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All content in this area was uploaded by Janice Du Mont on May 15, 2023
Content may be subject to copyright.
Social service providers' knowledge of domestic sex trafficking in the
Canadian context
Danielle Jacobson
a
, Janice Du Mont
a
,
b
, Frances Montemurro
a
, Rhonelle Bruder
a
,
Robin Mason
a
,
b
,
*
a
Women's College Research Institute, Women's College Hospital, Toronto, Canada
b
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
ARTICLE INFO
Keywords:
Social service providers
Knowledge
Canada
Sex trafficking
Domestic sex trafficking
ABSTRACT
Canadian research on the domestic sex trafficking of adolescents and adults is in its infancy with little exploration
of social service providers' knowledge. This is an important gap as international research has identified that
providers are well situated yet often lack the knowledge necessary to identify and help sex trafficked persons. The
current study used a critical social approach to examine social service providers' knowledge about domestic sex
trafficking in Canada. Fifteen in-depth, semi-structured interviews were conducted via Zoom with diverse pro-
viders from Ontario. Interviews were analyzed using Braun and Clarke's thematic analysis. Analysis revealed
varying levels of knowledge among providers, sometimes inconsistent with self-rated expertise and experience.
Some providers with moderate-to-high expertise conveyed detailed knowledge of sex trafficking definitions and a
continuum between sex work and sex trafficking while others with the same reported expertise conflated sex work
and sex trafficking, suggesting that they may have over-estimated their level of knowledge. Most discussed
“vulnerabilities”perceived as increasing sex trafficking risk: lack of belonging, stigmatization, societal and in-
dividual level racism. Providers described tactics used by traffickers to lure and retain individuals in sex traf-
ficking. Formal education about sex trafficking across regions and providers was lacking, suggesting that sex
trafficked persons are subject to the “luck of the draw”when seeking help from social service providers. The
development of a core curriculum could help ensure that all social service providers in Canada–and other ju-
risdictions in which domestic sex trafficking is an issue–have the necessary knowledge to appropriately address
sex trafficked persons' needs.
1. Introduction
An estimated 6.3 million individuals worldwide are sexually exploi-
ted (International Labour Organization ILO, 2022). Sex trafficking has
been recognized as a significant public health and human rights issue
with detrimental impacts on the health and well-being of trafficked
persons (Center for Disease Control and Prevention, 2022). While sex
trafficking involves coercion and manipulation of recruited persons and
may also entail the movement of such persons across local or interna-
tional borders (Government of Canada, 2021), domestic sex trafficking
describes individuals trafficked for sexual exploitation within the borders
of a particular country (Macy &Graham, 2012). In Canada, police re-
ported incidents of persons trafficked for the purpose of sexual exploi-
tation have been increasing since 2009 (Conroy &Sutton, 2022).
Despite sexual exploitation being the most common form of
trafficking in Canada (Conroy &Sutton, 2022), there has been little
Canadian focused research on the issue. Studies conducted in other
countries, including the United States, Central, and South America have
revealed gaps in what some health care providers know about trafficking,
including its identification, the needs of sex trafficked persons (occupa-
tional therapists; Bekmuratova et al., 2021), misconceptions about traf-
ficking indicators (health care providers including nurses, social workers,
doctors, and more; Viergever et al., 2015), and differentiating child
survivors of sex trafficking from other forms of child abuse (health care
providers including nurses, social workers, doctors, and more; Beck et al.,
2015). While there are some literature reviews conducted outside of
Canada of health care providers’(e.g., doctors, social workers, nurses)
awareness (Fraley et al., 2020) and knowledge of trafficking (Rapoza,
2022), there has been little focus on those working in social services in
Canada (Hodgins et al., 2022). The research that does exist has been
* Corresponding author. 76 Grenville Street, Toronto, ON, M5S 1B2, Canada.
E-mail address: robin.mason@wchospital.ca (R. Mason).
Contents lists available at ScienceDirect
SSM - Qualitative Research in Health
journal homepage: www.journals.elsevier.com/ssm-qualitative-research-in-health
https://doi.org/10.1016/j.ssmqr.2023.100279
Received 20 June 2022; Received in revised form 1 May 2023; Accepted 1 May 2023
Available online 2 May 2023
2667-3215/©2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-
nc-nd/4.0/).
SSM - Qualitative Research in Health 3 (2023) 100279
primarily quantitative and lacked consideration of how social service
providers themselves characterize their knowledge and knowledge gaps.
The importance of qualitative investigations that incorporate this focus
was highlighted in a study of social service providers’knowledge of sex
trafficking risk for LGBTQþindividuals in the Midwest United States
(Gerassi &Pederson, 2022). While an important contribution to the
literature, it is necessary to understand what social service providers
know about sex trafficking of all persons, supporting those at risk of or
currently being sex trafficked, and the influence of social determinants on
sex trafficking risk (Gerassi et al., 2021).
Education is an important and often overlooked social determinant
(Lancet Public Health, 2020) with impacts on social service providers'
knowledge. While not specific to social service providers, American re-
searchers Havig and Mahapatra (2021) pointed to the importance of
education to strengthen health care providers’confidence in their
knowledge and readiness to care for trafficked persons. Education and
training in the United States has fostered confidence among providers in
identifying sex trafficking and providing services (Beck et al., 2015).
Education in this context may be formal or informal and includes
learning acquired through experiential or practice-based activities.
There has been little Ontario-based research on providers’education
or training needs despite the province having had the highest number of
documented cases of domestic sex trafficking in the country (Royal Ca-
nadian Mounted, 2013). Of the limited research, one study found that
medical students lacked knowledge of, and ability to, identify trafficking
(Wong et al., 2011). Earlier research by McDonald and Timoshkina
(2007) found that Ontario service providers had negative attitudes about
“trafficked sex workers”(p. 211). More recently, Nagy et al. (2018) re-
ported that 58 percent of service providers surveyed in northeastern
Ontario had received no training on (sex) trafficking.
To address this gap in the Ontario-based literature, the current study
forms part of a larger program of research on providers' perceptions of
and capacity to respond to sex trafficked persons. Here we focus our
attention on social service providers' knowledge of domestic sex traf-
ficking in the Canadian context. This study's findings may be useful in
developing core curricula for social services wherever domestic sex
trafficking is an issue.
