The Impact of COVID-19 on Research with Sex Trafficked Women and Women Engaged in Commercial Sex Activities: Implications for Funding, Outreach and Engagement

In response to the Coronavirus (COVID-19) outbreak, many forms of communications have moved to Zoom, Skype, social media outlets, and a number of other online platforms. Research through these mediums, however, poses a unique set of challenges when the population involves sex trafficked populations and those who engage in commercial sex. Sex trafficking involves the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act (Public Law No. 106-386), while commercial sex activities refer to the selling or exchanging of sex for some material good (e.g., money, drugs, housing, etc.). These two populations may be fluid and not necessarily always independent of one another.

Case 1. A woman may engage in sporadic prostitution to make ends meet, but later finds herself forced into persistent prostitution by a trafficker.

Case 2. A teenager may be forced into prostitution for 10 years and as a result develops an addiction to drugs and is later sentenced to jail. Due to COVID-19, however, she is released from jail but now has nowhere to stay. She starts to engage in prostitution out of desperation.

Both cases illustrate marginalized women whose victimization legally met the criteria for both sex trafficking and prostitution at different times. Based on the number of infections and deaths due to COVID-19 in the United States, we know that marginalized groups are disproportionately affected. Researchers and epidemiologists do not know how the pandemic is negatively affecting sex trafficked persons and women who engage in commercial sex activities though. We do know though that ‘… people who are already marginalized by society are always the ones most impacted by any local, national, or global crisis’ (Rosseland, 2020, para 6). Therefore, it is critical to search out the voices and experiences of these marginalized individuals.

Due to the illicit and clandestine nature of sex trafficking specifically, social work researchers heavily rely on personal relationships with trafficked persons to conduct their research. Social distancing and telecommunications are barriers to developing these kinds of relationships. Sending out “cold” surveys, hosting focus (research) groups online, conducting individual interviews online, and implementing interventions over the internet with trafficked persons are not easy through these platforms given the nature of the sensitive information being sought. Accessibility to electronic devices and internet access is also not a given with marginalized populations. In this article, the authors discuss why it is imperative to creatively get around barriers to conducting research so that funding can be secured to assist frontline workers with their outreach and engagement with sex trafficked persons and those who engage in commercial sex activities.

Prevalence of COVID-19

In late 2002 onto mid-2003, SARS (Severe Acute Respiratory System) ravaged across 29 countries (Centers for Disease Control and Prevention, 2003). Before it was contained, 8098 people fell ill while 774 died from it (Centers for Disease Control and Prevention, 2017). Between December 2013 and June 2016, Ebola resulted in 11,323 deaths and 28,000 suspected, probable and confirmed cases in 10 countries (Centers for Disease Control and Prevention, 2019). Both pandemics were devastating but COVID-19 has impacted the world like nothing in modern history. As of May 16, 2020, COVID-19 has claimed 311,813 lives worldwide and infected 4,703,955 people in 213 countries and territories (Worldometer, 2020). The statistics change by the minute—in an upward fashion in most places in the world. No country or group of people has gone unscathed. This potentially includes marginalized groups of people who are sex trafficked or who participate in commercial sex activities. No one knows the numbers of trafficked persons who have been infected with the Coronavirus, but it is safe to guess that they have been infected and impacted as well. The Avery Center for Research & Services report that that men are still buying sex during the COVID-19 pandemic (Rosseland, 2020). This means that there are women out there still selling it. Therefore, it is critical for researchers to collect data from women engaging in commercial sex (consensually or not) to assess the impact of COVID-19 on their health, behaviors, and risks to exposures.

Challenges in Collecting Data: Lessons Learned

Wanting to collect data during a pandemic is one thing but being able to do it is another. For instance, the authors have two research projects currently on hold due to the pandemic. They both were approved by our institution’s human subjects review board the week before the university went to working from home and the Governor enacted stay-at-home orders. The studies involved interviewing and paying sex trafficking survivors to participate in lengthy interviews. When those studies were put on hold because of the pandemic, we immediately sought to find out how survivors are coping with the pandemic instead. We decided that a mobile-friendly survey that would take just 5 minutes would be a quick and easy solution to getting the temperature of the impact of COVID-19 among those on the street. Given that the survey only takes about 5 minutes to complete, we hoped that non-payment for participation was acceptable. We ran our proposed survey by three survivors serving in a leadership capacity in the anti-trafficking arena. By speaking with these survivors as the experts in the field, we learned some valuable lessons. They recommended changes in wording in some areas and recommended additional questions in other areas. To our surprise, none of the three survivors were overly optimistic about the feasibility of completing the short surveys due to barriers. Table 1 highlights the barriers to completing research during the COVID-19 pandemic.

