Sex Trafficking and Commercial Sex: Outcomes In Suicidality and Economic Strain Among Young Women

Background and Purpose:
Sex trafficking and commercial sex are associated with psychological, economic, and social harms, yet less is known about whether these harms differ between women in commercial sex classified as sex trafficking victims and those who are not. This gap matters for social work because screening and service systems often rely on binary trafficking classifications that may not fully capture variation in risk and intervention needs. In gold-mining communities in Kédougou, Senegal, prior work documented a high prevalence of sex trafficking among women engaged in commercial sex. This study examined whether suicidality, economic strain, food security, and self-efficacy differed by sex trafficking classification, whether sex trafficking classification was independently associated with suicidality after adjustment for age and economic and coping factors, and whether trafficking experience domains and cumulative domain exposure related to suicidality beyond binary classification.

Methods:
Data came from an endline survey of women engaged in commercial sex in the artisanal and small-scale gold mining region of Kédougou, Senegal. Recruitment used link-tracing sampling, and respondent-driven sampling weights were applied in descriptive and regression analyses. The analytic sample included 842 respondents; 450 (53.4%) were classified as sex trafficking victims. Suicidality was measured using the Ultra-Short Suicidal Ideation Scale and modeled as continuous severity and binary any-suicidality outcomes. Predictors included sex trafficking classification, economic strain, food security, self-efficacy, and age. To examine heterogeneity beyond binary classification, four trafficking experience domains were constructed: recruitment and entry mechanisms, employment and debt-related exploitation, coercion and control, and mobility restriction and surveillance. Survey-weighted descriptive and regression analyses were estimated.

Results:
Weighted descriptive comparisons showed modest differences between respondents classified as sex trafficking and those not classified. In multivariable models adjusting for age, economic strain, food security, and self-efficacy, sex trafficking classification was not independently associated with suicidality severity or any suicidality. Greater economic strain was associated with higher suicidality severity (b = 0.078, p = .017) and higher odds of any suicidality (OR = 1.22, 95% CI [1.06, 1.41], p = .006). Higher self-efficacy was associated with lower suicidality severity (b = -0.183, p < .001) and lower odds of any suicidality (OR = 0.69, 95% CI [0.56, 0.85], p < .001). Food security showed a protective trend. Domain prevalence differed sharply by trafficking classification, but no single domain uniquely predicted suicidality after adjustment. Mobility restriction and surveillance showed the strongest risk trend, and cumulative trafficking domain exposure showed a modest dose-response association with suicidality severity (b = 0.063, p = .019).

Conclusions and Implications:
Suicidality among women engaged in commercial sex in Kédougou was more strongly associated with material hardship and coping capacity than with binary sex trafficking classification. Findings suggest that social work screening, assessment, and intervention should move beyond classification alone to address economic strain, strengthen self-efficacy, and assess cumulative trafficking-related harms, particularly restrictions on freedom. This study adds to the social work knowledge base by showing that multidimensional assessment may better identify risk and inform integrated, trauma-informed, and context-responsive responses for women involved in commercial sex and sex trafficking.