2. Conceptual Framework
A critical-social approach with a social justice orientation informed
the conceptualization of the research program and guided recruitment,
participation, data collection, and dissemination in this study. Sensitivity
to participants’individual characteristics and life circumstances is an
element of the critical approach particularly appropriate to this study, as
we uncover “sites for change”(Denzin, 2015, p. 33). The knowledge
garnered from critical research on sex trafficking has been emphasized as
necessary to inform needed structural and systemic change (Vollinger,
2021): the social service systems and the institutions that provide these
services, along with related training programs and professional regula-
tory bodies, present promising potential sites.
We explored how social service providers' education and experience
influenced their perceptions of, capacity to respond to, and knowledge
about sex trafficking. We also considered how that knowledge was ac-
quired. Critical-social approaches require reflexivity from researchers
about their social and professional identities and privileges (Day, 2012)
and viewpoints derived from their specific disciplines as they plan and
carry out a study. In this instance, research team members came from
different racial/ethnic backgrounds and had varying levels of employ-
ment security and education in women's health, public health, psychol-
ogy, and social work. These standpoints were particularly relevant to the
interviewing and analytic stages of this study.
3. Methods
Women's College Hospital Research Ethics Board approved this
research in December 2021 (REB# 2021-0133-E).
3.1. Recruitment and participants
Recruitment took place from January 12, 2022, to February 17, 2022.
An email with study information was shared with staff from organiza-
tions across the seven regions of Ontario: central, central west, central
east, southwest, east, northeast, and northwest. The research team also
tweeted a study flyer and posted in a Facebook group used by social
service providers in Canada. Eligibility to participate in the study
required participants to live and practice as a social service provider in
Ontario at the time of the interview. Experience providing services to a
sex trafficked person was not a prerequisite; there was no exclusion to
participation based on the type of social service provider.
Participants who expressed interest in the study were sent a consent
form and a socio-demographic questionnaire (which re-confirmed eligi-
bility) to be completed and emailed to the first author. The consent form
outlined the study's purpose, described the risks and benefits of partici-
pation, and indicated that participation would be anonymous and
confidential. The socio-demographic questionnaire included questions
about participants' social identity (including age, gender identity, race,
ethnicity) in addition to education and experience with sex trafficked
persons. Participants were asked how long they had been working as a
social service provider, how often they provided care to someone who
had been sex trafficked (<1 client/year, 1–5 clients/year, 6–10 clients/
year, >10 clients/year, other), and to self-rate their current overall
expertise in caring for this population (none, low, moderate, high, very
high; see Table 1).
Fifteen social service providers between the ages of 26 and 55
participated in interviews via Zoom (an online video-conferencing soft-
ware that allows for audio-visual taping of online meetings; Zoom Video
Communications Inc., 2016). Twelve participants identified as women
and three as men. Twelve participants worked in urban areas, and three
in suburban areas. Participants identified as white or Caucasian (7), Black
(5), South-Asian (1), or “Canadian”(2). Thirteen participants had an
undergraduate or master's degree. Participants included five super-
visors/managers, two case workers, two social workers, one addictions
worker, one support worker, one harm reduction counsellor, one child
welfare worker, one child and youth care practitioner, and one who
provided no job title.
Three participants had never provided services for sex trafficked
persons, five had provided services to one to five sex trafficked clients per
year, two six to ten clients per year, two more than ten clients per year,
and three did not know. Participants rated their sex trafficking expertise
as none or low (4), moderate (5), moderate/high (2), high (2), or very
high (2). Participants had been working as a social service provider for
between zero and five years (7), six and ten years (3), over ten years (2),
Table 1
Summary of Participant's self-rated experience and expertise.
Participant Sex Trafficking
Expertise
# Sex Trafficked Clients
Per Year
Years of
Experience
Jaime High 1–51–5
Riley Moderate Unknown 1–5
Robin None 0 1–5
Kit Moderate Unknown 6–10
Jordan None Unknown >10
Morgan Moderate/high >10 1–5
Remy Moderate 0 6–10
Wren Moderate 0 <1
Storm Low 1–56–10
Alex High 6–10 30
Phoenix Very high 6–10 1–5
Avery Moderate/high >10 >10
Stevie Moderate 1–5>30
Quinn Low 1–530
Arden Very high 1–51–5
D. Jacobson et al. SSM - Qualitative Research in Health 3 (2023) 100279
2
or 30 or more years (3). As a token of appreciation, participants received
a $25 CAD e-gift card.
3.2. Interview guide
Drawing upon gaps noted in the literature, a semi-structured inter-
view guide was developed and utilized for the larger study on service
providers' knowledge, attitudes, and practices related to sex trafficking. A
team member with a background in social work helped to create the
guide, phrasing questions targeted specifically toward social service
providers. Our goal was to elicit meaningful and in-depth responses from
participants. The interview guide was then peer-reviewed by a qualita-
tive expert from another institution external to the team, and their
feedback was incorporated. This guide helped to ensure that topics of
interest were discussed during the interview while still allowing partic-
ipants to determine the course of the conversation; probes were used to
spark additional thoughtful responses within any particular topic area.
Several questions were adapted from Cunningham and DeMarni Crom-
er’s (2016) Human Trafficking Myths Scale. Questions and prompts
focused on social service providers' knowledge–the focus of this study–
included, among other items: “In your own words, what is sex traf-
ficking?”,“Who do you think are the usual victims of sex trafficking?”,
“What does domestic sex trafficking include?”,“How is sex trafficking the
same/different from sex work?”,“Are certain groups more likely to try to
escape sex trafficking or seek help? Please explain.”,“What social and
other circumstances do you think affect whether someone becomes sex
trafficked?”, and “What formal education or training on sex trafficking
have you had, if any?”
3.3. Data collection
Fifteen one-on-one, in-depth, semi-structured interviews were con-
ducted with social service providers in Ontario, Canada between January
28th, 2022, and February 17th, 2022. Interviews were 1-2 hours in
length. Prior to beginning the recorded interview, participants were
provided with a brief overview of the study and were reminded that they
could stop the interview or skip questions without consequence. All
participants provided verbal consent to begin the audio and video
recording. Pseudonyms were assigned by the interviewer to be used in all
documentation, including this article.
After each interview, the interviewer completed memos which
included initial thoughts, observations, and critical reflections (Phillippi
&Lauderdale, 2018). Audio and video recordings, as well as a
Zoom-generated transcript, were automatically saved on Zoom. Imme-
diately after each interview, these data were saved to a secure OneDrive
file with access limited to the research team, and the Zoom files were
deleted. Interviews were conducted until no significant new information
relevant to the research arose (Caelli et al., 2003;Guest et al., 2006).
