Nonvolitional Sex and Sexual Health

Nonvolitional sex is sexual behavior that violates a person's right to choose when and with whom to have sex and what sexual behaviors to engage in. The more extreme forms of this behavior include rape, forced sex, childhood sexual abuse, sex trafficking, and violence against people with nonconventional sexual identities. More nuanced forms of nonvolitional sex include engaging in sexual behavior that masks one's nonconventional sexual identity, or that protects one's position with peers, or that represents a quid pro quo for the economic support that one obtains within an intimate relationship. The aim of this essay is to highlight the ways in which nonvolitional sex threatens sexual health and to identify strategies for ameliorating this problem. These strategies will have to be as broad in scope as is the problem that they are designed to address. The essay discusses the following strategies to reduce nonvolitional sex: (1) advocacy for sexual rights, gender equality, and equality for individuals with nonconventional sexual identities; (2) primary prevention programs and interventions that offer comprehensive sexuality education that establishes volitional sex and sexual health as basic human rights; (3) health services that routinely ask clients about their experiences with nonvolitional sex in an open and culturally appropriate manner; and (4) secondary prevention programs to meet the needs of victims of nonvolitional sex identified by the "screening" programs.     

„Human Trafficking,Public Health and the Law“ – eine interdisziplinäre „Spring School“

Background

Currently approximately 20.9 million human beings are victims of human trafficking worldwide—a modern form of slavery. The victims are mostly women and children and come from a variety of different countries. As part of an Erasmus Intensive Program a two-week spring school was held on “Human Trafficking, Public Health and the Law” focusing the issue of human trafficking, particularly from the perspectives of Law and Public Health.

Results

Students and teachers from five universities from different countries worked out the principles on the international fight against trafficking in human beings using the method of the “New Haven School of Jurisprudence”. These “Siena Principles on Human Trafficking and Public Health” focus on the three levels prevention, prosecution of traffickers and protection of victims.

Conclusion

The Spring School should set an sign to encourage the international, interdisciplinary discourse on the problem of trafficking in persons. In the future, in particular research in the field of Public Health should be intensified as the basis for development of targeted measures in the fight against human trafficking. In the following article the contents of the Spring School will be illuminated, including the methodology used, and the final result—the written principles—illustrated.     

Supporting ALL victims of violence,abuse, neglect or exploitation: guidance for health providers

Smaller groups of victims of violence, abuse, neglect or exploitation – such as male victims of intimate partner violence (IPV), victims of elder abuse, victims of abuse by carers, victims of parent abuse, victims of human trafficking, girls and boys below 18 years engaging in sex work, victims of sexual exploitation by gangs or groups and victims of honour based violence (such as forced marriages and female genital mutilation) – are often in contact with the health care system without being identified as such and frequently do not receive appropriate treatment. To address this problem, two things need to happen: 1) that ALL groups of victims of violence, abuse, neglect or exploitation are explicitly listed in policies and protocols, and 2) that both the similarities as well as the differences between the groups with regard to identification, support and referral – described in this article – are explained, so that health providers are appropriately supported in this important function.     

Prevalence of violence against indigenous women victims of human trafficking and its implications on physical injuries and disabilities in Monterrey city,Mexico

Human trafficking victims suffer different kinds of physical abuse and torture that cause severe physical injuries. During 2016–17 a total of 68 indigenous labor and sex-trafficking women victims were surveyed in Monterrey city, Mexico to explore the prevalence of violence against them and its implications on physical injuries and disabilities. We found that women reported different types of injuries and long term disabilities. Considering the level of violence and occupational hazards faced by victims, we suggest there is an urgent need to create instruments in the Mexican national human trafficking program to address the unmet health needs of the victims.     

An International Comparative Public Health Analysis of Sex Trafficking of Women and Girls in Eight Cities: Achieving a More Effective Health Sector Response

Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders.     

