Methods
Search Strategy and Selection Criteria
A broad search on the English-language literature was performed, identifying articles through electronic database searches on online bibliographic archives. Sociological Abstract and Scopus have been chosen as search engines because they provide abstracts and indexes of international literature concerning sociology, social work (including social policy, social welfare), and related disciplines in the field of social sciences. Scopus is the largest abstract and citation database of peer-reviewed literature, but it does not always provide full texts. For this reason, we also used Sociological Abstract because it makes the full text of the indexed manuscripts available in premium sociology or social science collections. The only limitation of Sociological Abstract is that almost 60% of the publications come from North America. The search included a combination of the following terms and key words: (sex traffick OR forced prostitution OR commercial sexual exploitation) AND (survivor OR exit OR recovery). Articles published until July 2019 are included without any time limit. The other relevant articles have been identified through the snowballing method, starting from the indicated search engines. Studies of any design (both qualitative and quantitative) were included as long as they investigated the exit process from sex trafficking from the victims’ point of view, highlighting the obstacles or resources they faced. Studies that provide descriptions of exit factors and had an empirical research design (sampling and measures) were also included. The sample was not curbed based on nationality, gender (male or female or transgendered), or age (children, teens, and adults are considered). The review included both peer-reviewed journals and non-peer-reviewed publications.
Screening and Data Extraction
The sample was selected through two levels of screening. Firstly, publications were excluded according to the following criteria: publications in languages other than English, newspapers or editorials, books, blog or web sites, lectures, dissertations. When a publication was classified as relevant, its abstract was then selected based on the following criteria:
- Discussing personal, relational-interpersonal, and structural factors intervening during the exit process from sex trafficking
- Qualitative or quantitative studies
- Having female victims of sex trafficking as a research sample
The selection criteria were chosen based on the research question; respectively, the criteria allowed for the collection of the factors involved in the exit process, identified empirical studies, and were based on the victims’ point of view.
When the abstract met the inclusion criteria, a copy of the full text was obtained. Where necessary, authors of the articles were contacted for additional data or to obtain the full text if it had not been uploaded to the database. Secondly, after reading the entire articles, only those that actually met the selection criteria used during the first selection step have been included in the systematic review. The publications for which the full text was unobtainable and those not fitting the aforementioned criteria were excluded.
Subsequently, to organize data for each study, the following details were extracted: (Figure 1: Features of the 13 included observational studies on the exit factor of female victims of sex trafficking (studies are in alphabetical order); type of study (quantitative or qualitative); sample size and characteristics of participants (gender, age, nationality); instruments and main topics; site of exploitation (indoor or outdoor); and migratory route (national or transnational). All the exit variables from sex trafficking identified by researchers in the selected articles have been described and organized into different levels (individual, relational, and structural), highlighting their role in the process of abandoning sex trafficking (facilitators, hindering, controversial). None of the studies employed doubtful methodologies.
Data Analysis
Analyses were designed to produce descriptive information on the characteristics of all included studies. Having included both qualitative and quantitative studies, the analysis was conducted through the construction of theoretical categories, synthesizing in a narrative way all the included records. The first entailed the coding of the samples of the selected studies based on gender, age group, nationality, type of exploitation (indoor or outdoor), or migratory route. Secondly, the factors involved in the process of exiting sex trafficking have been extracted and categorized to one of these three levels: individual, relational, or structural. Specifically, in line with the model proposed by Finigan-Carr, Johnson, Pullmann, Stewart, and Fromknecht (2019), the individual or intrapersonal level refers to all the elements concerning the characteristics of the subject. This level includes all the psychological and biological variables of the subjects, their beliefs, desires or expectations, and the behavioral styles implemented by the people who can influence the path of exit from sexual trafficking. The relational level considers the relationships that the victims of sex trafficking have with the other people they encounter during the exit process. The third level concerns the objective social structures (Bourdieu, 1979). Specifically, this thematic area concerns the socio-economic system, the social institutions with their respective functions, and the normative and cultural system. Finally, once the identified constructs were labeled according to the levels on which they operate (individual, relational, or structural), each of them was classified either as hindering, facilitating, or controversial in regard to the exit process.