Informational redundancy (sometimes referred to as data saturation) was
reached with 15 interviews, at which point no additional changes were
made to the codebook; this is consistent with the literature indicating
that with sufficiently rich data and a targeted scope of the project,
saturation may be reached with approximately 15 interviews (Guest
et al., 2006).
3.4. Data analysis
Data analysis took place from February 3rd, 2022 to May 15th, 2022.
The research team met bi-weekly to reflect on the interviews, to chal-
lenge each other about any implicit biases, and to consider the ways in
which our social identities (Jacobson &Mustafa, 2019) might influence
data interpretation. For example, during data collection, we reflected on
the ways in which the interviewer's socio-economic status and race may
have influenced the way that participants of similar and different back-
grounds answered questions about their own social identity and about
the difficulties they experienced in providing clients with appropriate
care. A reflexive journal was kept throughout the analytic process, doc-
umenting all insights and decisions (Lincoln &Guba, 1985;Nowell et al.,
2017).
Transcripts were de-identified (by removing proper names), checked
for accuracy (by listening to the audio recording while correcting the
text), and uploaded to Dedoose Management Software (Version 9.0.46.,
2022). Braun and Clarke's (2006) six phases for thematic analysis guided
the analytic approach. Two authors repeatedly read transcripts and one
repeatedly listened to interviews (phase one). Initial thoughts and ob-
servations were noted and discussed during team meetings. Team
meetings guided by the senior researchers with expertise in qualitative
and gender-based violence research facilitated thoughtful discussion of
the analytic process. Reflexive fieldnotes and these critical discussions
contributed to trustworthiness and dependability of the findings (Lincoln
&Guba, 1985;Nowell et al., 2017).
Two authors independently coded the first transcript (phase two).
Memos were developed, noting initial thoughts, justifications for codes,
and reflections. The research team then discussed convergences and di-
vergences across the codes. For example, while code names sometimes
differed, there was agreement on the meaning of most of the codes with
few exceptions. At this stage, disagreement on the level of a particular
code (parent or child) was also resolved. Discrepancies were resolved
with ease and the final naming of codes was determined through critical
discussion and revisions of the codebook. This process was repeated for
two additional transcripts and a preliminary codebook was formed. After
the first three transcripts were coded, no new codes emerged. Instead,
similar codes were merged and sub-codes were created, resulting in the
generation of preliminary themes (phase three).
Independent coding continued for five additional transcripts with few
disagreements indicating the reliability of the codebook (Campbell et al.,
2013). The first author coded the remaining transcripts, meeting with the
research team to refine emerging themes (phase four), which were so-
lidified and organized into more nuanced sub-themes (phase five). Re-
petitive emerging themes and/or sub-themes were merged and renamed.
Illustrative quotes from each theme were then identified and extracted
(phase six).
4. Results
Analysis of the interview transcripts resulted in 5 knowledge-related
themes (13 subthemes), including Definitions of Sex Trafficking, the
Continuum of Sex Work and Sex Trafficking, Sex Trafficking: Contextual
and Contributing Factors, Manipulation and Fear: Traffickers' Recruit-
ment and Retainment Tactics, and Knowledge Sources for Learning
About Sex Trafficking (Table 2). Participants' expertise and experiences
are provided the first time they are quoted within a theme to highlight
factors that might influence their knowledge and provide some context
for their comments. Self-rated experience and expertise were collected as
part of participants' socio-demographic information and are provided to
share context into participants’professional backgrounds.
4.1. Definitions of sex trafficking
Most participants described sex trafficking using terms including
“force,”“exploitation,”and/or “coercion,”and emphasized the lack of
consent involved. For example, Jaime (high sex trafficking expertise, 1–5
sex trafficked clients/year, 1–5 years of experience) explained how sex
trafficking happens “without their [the sex trafficked person's] agree-
ment to do so.”Riley (moderate sex trafficking expertise, unknown
number of sex trafficked clients/year, 1–5 years of experience), defined
sex trafficking as “any situation …where an individual is being forced or
coerced and/or threatened in some way to engage in sexual favours.”
While most participants defined sex trafficking in similar ways, there
were some exceptions. For example, Robin (no sex trafficking expertise,
0 sex trafficked clients/year, 1–5 years of experience) said sex trafficking
is “like hijacking or …kidnapping of people and transferring them to
D. Jacobson et al. SSM - Qualitative Research in Health 3 (2023) 100279
3
another place.”Conversely, Kit (moderate sex trafficking expertise, un-
known number of sex trafficked clients/year, 6–10 years of experience)
described the notion of someone being kidnapped and transported as an
inaccurate trope: “It's [sex trafficking] definitely not what we see on TV
…I thought it was just you throw someone in a white van and you move
them around. But I've come to understand through my experience that
it’s manipulation. It's coercion.”
When asked to define domestic sex trafficking, participants offered a
range of interpretations. Some participants with little experience work-
ing with sex trafficked persons interpreted the word “domestic”to mean
the trafficker was either part of or close with the survivor's family. Jordan
(no sex trafficking expertise, unknown number of sex trafficked clients/
year, >10 years of experience) described, “It would be more of a …
family situation. Whether it would be by a family member, a friend, a
known person.”More experienced participants indicated that “it's
Table 2
Summary of themes with illustrative quotes.