Child organ trafficking: global reality and inadequate international response

In organ transplantation, the demand for human organs has grown far faster than the supply of organs. This has opened the door for illegal organ trade and trafficking including from children. Organized crime groups and individual organ brokers exploit the situation and, as a result, black markets are becoming more numerous and organized organ trafficking is expanding worldwide. While underprivileged and vulnerable men and women in developing countries are a major source of trafficked organs, and may themselves be trafficked for the purpose of illegal organ removal and trade, children are at especial risk of exploitation. With the confirmed cases of children being trafficked for their organs, child organ trafficking, which once called a “modern urban legend”, is a sad reality in today’s world. By presenting a global picture of child organ trafficking, this paper emphasizes that child organ trafficking is no longer a myth but a reality which has to be addressed. It argues that the international efforts against organ trafficking and trafficking in human beings for organ removal have failed to address child organ trafficking adequately. This chapter suggests that more orchestrated international collaboration as well as development of preventive measure and legally binding documents are needed to fight child organ trafficking and to support its victims.     

Human trafficking: The relationship between government efforts & survivor punishment

ABSTRACT

Human trafficking is a global public health and human rights issue, although it remains unknown how governmental-level systems impact survivors of human trafficking. Survivor punishment (where federal or local officials arrest, fine, imprison, deport, or otherwise punish survivors) is evident even with global promotion of survivor-centred approaches to human trafficking. This study serves as an initial investigation of how government involvement in survivor services and prevention progress are related to survivor punishment. This cross-national study utilised the 2011 Human Trafficking Indicators. Although this dataset heavily relies on the U.S. TIP reports, our analyses are guided by a human rights framework that recognises the importance of prevention and partnerships in mitigating the vulnerability of survivors. Multiple logistic regression was conducted to determine factors associated with survivor punishment. Findings indicate that countries categorised by the U.S. as showing substantial prevention progress have a lower likelihood of survivor punishment (OR = 0.30; 95% CI [0.15, 0.62]). Government survivor service offering was not significantly associated with punishment (OR?=?0.65; 95% CI [0.33, 1.28]). Findings call for the development of global measures resulting from international partnerships to characterise stocks and flows of human trafficking, as well as the quality and effectiveness of governmental efforts and partnerships.     

Rumours of Child Trafficking after Natural Disasters

Rumours of child trafficking have surfaced quickly after every major natural disaster since the Asian tsunami. Although usually proved false or exaggerated, stories of traffickers preying on vulnerable victims have become an integral feature of the disaster narrative and donors and relief workers are constantly urged to do more to help the supposed victims. This article looks at the way that this threat to children has been reported in four major disasters of the last decade—the Asian tsunami of 2004, the Pakistan earthquake of 2005, the Myanmar cyclone of 2008 and the Haiti earthquake of 2010—and suggests reasons why fears of child trafficking in disaster zones have developed so rapidly, become so firmly established and what this says about Western fears and concerns about childhood.     

Migrations forced by violence: the Colombian case

The human migrations have been one of the motors in the history of humanity. During the twentieth century, internal forced displacement has been an important component of the migration processes in the world. Colombia, a paradigm for this phenomenon, is a country with more than three and a half million people displaced over the last 25 years by force of the violence resulting from an internal armed conflict. Besides the socio-demographic effects in the reconfiguration of the cities, this problem affects the human condition of the victims deteriorating their health and quality of life. This article aims to show the general panorama of migrations forced by violence in the world and to analyze the peculiarities of this phenomenon in the Colombian case. We conclude that forced displacement is a serious violation of human rights producing a human drama by exposing the affected individuals and communities to vulnerability and a deep deterioration of their quality of life and health.     

Auswirkungen des Menschenhandels auf die Gesundheit von betroffenen Frauen und m?gliche Handlungsoptionen

Human trafficking is the modern form of slavery. Annually, thousands of women, children and men of all ages are affected. Trafficking in persons has a severe impact on the health of those affected. In particular, young women are very vulnerable and easily accessible for perpetrators. They are forced into prostitution in their own country or abroad. The soundest knowledge is available in the field of exploitation of women with the purpose of prostitution which is why this article will focus on this phenomenon. The causes are reflected in a complex system of push and pull factors. The health implications are enormous. Not only do the women suffer from sexually and non-sexually transmitted infections but also from the physical abuse caused by the perpetrators. The injuries and trauma often lead to post-traumatic stress disorder (PTSD). Doctors are often the only ones who have contact with those concerned which is the reason why they are responsible for identifying and treating the victims as well as helping them to escape their miserable situation. In the area of trafficking in women and minors for sexual exploitation much research is needed. Furthermore, an extensive education campaign is necessary to sensitize medical health care professionals to this situation. Thus, doctors can handle and use the given diagnostic questions and symptom complexes to identify victims and although medical health care professionals are capable of using and handling diagnostic measures to identify the victims, they are not able to prevent human trafficking. However, they can contribute by identifying victims and supply them with medical services and provide educational work.     

