Potential Solutions/Ethical Dilemmas

Public health has a tradition of protecting communities from communicable diseases. An ongoing dilemma is the need to balance person rights with the need for protection of the larger society. A difficult question for even the most committed advocates of HIV/AIDS immigrants and trafficking victims is how to achieve this balance. Some communicable diseases including drug-resistant tuberculosis, malaria, and polio are believed to be on the increase in the United States due to the presence of illegal immigrants (Pelner, 2005). The possibility of HIV/AIDS infected sex workers with to potential spread the disease to others including their own unborn children has ethical, medical, and financial implications. There is a need to consider the risk factors in planning successful interventions that might protect both individuals and the larger society.

It is known that certain policy interventions, including tighter border controls and the legalization of prostitution fail to reduce the incidence of human trafficking. More restrictive immigration laws and the legalization of prostitution may actually provide greater opportunities for traffickers (Chuang, 2005; Dougherty, 2006; Webber & Shirk, 2005).

Persons desperate to escape lack of opportunities or violence in their home countries are much more vulnerable when their presence and activities are hidden.

At the most basis level, interventions can begin with provision of information about human trafficking and more specifically, HIV/AIDS risks and prevention. Some programs, including prevention efforts in Korea, have demonstrated effectiveness through public information (Schuckman, 2006). Potential victims and professionals likely to come in contact with potential victims are provided with information about human trafficking, cautioning about potential risks. On a domestic level, health care providers, shelter workers, and law enforcement personnel likely to encounter trafficking victims need training in how to recognize and assist victims (Maxell, Cravioto, Galvan, Ramirez, Wallisch, & Spense, 2005; Webber & Shirk, 2005). Knowledgeable and resourceful professionals might help trafficking victims access legal, health, and social support systems. Connection to resources is not only essential for individual victims, but for the protection of society, including potential unborn children of trafficking victims. On a global level, potential trafficking victims can be provided with information in their home countries that may help lessen vulnerability to exploitation. Human rights, as well as individual needs, are public health concerns (de Caralho, Ayres, Paiva, Franca, Gravato, Lacerda, Negra et al., 2006).

Empowerment models allow for the development of interventions based on stated needs and desires of those impacted versus the agendas of organizations providing care. Some note that “rescue efforts” are not likely to be successful if a holistic approach including specialized shelter, case management, legal and practice services are not provided. Effective interventions need to consider the actual wants and needs of trafficking victims. Care should be taken to avoid further exploitation and trauma by promoting organizational agendas with little input from trafficking victims themselves (Davies, 2004). Cultural and language barriers may impair advocacy efforts, thus need to be addressed in intervention strategies (Gavagan & Brodyaga, 1998). Legal representation is essential, given the complexity of laws and policies, as well as discretion within systems. Services and advocacy may be limited in rural areas, resulting in a need for creative networking and information sharing (Chuang, 2004).