Theme Sub-Theme Illustrative Quote
Definitions of Sex
Trafficking
“[A]ny situation …where an
individual is being forced or
coerced and/or threatened
in some way to engage in
sexual favours.”-Riley
The Continuum of Sex
Work and Sex
Trafficking
Opposite Ends of the
Continuum
“I talk about a continuum …
choice would be on the one
side where the person is
choosing to do this, is
deciding when they work,
who they see, what services
they offer, what they
charge, and they keep the
funds …trafficking is the
other end of the continuum
with someone tricking
someone or forcing them to
do something they don't
want to do.”-Alex
Recognition of Fluid
Status on the Continuum
“It can be hard to know
sometimes where it begins
and ends …it's more of a
continuum than black and
white …It can be not full
coercion all of the time,
sometimes circumstantial,
sometimes in between”-
Morgan
Conflating Sex Work and
Sex Trafficking
Sex trafficking is when
someone “engage[s] in some
illegal sex work.”-Robin
Sex Trafficking:
Contextual and
Contributing Factors
Vulnerability Due to
Lack of Belonging
“There's some individual
factors that would make you
more likely to be a target …
maybe you're struggling at
home or at school, you've got
low self-esteem …you don't
have that unconditional love
at home with parents.”-Alex
Vulnerability Due to
Stigmatization
“People who are in
minorities, whether it's
because they have a
disability …or if it's a sexual
or gender-based identity
issue, or a race thing …
they're already feeling like
they can't reach out for help
to begin with because they
are used to that
stigmatization …
[Traffickers] are used to
looking for those
insecurities.”-Riley
Vulnerability Due to
Societal and Individual
Level Racism
“Race plays a part in it. We
know that Indigenous and
Black women are more
vulnerable [to sex
trafficking] …That comes
into systemic issues around
inequities in our society with
pay and education, and
environmental racism, how
we build our neighborhoods
and what resources we put in
our neighborhoods, and who
lives there.”-Kit
Manipulation and Fear:
Traffickers'
Recruitment and
Retainment Tactics
Entering into Sex
Trafficking
“Whatever the vulnerability
is, they [traffickers] hone in
on that and exploit that to
gain trust of the victim and
bring them in. And they
isolate them from their
friends and their family …
And then gradually, it slowly
Table 2 (continued )
Theme Sub-Theme Illustrative Quote
turns. Like, ‘well, all this
stuff I [the trafficker] gave
you wasn't free …and now
you have to pay this back.’”-
Stevie
Remaining in Sex
Trafficking
“Sex trafficked persons
feared that traffickers would
'kill' them if they 'tried to
leave' or if they said
'anything [about sex
trafficking] to anyone.”-
Quinn
Leaving Sex Trafficking “It's important not to make
promises you can't keep, like,
‘we're going to take care of
you, everything's gonna be
fine.’It probably won't be for
a while …It has to get to a
point for that person where
the situation that they're
currently in is worse than the
one that they might find
themselves in [upon
exiting].”-Morgan
Knowledge Sources for
Learning about Sex
Trafficking
Learning about Sex
Trafficking in School
“In school, the approach is
very stigmatizing. I didn't
like how they talked about it
…it's so outdated …they
give the impression …that
she's voiceless, she doesn't
know, like she's an idiot.”-
Kit
Learning about Sex
Trafficking on the Job
“Whenever I graduated …
there was not that focus [sex
trafficking]. It was not where
my education was. It was just
the nature of my work that
kind of led me there.”-Stevie
Learning about Sex
Trafficking from
Webinars/Seminars and
Social Media
“We talk and we share our
interests and everything
from Facebook …we ask
each other how to help
people out of it [sex
trafficking].”-Phoenix
Need for Sex Trafficking
Education and Training
“[Having] education and
tools about the services and
the supports to help [sex
trafficked] people …I would
feel far more confident in
broaching that topic, or
sharing those things, or
knowing what to look for …
If it's not something that
you're aware of …how do
you know what to do?”-
Jordan
D. Jacobson et al. SSM - Qualitative Research in Health 3 (2023) 100279
4
domestic because [the sex trafficked person is] not being moved across a
border of any kind”(Morgan; moderate/high sex trafficking expertise,
>10 sex trafficked clients/year, 1–5 years of experience). Some partici-
pants conveyed both notions. Remy (moderate sex trafficking expertise,
0 sex trafficked clients/year, 6–10 years of experience) described, “Do-
mestic could be within your country, potentially. Or domestic meaning
whether it be your father, your mother, your sister, your brother traf-
ficking you …I think you could look at it both ways.”
Other participants were hesitant about defining domestic sex traf-
ficking. Wren (moderate sex trafficking expertise, 0 sex trafficked clients/
year, <1 year of experience) stated, “I'm not very sure of the term do-
mestic sex trafficking,”while Kit said, “I don't think I've heard of that
term,”and Riley explained, “[T]his is where it kind of gets a little more
out of my element.”Participants' familiarity with sex trafficking did not
necessarily indicate knowledge of domestic sex trafficking specifically.
4.2. The continuum of sex work and sex trafficking
4.2.1. Opposite ends of the continuum
Participants discussed the difference between sex work and sex traf-
ficking, often acknowledging a continuum between the two. The dis-
tinguishing factor was choice: “Sex work is work. People make choices to
do that work. Whereas I think with sex trafficking, that's not the case”
(Storm; low sex trafficking expertise, 1–5 sex trafficked clients/year,
6–10 years of experience). The presence or absence of consent helped
participants place sex work and sex trafficking at opposite ends of a
continuum (see Fig. 1). Alex (high sex trafficking expertise, 6–10 sex
trafficked clients/year, 30 years of experience) explained:
I talk about a continuum …choice would be on the one side where the
person is choosing to do this, is deciding when they work, who they
see, what services they offer, what they charge, and they keep the
funds …trafficking is the other end of the continuum with someone
tricking someone or forcing them to do something they don't want to
do.
Somewhere between choice (sex work) and coercion (sex trafficking),
participants described circumstantial or survival sex work. Alex
continued:
In the middle, you've kind of got that circumstantial sex work where
we see it with homeless …people with mental health or addictions
issues. Their situations are just naturally exploit[at]ive. But a third
person isn't doing it to them …It's kind of that grey area.
This complex “middle”of the continuum included engaging in sex
work when, for example, it was “the only way for [the person] to support
their addiction”or “survive on the street”(Morgan; moderate/high sex
trafficking expertise, >10 sex trafficked clients/year, 1–5 years of expe-
rience). Circumstantial or survival sex work were considered exploitative
when consent was limited by an individual's circumstances.
4.2.2. Recognition of fluid status on the continuum
Participants reflected that individual circumstances were not always
static, which made distinguishing between choice (sex work) and force
(sex trafficking) difficult: “It can be hard to know sometimes where it
begins and ends …it's more of a continuum than black and white …It
can be not full coercion all of the time, sometimes circumstantial,
sometimes in between”(Morgan). As an individual's circumstances
change, so may their status on the continuum. For example, Kit (mod-
erate sex trafficking expertise, unknown number of sex trafficked clients/
year, 6–10 years of experience) described working with a “pimp”who
made “the girl believe that she's his girlfriend,”and then got her to
perform sexual acts for money. Kit had difficulty deciphering whether
this really constituted a choice: “I had to learn how this was still sex
trafficking because the misconception is …she knows what's happening
…she's getting in the car and going to the hotel.”Kit elaborated on their
understanding of the transformation from choice into force: “They do it
[circumstantial sex work] as a choice, because you have a mouth to feed.
And then …you're stuck because you don't get to walk off …It's not like,
‘I quit!’” The inability to exit sex work was the juncture at which par-
ticipants viewed a change in an individual's status on the continuum from
sex work to sex trafficking.