Sexual slavery without borders: trafficking for commercial sexual exploitation in India

Trafficking in women and children is a gross violation of human rights. However, this does not prevent an estimated 800 000 women and children to be trafficked each year across international borders. Eighty per cent of trafficked persons end in forced sex work. India has been identified as one of the Asian countries where trafficking for commercial sexual exploitation has reached alarming levels. While there is a considerable amount of internal trafficking from one state to another or within states, India has also emerged as a international supplier of trafficked women and children to the Gulf States and South East Asia, as well as a destination country for women and girls trafficked for commercial sexual exploitation from Nepal and Bangladesh. Trafficking for commercial sexual exploitation is a highly profitable and low risk business that preys on particularly vulnerable populations. This paper presents an overview of the trafficking of women and girls for sexual exploitation (CSE) in India; identifies the health impacts of CSE; and suggest strategies to respond to trafficking and related issues.     

Pathologies of power: rethinking health and human rights.

The field of health and human rights has grown quickly, but its boundaries have yet to be traced. Fifty-one years after the Universal Declaration of Human Rights, consensus regarding the most promising directions for the future is lacking; however, outcome-oriented assessments lead us to question approaches that rely solely on recourse to formal legal and civil rights. Similarly unpromising are approaches that rely overmuch on appeals to governments: careful study reveals that state power has been responsible for most human rights violations and that most violations are embedded in "structural violence"--social and economic inequities that determine who will be at risk for assaults and who will be shielded. This article advances an agenda for research and action grounded in the struggle for social and economic rights, an agenda suited to public health and medicine, whose central contributions to future progress in human rights will be linked to the equitable distribution of the fruits of scientific advancement. Such an approach is in keeping with the Universal Declaration but runs counter to several of the reigning ideologies of public health, including those favoring efficacy over equity.     

Shan women and girls and the sex industry in Southeast Asia; political causes and human rights implications.

The human rights abuses which occur during civil conflicts pose special threats to the health and lives of women. These can include rape, sexual violence, increased vulnerability to trafficking into prostitution, and exposure to HIV infection. The long-standing civil conflict in the Shan States of Burma is investigated as a contributing cause to the trafficking of ethnic Shan women and girls into the Southeast Asian sex industry, and to the subsequent high rates of HIV infection found among these women. The context of chronic human rights abuses in the Shan states is explored, as well as the effects of recent forced population transfers on the part of the Burmese Military Regime. Rights abuses specific to trafficked women may further increase their vulnerability to HIV and other STD. The need for a political resolution to the crisis in Burma is discussed, as are approaches aimed at preventing trafficking, empowering women already in the sex industry, and reducing the risks of HIV and other STD among these women and girls.     

The Sexual Exploitation of Children and Young People in Northern Ireland: Overview from the Barnardo's Beyond the Shadows Service

The present paper provides an overview of child sexual exploitation in Northern Ireland and related issues. It focuses on Barnardo's response to the problem of sexual exploitation and sets it in both a historical and a contemporary context. The paper considers the importance of recognising exploitation as child abuse and addresses specific myths associated with this. It makes use of recent research and campaigning by Barnardo's to challenge and change public perception. The paper presents a range of risk factors and indicators that are used to identify children and young people who are most likely to experience or be at risk from sexual exploitation. It examines the who, what and why of sexual exploitation of children in Northern Ireland, presenting local research and anecdotal evidence to demonstrate the extent and range of the problem, while acknowledging the often hidden nature of this activity. As well as focusing on young people abused through prostitution, the paper also makes reference to the issue of human trafficking and the increasing problems of abuse via the Internet and mobile phone technology. The paper draws on international human rights standards and domestic legislation in relation to child sexual exploitation and explores the existing legislative context in Northern Ireland. Included is a summary of the Barnardo's Beyond the Shadows Service established to respond to this issue. The paper lays out the four main aims of the service and provides an overview of its work. It concludes by challenging the audience, legislators, policy-makers and service providers to respond strategically and operationally to the experiences and needs of children and young people who are sexually exploited or at risk of this.     

