Sexual violence at each stage of human trafficking cycle and associated factors: a retrospective cohort study on Ethiopian female returnees via three major trafficking corridors

Objectives Evidence showed that the prevalence of sexual violence during the whole human trafficking period was high. However, the distribution of sexual violence along the stages of the trafficking cycle is unclear. This study aimed to determine the prevalence of sexual violence at each stage of trafficking and factors associated with it among Ethiopian trafficked females. Design A retrospective cohort study was conducted to study trafficking returnees regarding their previous experiences at each stage of trafficking. Settings Data were collected at immigration offices in three border towns of Ethiopia located bordering Sudan, Kenya and Djibouti. Participants Six hundred and seventy-one women who were trafficked from Ethiopia were recruited into the study consecutively. They were recruited when they came back home via the three border towns either by deportation or voluntary return. Outcome measure The outcome variable was sexual violence. Results The prevalence of sexual violence was estimated at 10% (95% CI 7.9 to 12.5) during predeparture, 35.0% (95% CI 31.5 to 38.7) travelling period, 58.1% (95% CI 54.2 to 61.8) at destination and 19.5% (95% CI 15.2 to 24.6) detention stages. The odds of sexual violence among returnees aged 14–17 years was about twofold when compared with that of women aged 26–49 years (adjusted OR (AOR)=1.97; 95% CI 1.11 to 3.52). Similarly, being smuggled initially (AOR=1.54; 95% CI 1.09 to 1.93), restricted freedom (AOR=1.45; 95% CI 1.13 to 1.86) and time spent at each stage of trafficking (AOR=1.028; 95% CI 1.024 to 1.033) were positively associated with sexual violence. Conclusions The prevalence of sexual violence at each stage of trafficking after departure was high. This could imply that victims might be affected by subsequent negative sexual health outcomes. Young age, initially being smuggled and time spent at each stage of the trafficking process were positively associated with the events of sexual violence. Efforts must be made on modifiable factors such as ‘smuggling’ to minimise subsequent sexual violence during trafficking.