4.2.3. Conflating sex work and sex trafficking
Some participants conflated sex work and sex trafficking or described
colleagues who “confus[ed]”the two terms. For example, Robin (no sex
trafficking expertise, 0 sex trafficked clients/year, 1–5 years of experi-
ence) defined sex trafficking as when someone “engag[d] in some illegal
sex work.”Phoenix (very high sex trafficking expertise, 6–10 sex traf-
ficked clients/year, 1–5 years of experience) also defined sex trafficking
as when people are “sold out for sex work.”Though describing sex traf-
ficking, the language of sex work was used, thereby blurring the line
between the two. Storm described the impact of this conflation, articu-
lating that it “can be really challenging when working on a team of
people”who “confuse sex work and sex trafficking as being the same
thing”as this made it difficult to “develop safety plans”for clients and to
“support [their] choices.”
4.3. Sex trafficking: Contextual and contributing factors
Participants discussed social identities and circumstances they
thought influenced sex trafficking risk. They indicated that traffickers
targeted “young”(Morgan; moderate/high sex trafficking expertise, >10
sex trafficked clients/year, 1–5 years of experience), “Indigenous and
Black women”(Kit; moderate sex trafficking expertise, unknown number
of sex trafficked clients/year, 6–10 years of experience), “looking for …
relational support”(Avery; moderate/high sex trafficking expertise, >10
sex trafficked clients/year, >10 years of experience), those with “low
socio[economic status]-income”(Robin; no sex trafficking expertise,
0 sex trafficked clients/year, 1–5 years of experience), and “anybody
who's immigrated recently”(Riley; moderate sex trafficking expertise,
unknown number of sex trafficked clients/year, 1–5 years of experience).
“Vulnerability”was identified as a common concept across the social
identities discussed.
4.3.1. Vulnerability due to lack of belonging
Participants believed that individuals who felt they did not belong
were potentially at a higher risk for sex trafficking. Alex (high sex traf-
ficking expertise, 6–10 sex trafficked clients/year, 30 years of experi-
ence) explained, “There's some individual factors that would make you
more likely to be a target …maybe you're struggling at home or at school,
you've got low self-esteem …you don't have that unconditional love at
Fig. 1. The continuum of sex work and sex trafficking.
D. Jacobson et al. SSM - Qualitative Research in Health 3 (2023) 100279
5
home with parents.”Vulnerability to sex trafficking was considered
higher when there was a lack of familial and social connection. Avery
described how “a lot of pimps kind of play on,”and “build up”these
feelings of being “an outsider,”“having low self-esteem,”and the “need
to feel loved”. Participants viewed traffickers as experts at identifying
and targeting such insecurities.
4.3.2. Vulnerability due to stigmatization
Another vulnerability described by participants was stigmatization
faced by minorities:
People who are in minorities, whether it's because they have a
disability …or if it's a sexual or gender-based identity issue, or a race
thing …they’re already feeling like they can't reach out for help to
begin with because they are used to that stigmatization …[Traf-
fickers] are used to looking for those insecurities. (Riley)
Stigmatization was viewed as an impediment to a person's ability to
“reach out for help”—a“vulnerability”that traffickers appeared to be
experts at targeting. Participants further discussed vulnerabilities rooted
in intersecting determinants of health (e.g., sexuality, social network,
housing, and their influence on mental health and addiction):
That population [LGBTQ2Sþ] tends to have higher mental health
issues, addictions, homelessness …which then also leads to more of
those vulnerabilities …that isolation from the positive supports in
your life that can happen when somebody has come out. (Morgan)
Lack of social support resulting from intersecting forms of stigmati-
zation–in particular as experienced by the LGBTQ2S þcommunity,
homeless persons, and individuals with addictions–was seen to increase
vulnerability to sex trafficking.
4.3.3. Vulnerability due to societal and individual level racism
Some participants viewed more significant societal inequities rooted
in racism as informing the vulnerabilities that led to an increased risk of
sex trafficking. Kit explained:
Race plays a part in it. We know that Indigenous and Black women are
more vulnerable [to sex trafficking] …That comes into systemic is-
sues around inequities in our society with pay and education, and
environmental racism, how we build our neighborhoods and what
resources we put in our neighborhoods, and who lives there.
The sentiment that structural racism contributed to the vulnerabilities
that increased sex trafficking risk was echoed by Robin, who clarified
that such individuals “don't have the kind of support as other people, like
other races.”Storm (low sex trafficking expertise, 1–5 sex trafficked
clients/year, 6–10 years of experience) described how the “medical
system, social services, [and] police”have had a “past and current history
of bringing down violence on those communities”since such institutions
“were instrumental in taking children away from [Indigenous] families
…[and] often don't look for people when they're missing.”For these
reasons, Storm explained that “accessing support can be really chal-
lenging and difficult and perhaps not safe for them [racialized persons].”
Although participants recognized some of the many structural and
institutional forms of racism that could increase vulnerability to traf-
ficking, the lack of “safe”social and other supports was given particular
emphasis.
4.4. Manipulation and fear: Traffickers’recruitment and retainment
tactics
4.4.1. Entering into sex trafficking
Most participants discussed the manipulation they thought was
involved in luring an individual into sex trafficking, which included the
trafficker “getting to know …what they're [sex trafficked persons]
hoping for, what their dreams are”(Alex; high sex trafficking expertise,
6–10 sex trafficked clients/year, 30 years of experience). Stevie (mod-
erate sex trafficking expertise, 1–5 sex trafficked clients/year, >30 years
of experience) described this process: “It kind of boils down to a sense of
belonging and a sense of ‘finally someone understands me, someone gets
me. And my family doesn't get me, but these people get me …They're
getting me the things I need.’” Traffickers were described as exploiting a
sex trafficked person's lack of belonging by fulfilling their unmet needs,
constructing an illusion of belonging to gain individuals' trust and drive
them away from family and friends. Stevie continued:
Whatever the vulnerability is, they [traffickers] hone in on that and
exploit that to gain trust of the victim and bring them in. And they
isolate them from their friends and their family …And then gradu-
ally, it slowly turns. Like, ‘well, all this stuff I [the trafficker] gave you
wasn't free …and now you have to pay this back.’
As expressed by several participants, these manipulation tactics
culminate with traffickers requiring they be “pa[id] …back”for fulfilling
material needs—a stipulation not previously shared with the sex traf-
ficked person.
Some participants also discussed trafficking by the individual's fam-
ily. Riley (moderate sex trafficking expertise, unknown number of sex
trafficked clients/year, 1–5 years of experience) conveyed that “some
clients are born into [sex trafficking],”and Alex explained:
We had one young girl …whose mother was involved in the traf-
ficking [as the trafficker] …And she [the girl] wanted to leave. And
she’s not the only one. We’ve had other ones where family is involved
[as the trafficker]. If they leave, they are going to have no contact
with anyone, because everyone in their life is involved in that life.
