Theoretical Background
The literature that attempts to explain the dynamics of the departure from sex trafficking often describe theoretical approaches and are not always grounded in empirical data. Among the
2 TIP: Office to Monitor and Combat Trafficking in Persons in the U.S. Department of State.
latter, some focus only on the barriers that hinder exit without focusing on resources (Howell, Schiferl & Ruhlmann, 2019; Roth & Wells, 2019), while some do the opposite; the result is that we don’t have a uniform picture of all the factors involved in the exit process. Baker, Rochelle, Dalla, and Williamson (2010) have systematized four theoretical models that study the exit process and are the most commonly used for the analysis of emancipation from the sexual industry. This includes not only victims of sex trafficking, but also street workers and women who slide into prostitution, who were not necessarily trafficked but, for various social and economic reasons, started working as prostitutes3 . Regarding the 4 models mentioned, two are more generic—Stage of Change model (Prochaska et al., 1992) and Role Exit Model (Fuchs Ebaugh, 1988)—while the other two are more specific—Breaking the Matthew Effect (Månsson & Hedin, 1999) and Becoming an ex-sex worker (Sanders, 2007). These models explain the steps a person goes through before changing their life situation and getting out of prostitution. The change in the behavior of one person can be self-initiated or promoted by professional help. Regardless, exiting the sex industry is often associated with a dynamic process that includes numerous exit-re-entry exit cycles. The models find evidence that the trend of these cycles is influenced both by personal factors (motivation, awareness of one’s condition, health), but also by relational factors (family, encouragement from significant others). In line with these four models, another prototype used for the sex trafficking is the Traumagenic Social Ecological Framework (Finigan Carr, Johnson, Pullmann, Stewart & Fromknecht, 2019). According to a socio-ecological framework, it highlights all the levels and risk factors that make individuals more susceptible to sex trafficking, particularly for children. The result is the emergence of factors that intervene on the social level (as the diffusion of the capitalism), on the community level (as the level of people aware of the sex trafficking problem), on the interpersonal level (as the relation with family or the peer group), and on the individual level (as health). In summary, although all of these theoretical models differ from each other, integrating their contributions, they hypothesize the presence of individual, relational, and structural factors that intervene in the process of exiting prostitution, including sex trafficking. The models, therefore, suggest three levels of analysis that we must keep in mind if we want to understand what factors are involved in the exit process.
Based on what is suggested by the theoretical models presented above, the purpose of this study is to systematically identify and synthesize the empirical research on personal, relationalinterpersonal, and structural factors that constitute hindrances or resources in the process of exiting sex trafficking. In fact, we want to focus not on the entire sex industry, but only on the sex trafficking. The aim is to select only empirical studies. The following research question guided this study: What are the individual, relational, and structural factors that intervene during the exit process from sex trafficking of women?
The review question is important when it comes to organizing data from empirical research—not only from theoretical models—in order to have a complete overview of the factors that come into play during the process of exiting sex trafficking. The aim is to highlight both the factors that hinder and facilitate the exit, including the controversial ones, so as to have a comprehensive overview of victims’ exit from trafficking, an emerging topic of research in sex trafficking. The systematic review also has important operational consequences such as giving indications to operators involved in sex trafficking intervention programs on which factors to strengthen in order to facilitate the emancipation of victims and which ones to avoid.
3 We refer to prostitution activities as all sexual services offered in exchange for money. In this sense, not only street prostitution falls within this definition, but also prostitution in indoor apartments (nightclubs or massage centers …), digital environments (passing through social networks), and even pornographic activities.