Screening for Human Trafficking among Refugees in Germany: Determining Prevalence and Test Accuracy of a Modified Version of the Adult Human Trafficking Screening Tool

Abstract

Abstract Background Human trafficking consists of the exploitation of a person by means of force, intimidation or deceit. Though it occurs all over the world, its true extent is still unknown. Refugees are especially vulnerable to human trafficking due to language barriers and difficult living conditions. Therefore, the purpose of this study was to design a screening tool to identify survivors of human trafficking among refugees in a German state registration and reception centre. Methods In a joint project with the Ministry of Justice and Migration Baden-Württemberg and the Regional Administrative Authority of Karlsruhe (‘Regierungspräsidium’), we asked newly arrived refugees at the initial reception centre in Heidelberg about their experiences with human trafficking. We used a combination of the Adult Human Trafficking Screening Tool and one question borrowed from a publication by Mumma et al. to address all forms of exploitation. The results of the screening tool were cross-checked by a short interview afterwards. Results In total, 13 of the 176 asylum seekers had experienced trafficking, which corresponded to a prevalence of 7.3%. The questionnaire had a sensitivity of 76.9% and a specificity of 84.0% at a newly selected cut-off of six positive responses. In an exploratory descriptive analysis on subregions, refugees from West Africa had a substantially higher prevalence (33.3%) for human trafficking within our sample, especially women. However, when we excluded this region from our analysis, we found no significant gender difference for the rest of the sample. Conclusions The screening tool distinguishes reliably those who had experienced human trafficking from other refugees. The high prevalence of trafficking in most regions, regardless of gender, suggests that more effort is needed to identify and protect all trafficked persons.