In circumstances when a family member was the trafficker, partici-
pants perceived that the lack of connection to other positive social sup-
ports reinforced vulnerabilities to sex trafficking.
4.4.2. Remaining in sex trafficking
Participants described scare tactics traffickers used to prevent sex
trafficked persons from (considering) leaving. For example, traffickers
threatened that if sex trafficked persons left, they would end up finding
“someone else who's going to rape”them (Riley) or would “be on the
streets the rest of your [their] life”(Remy; moderate sex trafficking
expertise, 0 sex trafficked clients/year, 6–10 years of experience). Quinn
(low sex trafficking expertise, 1–5 sex trafficked clients/year, 30 years of
experience) described how sex trafficked persons feared that traffickers
would “kill”them if they “tried to leave”or if they said “anything [about
sex trafficking] to anyone.”Traffickers not only “threatened [their]
family”(Remy), but also coerced survivors to stay in sex trafficking by
breaking them “down psychologically [and] mak[ing] them afraid”
(Alex) of what may happen to them should they leave.
Participants also thought traffickers instilled fear that the sex traf-
ficked person would lack support upon exiting trafficking. Riley
described sex trafficked persons' apprehension that “people won't believe
them, that they won't be heard.”Robin (no sex trafficking expertise, 0 sex
trafficked clients/year, 1–5 years of experience) echoed this sentiment,
“They're fearing maybe going back to the society [that] would start
judging them.”To retain trafficked persons, traffickers not only incited
fear about a lack of social support, but invoked fear of an unforgiving,
judgmental society.
4.4.3. Leaving sex trafficking
Some participants emphasized the difficulty in helping someone exit
sex trafficking. Morgan explained how “social services agencies cannot
fill all of those things that they're getting”from the trafficker, which
makes it “a hard sell …to leave [trafficking].”Especially if a person faced
drug addiction, a need for which social services were unable to provide,
Jordan (no sex trafficking expertise, unknown number of sex trafficked
clients/year, >10 years of experience) described how it becomes “very
D. Jacobson et al. SSM - Qualitative Research in Health 3 (2023) 100279
6
difficult …to make a sound decision to …try and leave.”Some partic-
ipants knew they would be unable to fully meet their client's needs,
which evidenced the importance of knowing about and discussing the
realities of exiting trafficking. Morgan said,
It's important not to make promises you can't keep, like, ‘we're going
to take care of you, everything's gonna be fine.’It probably won't be
for a while …It has to get to a point for that person where the situ-
ation that they're currently in is worse than the one that they might
find themselves in [upon exiting].
Participants also described facilitators they viewed as beneficial to a
person exiting sex trafficking, including familial and community support:
“Whether it's family support or they have built the support within the
community …they need that support to be able to get out”(Avery;
moderate/high sex trafficking expertise, >10 sex trafficked clients/year,
>10 years of experience). Morgan explained how these forms of support
filled the gaps presented by the absence of social service supports
“outside of regular office hours,”leading to more “success”in exiting
trafficking for these individuals: “At 5:30 on a Saturday night, there isn't
really much [formal support] …Personal supports …can be a huge factor
in making it [exiting] a little bit easier.”Having other informal familial
and community support was considered essential to a person's successful
efforts to leave sex trafficking.
4.5. Knowledge sources for learning about sex trafficking
4.5.1. Learning about sex trafficking in school
With the exception of two participants, the majority described not
having learned about sex trafficking during their formal education. Kit
(moderate sex trafficking expertise, unknown number of sex trafficked
clients/year, 6–10 years of experience) explained that there was just one
lesson in which sex trafficking was discussed and they found the content
was stigmatizing and unhelpful to their practice: “In school, the approach
is very stigmatizing. I didn't like how they talked about it …it's so
outdated …they give the impression …that she's voiceless, she doesn't
know, like she's an idiot.”However, most participants who discussed
their schooling indicated that they had not learned anything about sex
trafficking. In particular, the term “sex trafficking”may not have been
introduced to participants who had been a social service provider for 10
or more years. Jordan (no sex trafficking expertise, unknown number of
sex trafficked clients/year, >10 years of experience) described, “I don't
even think I knew that word or that term [sex trafficking] way back
then.”Given their lack of formal education on sex trafficking, partici-
pants sought other sources of knowledge.
4.5.2. Learning about sex trafficking on the job
Much of participants’knowledge of sex trafficking was learned on the
job. Stevie (moderate sex trafficking expertise, 1–5 sex trafficked clients/
year, >30 years of experience) stated, “Whenever I graduated …there
was not that focus [sex trafficking]. It was not where my education was. It
was just the nature of my work that kind of led me there.”Alex (high sex
trafficking expertise, 6–10 sex trafficked clients/year, 30 years of expe-
rience) further explained that they “did not go to school for this”and “on
the job learning was a big piece”of their sex trafficking education. Par-
ticipants had to go out of their way, connect with other professionals, and
undergo trial and error to learn about sex trafficking and support those
who were trafficked.
4.5.3. Learning about sex trafficking from webinars/seminars and social
media
All participants sought out further learning on sex trafficking,
whether through webinars/seminars or social media. Webinars/seminars
were typically 1-3 hours long and organized by service agencies or uni-
versities. Participants noted a variety of topics presented during these
sessions: survivors’stories, “what has to be involved to make it human
trafficking,”“the difference between sex work and trafficking”(Remy;
moderate sex trafficking expertise, 0 sex trafficked clients/year, 6–10
years of experience), geographic areas where traffickers recruit, “ways
that you [the social service provider] can offer support”(Jordan), simi-
larities to domestic violence, and “empowering male youth to speak up”
(Stevie). Some participants said it was most helpful when a survivor
spoke at these sessions, as hearing from survivors drew “local connec-
tions”to the educational information and to “really hit home …just how
easily it [sex trafficking] can happen to someone”(Jordan).
Some participants read news articles to learn more about sex traf-
ficking whereas others such as Robin (no sex trafficking expertise, 0 sex
trafficked clients/year, 1–5 years of experience) read articles shared by
colleagues on Facebook. Phoenix (very high sex trafficking expertise,
6–10 sex trafficked clients/year, 1–5 years of experience) was also part of
a group of social service providers on Facebook, where links to articles
and webinars were shared: “We talk and we share our interests and
everything from Facebook …we ask each other how to help people out of
it [sex trafficking].”While participants turned to YouTube, Facebook,
and Twitter to learn about sex trafficking, Robin had “never seen any
educative stuff on Instagram.”Participants favoured some media chan-
nels over others to learn about sex trafficking.