Table 1: Barriers to Completing Research During the COVID-19 Pandemic

  • Not all potential respondents own personal cell phones to complete surveys on.
  • Not all potential respondents have access to an iPad or computer especially since the libraries, schools, and universities are all closed.
  • Internet access is not as prevalent as assumed; it is a privilege for many.
  • Not being able to provide incentives or money to respondents for even a 5-minute survey would be a deterrent. Respondents generally expect to be paid for their time.
  • Even if the researchers had secured funding to pay participants electronically, not all respondents have access to Pay Pal, Venmo and other cash apps.
  • Administering brief surveys face-to-face would not be practical given the country’s six feet apart social distancing orders.
  • Wearing gloves and masks while conducting research may be offensive to some women on the street.

Before consulting with the three survivors prior to submitting our research protocol, we were unaware of these critical barriers to completing a “simple” and “quick” research project with women in the street during the COVID-19 pandemic. Their feedback has been a valuable lesson. It has changed the trajectory of our approach to research. We now know that we must become even more creative during these perilous times as researchers.

Implications for Funding, Outreach and Engagement

Marginalized women who are trafficked or engage in commercial sex acts are all too familiar with social distancing. They are often invisible, distanced from the general population as a rule, and underserved. Therefore, it is critical to understand their challenges during this public health crisis. They are most likely to be among the hardest hit. Data can be used to write grants to secure funding for agencies—especially non-profit agencies led by survivors themselves. Since the start of COVID-19, several higher education institutions and federal and state level organizations are offering competitive grant opportunities related to COVID-19. Being able to gather preliminary data to support a grant proposal is imperative. Once grant funding is secured, collaborating with survivor-led advocates is critical because these individuals are generally known in their communities and have the most access to victims. Collaborations with these individuals can result in immediate interventions and resources. For instance, COVID-19 has shown outreach advocates that there is an increased need for food, condoms, clothes, Narcan kits (used to revive someone after an opioid overdose), online mental health counseling, alcohol swabs to clean needles, facial masks, syringes, bottles of hand sanitizer, wound care kits for increased incidents of MRSA (staph bacteria infections), and temporary housing—to start. These resources cost money and grants are possible avenues for accessing funding.

Figure A
Outreach Nurse Examining MRSA Infection in Woman Engaged in Commercial Sex Activities
Esther Flores, BSN, RN, MBA
2020 May 6

COVID-19 is wreaking havoc across the world as seen in the media daily. It is one of the most contagious and misunderstood pandemics to date. We know that it kills people, disrupts normal social functioning, is wreaking havoc on economies around the world, and is projected to be with us for months to come. We do not know, however, how it is affecting women who are sex trafficked or engaged in commercial sex acts; we do not know how it is affecting any people who are enslaved. This is problematic to us as researchers given that it is estimated that 40 million men, women and children are entrapped in various forms of slavery around the world (Global Slavery Index, 2018). The impact on these enslaved individuals is sure to be devastating in ways that we are unprepared to address. We must get a handle on this crisis!


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Centers for Disease Control and Prevention. (2017 December 6). SARS basics fact sheet.

Centers for Disease Control and Prevention. (2003 December 12). Revised U.S. surveillance case definition for severe acute respiratory syndrome (SARS) and update on SARS cases—United States and worldwide, December 2003.

Public Law 106-386. (2000). Trafficking Victims Protection Act of 2000, H. R. 3244, (2000). 106th Cong., 2nd Sess.

Rosseland, J. (2020 May 5). Domestic sex trafficking trends during the COVID-19 pandemic. Medium.

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Recommended Readings

Cockayne, J., & Smith, A. (2020 April 2). The impact of COVID-19 on modern slavery. Our World: United Nations University.

Polaris. (2020 April 7). COVID-19 may increase human trafficking in vulnerable communities.

Rosseland, J. (2020 May 5). Domestic sex trafficking trends during the COVID-19 pandemic. Medium.

United Nation (UN) News. (2020 May 6). COVID-19 crisis putting human trafficking victims at risk of further exploitation, experts warn.

Authors Bylines

Jacquelyn C.A. Meshelemiah is a social work professor, researcher, and scholar activist in the anti-trafficking arena in the United States.
Sat Kartar Khalsa is first year medical student at a large Midwestern University in the United States. Her area of interest is in women’s health care, especially among the sexually exploited.
Esther Flores is a nurse and anti-trafficking activist who engages in outreach with trafficked men and women and those engaged in commercial sex activities.

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Jacquelyn C.A. Meshelemiah is a social work professor, researcher, and scholar activist in the anti-trafficking arena in the United States.

Sat Kartar Khalsa is first year medical student at a large Midwestern University in the United States. Her area of interest is in women’s health care, especially among the sexually exploited.

Esther Flores is a nurse and anti-trafficking activist who engages in outreach with trafficked men and women and those engaged in commercial sex activities.