. Sergio was exposed to viral infections and subjected to minor injuries from other children in the shelter. Marisol decided her best option was to run away. Given her lack of resources, education, and skills, Marisol soon found herself dependent on a man who put her back to work as a prostitute. She now keeps her HIV status hidden and avoids interactions with social service agencies or health care providers. Marisol is pregnant again, but her fears, previous experiences, and now, her current captor, keep her from accessing prenatal care or treatment for HIV/AIDS. Her lack of access to health care and information puts others, including her unborn child, at high risk of contracting HIV/AIDS.