4.5.4. Need for sex trafficking education and training
Approximately half of the participants conveyed the importance of
training for all social service providers since, as Quinn (low sex traf-
ficking expertise, 1–5 sex trafficked clients/year, 30 years of experience)
put it, “social service workers probably see them [sex trafficked persons]
more than most.”Quinn continued, “Sex trafficking should be mandatory
in all training moving forward for frontline workers of any ilk, because …
there is that lack of frontline knowledge that's a big big big big piece to all
of this.”Participants described the need for more formalized, compre-
hensive, and in-depth training. Jordan explained how “listening to an
hour-long presentation”was “a good start,”but “people need more than
that.”Jordan continued:
[Having] education and tools about the services and the supports to
help [sex trafficked] people …I would feel far more confident in
broaching that topic, or sharing those things, or knowing what to look
for …If it’s not something that you’re aware of …how do you know
what to do?
Kit shared this sentiment, explaining, “Let me know where am I
supposed to go with [sex trafficked persons] once I've discovered that this
is their situation …It's frustrating because it's like, I can't help them
unless …They tell us what to do.”With more comprehensive sex traf-
ficking education, participants indicated that they would feel more
confident in their capacity to provide services to this population. Existing
single webinar/seminar sessions were viewed as insufficient preparation.
Often, participants themselves requested and arranged these
singleton sessions, which Stevie described as “quite a lot of work …to get
approved.”Other times, there was a lack of funding for such training.
While supervisors were meant to pass on information they learned at
seminars to frontline workers, this was not always the case. Storm (low
sex trafficking expertise, 1–5 sex trafficked clients/year, 6–10 years of
experience) explained, “Our management team was getting training
around it [sex trafficking], but that information wasn't trickling down …
That can be often the case when there's [a] lack of funds available.”
Participants' ability to access webinar/seminar sessions was therefore
varied and inconsistent.
5. Discussion
This study represents a significant contribution to the sparse litera-
ture on sex trafficking, an issue of international relevance and impor-
tance. We addressed a prominent gap in the literature by exploring social
service providers’current knowledge and sources of information about
D. Jacobson et al. SSM - Qualitative Research in Health 3 (2023) 100279
7
domestic sex trafficking in Canada. The gaps and inconsistencies iden-
tified may be useful for the design of formal education, a vital structural
determinant (Lancet Public Health, 2020) of equitable social service
provision to sex trafficked persons.
Our findings are consistent with Drury Hudson’s (1997) model of five
types of knowledge, which were evidenced throughout the interviews
and substantiated through the analysis. These differing types of knowl-
edge, as mapped onto social service providers' areas of knowledge on sex
trafficking, has implications for the design of future formal education.
For example, theoretical knowledge (“a set of concepts, schemes, or frames
of reference”, p. 38) was demonstrated by the providers who offered
clear definitions of sex trafficking and the distinctions between sex
trafficking, circumstantial or survival sex work, and sex work. This type
of knowledge was distinct from personal knowledge (“intuition, cultural
knowledge and common sense”, p. 38),exemplified by those who
recognized the many intersecting vulnerabilities that contributed to
increased risk of recruitment into sex trafficking. Practice-based knowledge
(“gained from the conduct of …practice”, p. 38) was evident among
those who described traffickers' recruitment and retention tactics and
challenges for individuals attempting to leave sex trafficking. Providers
who understood how to support a sex trafficked person leaving the
trafficking situation demonstrated procedural knowledge (“organizational,
legislative, or policy context”,p.38). Providers did not reference sex
trafficking research, which would have evidenced empirical knowledge
(“derived from research”; p. 38); this is not surprising given the infre-
quency of sex trafficking education and training opportunities among this
cohort. While they did not specifically reference extant scholarship,
many providers acknowledged sex work and sex trafficking as different
points along a continuum, which reflects published literature (De Shalit
et al., 2020).
Some social service providers who indicated moderate to high
expertise conveyed in-depth knowledge about sex trafficking and sex
trafficking risk. For example, vulnerability to being sex trafficked was
identified by some (moderate to high expertise) as associated with a lack
of belonging, stigma, and structural and individual racism. Gerassi et al.
(2021) reported that some social service providers in their study recog-
nized the consequences of structural oppression leading to the “over-
representation of women of color at risk of sex trafficking”(p. 10). While
some participants in that study acknowledged the intersection of specific
social determinants of health including racism and classism, providers in
the current research instead alluded to the many “systemic issues”rooted
in current and historical racism as they were related to sex trafficking
risk. Vulnerability was also highlighted by a few providers (moderate to
high expertise) with reference to stigma faced by the LGBTQ2S þcom-
munity. Similar to those in a study by De Shalit et al. (2020) who dis-
cussed the intersection between survival sex work and addiction,
providers in this study acknowledged the ways in which addiction,
homelessness, and isolation increased risk of sex trafficking.
By considering social service providers' differing forms of knowledge,
we have begun to identify knowledge gaps and inconsistencies in what
they knew about sex trafficking and the ad hoc ways by which they ac-
quired (or did not acquire) this information. Sometimes, there were
discrepancies between providers’self-rated sex trafficking expertise and
the information they shared in the interviews. Some providers were
overly confident; for example, while a few (moderate expertise) were
unable to describe domestic sex trafficking, another participant (very
high expertise) conflated sex trafficking with sex work. Perhaps an
inability to differentiate sex trafficking from domestic sex trafficking or
even sex work should not be surprising given that in Canada, there is
often confusion in defining and distinguishing what is meant by these
terms (De Shalit &van der Meulen, 2015). It is important not to conflate
or mislabel sex trafficking (characterized by coercion) and sex work
(characterized by choice) because the needs of each respective group can
be very different.
