Human trafficking is defined as "the recruitment and movement of people by force, coercion or deception, for the purposes of exploitation" (Abas et al. 2013: 1). However, according to a 2013 study by Abas (et al.), current literature on the subject of human trafficking is somewhat problematic, given that research studies have focused on victims at different stages of trafficking and combined the perspectives of a wide range of persons of different ethnicities. This compromises the internal validity of the studies, given that so many other factors could impact results. Still, there is evidence that women who have been trafficked suffer from higher rates of depression, anxiety and post-traumatic stress disorder (PTSD) (Abas et al. 2013: 1). To offer a more controlled study, Abbas (et al. 2013) conducted a study on Moldavian women specifically. All women in the study were eligible to receive government post-intervention crisis care as a result of being victims of human trafficking. To ensure internal consistency, all women in the study were age 18 or over and had been returned to Moldavia within the past 12 months after being victimized. More than half had children. Countries they had been trafficked to included Turkey, Russia, and the EU, amongst others. Trained female interviewers conducted the actual interviews. So the women did not relive their trauma they were not specifically asked about the trafficking experience itself but about the symptoms they were experiencing and also incidents in their past such as physical and emotional childhood sexual abuse. Current social stressors they were experiencing included access to work; personal safety issues; a lack of legal assistance; and low self-esteem (Abas et al. 2013: 4). As well as interviews, previously validated screening instruments were used to address different categories of personal stress independently. Questionnaires were self-administered and not specific to trafficking. Both pre -- and post-trafficking demographic factors were tabulated including: "education status; pre-trafficking employment status; pre-trafficking residence (rural or urban) childhood emotional abuse; physical abuse; and sexual abuse; duration of trafficking; post-trafficking marital status; post-trafficking employment status; number of unmet needs; and social support score" (Abas et al. 2013: 5). Also, the type of exploitation (sexual vs. labor-related) was noted although, as previously stated, not the subject of the actual interviews.

This survey of mental status before trafficking revealed that many of the women were in highly stressful situations even before being trafficking -- up to 30% reported being abused (Abas et al. 2013: 7). Abuse victims are more likely to suffer PTSD. Over half of the women in the study met DSM-IV criteria for a mental disorder, including PTSD, depression, and anxiety disorders (Abas et al. 2013: 7). Previous victims of sexual abuse were even more likely to suffer from these disorders. Other exacerbating factors included longer duration of trafficking and a lack of social support after being trafficked. Implications of the study included the need for proper social support of victims, to minimize long-term effects.

In agreement with Abas (et al. 2013), Hepburn & Simon (2010) note that there are certain country-specific aspects of human trafficking, such as the heated nature of the debate about illegal immigration in the United States and the caste system in India which has exacerbated extreme poverty in rural areas and made persons vulnerable to trafficking (Hepburn & Simon 2010: 1). However, in contrast to Abas (et al. 2013), Hepburn and Simon believe that there are generalizable characteristics about human trafficking across nations and cultures. "Such common characteristics are fraudulent recruitment, exorbitant travel and recruitment fees, the withholding of the victim's visas and other identifying documentation, controlling and limiting the victim's movements, threatening deportation, threatening to harm the victim or his/her family, and physically harming the victim" (Hepburn & Simon 2010: 1). Hepburn & Simon's research constitutes a comprehensive review of existing literature on the subject of trafficking.

They found that existence of human trafficking continues because it is both lucrative and because it is widely concealed, despite its many victims, the majority of whom are assumed to be women. According to one study "women and girls make up 56% of persons trafficked for the purposes of forced labor while men and boys make up 44%. In terms of those trafficked for the purposes of forced commercial sexual exploitation, women and girls make up 98% and men and boys comprise 2%. Lastly, children constitute 40 -- 50% of the overall forced labor population" (Hepburn & Simon 2010: 2). According to the results of one study, this may be due to the...

The study found that of those remaining 32% are conscripted into forced labor and the rest for a mixture of purposes (Hepburn & Simon 2010: 2).
But this data is controversial: the United Nations Office on Drugs and Crime (UNODC) actually estimates that "domestic, food and care services, garment, and agricultural slavery make up 46.2% of trafficking cases," not the sex trade (Hepburn & Simon 2010: 3-4). This startling discrepancy in statistical data highlights the tremendous challenge of keeping accurate records regarding victims of trafficking. The crime by its nature is clandestine and victims may fear revealing their status for a considerable length of time -- if ever -- causing their victimization to be not only unpunished but uncounted.

This indicates there may be a widespread underestimation of the number of males trafficked. In a 2010 U.S.-specific study it was noted there was a 15% increase in adult male trafficking victims versus 2007 and a 39% increase since fiscal year 2006. The fact that this coincided with the recent economic downturn suggests that businesses may be more willing to use questionable labor sources to save money (Hepburn & Simon 2010: 3-4). Trafficking in New Orleans also experienced a notable spike in the wake of Hurricanes Rita and Katrina and the economic as well as the physical devastation these events generated (Hepburn & Simon 2010: 5).

One common feature of trafficking is charging victims exorbitant fees to smuggle them into the U.S., effectively holding them hostage to their 'owners.' Victims believe they are genuinely indebted although the cycle is never-ending given that they are charged for their room, boarding, and other specious expenses. Through violence and intimidation they are forced to work with no real hope of release (Hepburn & Simon 2010: 5). Some trafficked workers are initially bought into the United States legally but then are conscripted into servitude. For example, 95% of migrant workers trafficked in the Gulf Coast were initially visa holders under the H-2 program. However, the "H-2 visa is employer specific and is not valid with any other employer. As a result, the visa holder becomes suddenly 'illegal' if they no longer work for the employer identified on their visa application. This dependence creates a dynamic where the visa holder is particularly vulnerable to employer exploitation" (Hepburn & Simon 2010: 5). Thus, trafficking takes place in often complex ways.

Hepburn & Simon (2010) also chronicle rifts within the anti-trafficking movement that have occasionally hampered progress on the issue. For example, some anti-trafficking activists focus primarily on the sex trade, arguing that this makes up the majority of the most vulnerable victims (underage women and children) and the fact that these people are often treated as 'criminals' when arrested for prostitution further highlights the need to focus on their plights. Other anti-trafficking activists believe in the necessity of a more broad-based approach and think that trafficking for the purposes of slave labor is underreported because the image of the sex industry is more lurid and thus generates more media interest (Hepburn & Simon 2010: 13). However, some protections have been instituted to protect victims including the TVPA legislation and a public awareness campaign (Hepburn & Simon 2010: 23).

According to Duong (2012), rather than focusing solely on the countries to which persons are trafficked to, there should be greater focus on the places where people are trafficked from. For example, Vietnam has been particularly notorious as a 'feeder' site for trafficking of women and children. "From 1998-2008, approximately 5,700 Vietnamese women and children were trafficked, 8,000 were absent from home and assumed to have been trafficked, and another 11,000 women may have been victims of the illegal bride trade" (Duong 2012). As well as more conventional trafficking for the sex trade, women have also been trafficked to serve as surrogates for infertile couples and to China to serve as brides (Duong 2012).

Duong (2012) believes that to be effective, anti-trafficking efforts must be conducted worldwide rather than in a country-specific fashion. For example, 117 countries have signed the UN Protocol 2000 and there is increasing international awareness on the issue. Vietnam's poverty and political instability in recent years has made it particularly vulnerable as a site of trafficking. Specific issues have made women particularly apt to be trafficked in poor Southeast Asian countries such as Vietnam, including the 'feminization of poverty' (a lack of economic mobility for women); the increase of women moving outside of the nation's borders to…