Media and Child Abuse Seminar, University of Ulster, 1 March 2002

For me it was an easy decision to waive my right to anonymity and allow the press to print my name following my father's conviction. There were a couple of reasons for this. First, my father held a very high profile as a human rights campaigner in the North. To me this image was a sham, just a lie to hide behind, and I wasn't prepared to let it continue and to let anyone else be conned by his new character. He was a vain man who thrived on the publicity he had drawn on himself through his involvement with FAIT and the NIHRB. I also wanted to appeal to other victims to report their attackers to the police. Although I understand the pain involved I feel that there is a duty to report if only to prevent other victims suffering at the hands of their offender.     

Worldwide rabies deaths prevention—A focus on the current inadequacies in postexposure prophylaxis of animal bite victims

The World Health Organization reports that over 60,000 humans die of rabies annually, worldwide. Most occur in remote regions of developing countries. Almost all victims received no postexposure rabies prophylaxis (PEP). There are no facilities or health personnel able to provide it in many areas where the disease is prevalent. A first approach to correct this problem would be by extending provision of modern PEP to areas where human rabies is most prevalent.     

The right to health of prisoners in international human rights law

This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non-binding or so-called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.     

Ensuring Rights while Protecting Health: The Importance of Using a Human Rights Approach in Implementing Public Health Responses to COVID-19

In response to the COVID-19 pandemic, governments around the world have implemented public health policies that limit individual freedoms in order to control disease transmission. While such limitations on liberties are sometimes necessary for pandemic control, many of these policies have been overly broad or have neglected to consider the costs for populations already susceptible to human rights violations. Furthermore, the pandemic has exacerbated preexisting inequities based on health care access, poverty, racial injustice, refugee crises, and lack of education. The worsening of such human rights violations increases the need to utilize a human rights approach in the response to COVID-19. This paper provides a global overview of COVID-19 public health policy interventions implemented from January 1 to June 30, 2020, and identifies their impacts on the human rights of marginalized populations. We find that over 70% of these public health policies negatively affect human rights in at least one way or for at least one population. We recommend that policy makers take a human rights approach to COVID-19 pandemic control by designing public health policies focused on the most marginalized groups in society. Doing so would allow for a more equitable, realistic, and sustainable pandemic response that is centered on the needs of those at highest risk of COVID-19 and human rights violations.     

The politics of risk: a human rights paradigm for children's environmental health research

A human rights paradigm for environmental health research makes explicit the relationship between poor health and poverty, inequality, and social and political marginalization, and it aims at civic problem solving. In so doing, it incorporates support for community-based, participatory research and takes seriously the social responsibilities of researchers. For these reasons, a human rights approach may be better able than conventional bioethics to address the unique issues that arise in the context of pediatric environmental health research, particularly the place of environmental justice standards in research. At the same time, as illustrated by disagreements over the ethics of research into lead abatement methods, bringing a human rights paradigm to bear in the context of environmental health research requires resolving important tensions at its heart, particularly the inescapable tension between ethical ideals and political realities.     

Climate Justice,Humans Rights,and the Case for Reparations

The global community is facing an existential crisis that threatens the web of life on this planet. Climate change, in addition to being a fundamental justice and ethical issue, constitutes a human rights challenge. It is a human rights challenge because it undermines the ability to promote human flourishing and welfare through the implementation of human rights, particularly the right to life and the right to health. It is also a human rights challenge because climate change disproportionately impacts poor and the vulnerable people in both low-income and high-income countries. Those living in many low-income countries are subject to the worst impacts of climate change even though they have contributed negligibly to the problem. Further, low-income countries have the fewest resources and capabilities at present to adapt or cope with the severe, long-lasting impacts of climate change. Building on human rights principles of accountability and redress for human rights violations, this paper responds to this injustice by seeking to make long-neglected societal amends through the implementation of the concept of climate reparations. After discussing the scientific evidence for climate change, its environmental and socioeconomic impacts, and the ethical and human rights justifications for climate reparations, the paper proposes the creation of a new global institutional mechanism, the Global Climate Reparations Fund, which would be linked with the United Nations Human Rights Council, to fund and take action on climate reparations. This paper also identifies which parties are most responsible for the current global climate crisis, both historically and currently, and should therefore fund the largest proportion of climate-related reparations.