Our finding that social service providers lacked a robust under-
standing of sex trafficking mirrors those of other studies, wherein some
frontline service providers (e.g., health care providers; (Beck et al., 2015;
Havig &Mahapatra, 2021;Viergever et al., 2015), medical students
(Wong et al., 2011), occupational therapy students (Bekmuratova et al.,
2021)) were deficient in their knowledge of trafficking. Given that, in the
current study, providers' self-rated expertise and practice-based experi-
ences were not always reflected in the knowledge they shared during the
interviews, further research is needed to understand how self-assessment
of expertise corresponds with actual knowledge. It might be useful to
investigate whether self-rated expertise is associated with particular
types of knowledge (i.e., theoretical versus practice-based) and how this
may affect provider confidence and service provision. This is important
as higher self-efficacy regarding trafficking knowledge may “lead to the
provision of appropriate services …in meeting the complex needs of
trafficked persons”(Bekmuratova et al., 2021, p. 7). Nsonwu et al.’s
(2017) Perceptions, Knowledge, and Attitudes About Human Trafficking
Questionnaire and Houston-Kolnik et al.’s (2016) Sex Trafficking Atti-
tudes Scale may be useful for future studies to quantitatively assess social
service providers' knowledge regarding trafficking in the Canadian
context.
The varying levels and types of knowledge exhibited by social service
providers in this study may reflect their lack of formal education on sex
trafficking. One provider who had obtained information about sex traf-
ficking during their professional education only received one related
lesson that stereotyped and stigmatized sex trafficked persons and was
unhelpful. Most providers learned about sex trafficking through practice-
based experience, by sharing and reading articles, or by attending
webinars/seminars. Providers indicated that these piecemeal educational
opportunities were helpful to their overall knowledge about sex traf-
ficking but were nonetheless insufficient. Providers pointed to an urgent
need for formal training for frontline service workers (beyond a single
webinar session, for example) to augment their knowledge of sex traf-
ficking and apply that knowledge in practice.
5.1. Recommendations
The identified gaps and inconsistencies in social service providers'
knowledge are useful to inform the design and core content of formal
education initiatives. Such training has the potential to significantly in-
fluence service providers’knowledge of sex trafficking and skill in
identifying and caring for those who have been trafficked (Stoklosa et al.,
2015). Training has been recommended for professionals including
counsellors (Litam &Lam, 2021), occupational therapist doctoral stu-
dents (Bekmuratova et al., 2021), medical trainees (Talbott et al., 2020;
Wong et al., 2011), and other providers (Beck et al., 2015;Grace et al.,
2014;Recknor et al., 2018). Suggestions for training content have
included insights from survivors (e.g., “acceptable approaches to physical
and psychosocial exams”;Chisolm-Straker et al., 2020, p. 410) and ex-
perts (e.g., “a multidisciplinary team response,“;Stoklosa et al., 2020,p.
405).
Recent work has also stressed the need for a “critically conscious
approach”to social service provider training in order to “convey the roles
of white supremacy and oppression that result in the overrepresentation
of Black, Latinx, and Indigenous communities in sex trafficking”(Gerassi
et al., 2021, p. 12). It is therefore important that education and training
programs include content on the social, political, and historical circum-
stances that have led to a disproportionate number of sex trafficked
persons from marginalized communities. Further, training programs
must incorporate a critical lens to encourage providers to question and
challenge the many assumptions and implicit biases that can permeate
social service institutions and providers’practices.
Given the consistent recommendations on the need for formal
training on human trafficking and what that training might include, there
is little reason for social service providers to go without this essential and
necessary education (Chisolm-Straker et al., 2012;Donahue et al., 2019;
Miller et al., 2020). Designing the training to promote competence within
each of Drury Hudson's (1997) types of knowledge will help minimize
D. Jacobson et al. SSM - Qualitative Research in Health 3 (2023) 100279
8
inconsistencies in providers' knowledge and eliminate the random “luck
of the draw”that currently shapes sex trafficked persons' access to pro-
viders with the requisite knowledge to appropriately help.
5.2. Limitations
It is important to note that given its qualitative methodology, this
study is not generalizable. The small sample included, though repre-
senting a range of social service providers across multiple occupational
settings, is not meant to represent the greater population and perspec-
tives within each occupational category. A more robust sample may have
brought additional considerations to the forefront. The results are
therefore particular to the time, locale, and Canadian cultural context
where interviews were conducted. Participants who informed this
research also lived in urban and suburban areas and may therefore have
had more possible encounters with sex trafficked persons than those in
rural or remote locations.
5.3. Strengths and future research
Further work is necessary to explore potential similarities and dif-
ferences in providers' knowledge across different locales, which may
shape additional recommendations for education. While the range of
providers included in the current study allowed for a broad scope
necessary to understand various social service providers’general
knowledge about sex trafficking, it may be prudent for future research to
hone in on the knowledge held by providers in particular institutions
(e.g., hospitals versus government assistance) to determine the unique
knowledge gaps and educational needs of particular providers in specific
spaces.
To the best of our knowledge, this is the first study in the Canadian
context to explore and build an understanding of social service providers'
knowledge and sources of information about domestic sex trafficking.
However, the current research is only a first step in elucidating the cur-
rent state of frontline providers' knowledge on the subject given our focus
only on social service providers in Ontario. Considering the sparse
literature on this topic in the Canadian context and the boundaries of this
formative research, the particular ways in which educational in-
terventions should be implemented are outside of this project's scope.
Future research may focus on the appropriate application of educational
interventions within various social service institutions with the goal of
narrowing existing knowledge gaps. This research may include various
types of social service providers and their knowledge about sex traf-
ficking, attitudes toward survivors, and practices of care in the broader
Canadian context, with the aim of ascertaining their educational and
practice-based needs (Jacobson et al., 2022). Insights gained from such
future work will help determine if different types of providers within
varying regions of Canada have disparate knowledge gaps that could be
addressed through one core curriculum.
6. Conclusion
Our study revealed that sex trafficked persons might face the “luck of
the draw”when encountering social service providers in Ontario, Can-
ada. We found significant gaps in sex trafficking knowledge as well as
substantial variability in what was known across providers. Moreover,
self-rated expertise did not always reflect the provider's comparative
level of sex trafficking knowledge. Our findings strongly support the
development and implementation of a core training module on sex
trafficking–a training that can incorporate and reflect the varying social
identities and circumstances of both providers and survivors.
Credit author statement
DJ: Conceptualization, methodology, investigation, formal analysis,
writing-original draft, writing-review &editing.
JDM: Conceptualization, methodology, formal analysis, writing-
review &editing, supervision, funding acquisition.
FM: Formal analysis, writing-review &editing.
RB: Methodology, writing-review &editing.
RM: Conceptualization, methodology, formal analysis, writing-
review &editing, supervision, funding acquisition.
Declaration of competing interest
We have no conflicts of interest to declare.
Acknowledgements
We gratefully acknowledge funding support from HART foundation.
The views expressed in this article do not necessarily reflect those of the
funder. We would also like to thank Dr. Frances Recknor for providing
feedback on an earlier draft of this manuscript and Emma Kelly for
editorial review and assistance.
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