Psychological aspects of the crime of human trafficking for the purpose of sexual exploitation: A systematic review

. Abstract In this article, a systematic review is carried out on the crime of trafficking in persons for the purpose of sexual exploitation.relating thepsychological aspects of the victims, the traumas and mental health disorders caused by the violation of human rights. The methodology followed the Prisma statement, with scientific articles deposited in three databases: Pubmed, Web of Science (WoS) and Springer; three search equations were crossed with their Booleans under inclusion and exclusion criteria. As a result of the screening, 27 documents were obtained to conclude that the crime of trafficking in persons qualifies as a crime against humanity given the psychological consequences of the victims and the difficulty of reintegration, but also the need to generate intercountry actions that allow dealing with organized crime, as well as offering interdisciplinary and specialized professional care to victims and reducing the inequalities that create the conditions for generating human trafficking.


INTRODUCTION
The violation of Human Rights has been a constant in different cultures regardless of social status.Among the different types of human rights violations is human trafficking, understood as a criminal act that threatens the integrity of the being, since the victim is subjected against their will using force, manipulation or even the kidnapping.Sometimes, the victim is mobilized to other places and their identity is replaced.The foregoing with the purpose of exploiting the subject, violating their integrity (Litam 2017) It should be noted that these events are promoted by criminal mafias in networks worldwide, dedicated to the illegal commercialization of human beings, which has positioned them in one of the most lucrative businesses, focused on the interests of the trafficker, who subdues the victim through abuse of power and annuls them through the invisibility and degradation of the integrity of the being (Franchino Olsen 2021).
According to reports generated by the United Nations Office on Drugs and Crime UNODC, there are an average of eight hundred thousand victims worldwide who are subjected to sexual exploitation.The female population stands out in an average greater than 80% and girls in approximately 70%.Situations that are more evident in developing regions.( (Marburger and Pickover 2020).
Although this is a phenomenon that generates multiple crimes, from the point of view of existing protocols, greater concentration is required on the part of the state instances established for this purpose.In that same order, it is highlighted how in the criminal organization, whoever assumes the role of trafficker, previously performs a profile study of his victim, where it is possible to identify aspects related to economic deprivation, lack of job opportunity, actions related to desire to contribute to the substantial improvement of living conditions and fill the gaps caused by inequality, extreme poverty and forced displacement (Palines et al. 2019).
In relation to sexual exploitation, this is considered a type of practice where a subject through the payment of economic contributions can obtain, in exchange, enjoyment and sexual pleasure, situations that can also promote practices related to prostitution and pornography.Hardy et al. (2020).This affects the integrity and dignity of the subjects, due to the submission of acts associated with enslaving events, servitude or salary exploitation.(Jaeckl 2021).
As a consequence, in the case of the victims, it is noteworthy that the experience of trafficking is related to various effects on both physical and psychological health.(Ferrari 2022).In this sense, from the perspective of physical health, it stands out how from the condition of the ideal state of well-being, this can be affected by various diseases such as Acquired Immunodeficiency Virus (HIV), as well as different sexually transmitted diseases (STDs), tuberculosis, malnutrition, injuries, traumas, as well as the increase in sequelae caused by social isolation, emotional restrictions and the consumption of psychoactive substances to which they are forced during the time of retention to achieve submission (Sambo and Spies 2021).
On the other hand, from the psychological affectations product of coercion and manipulation, the following may be evident: anxiety disorders, depression and suicidal ideation.Being altered, the mental health of the subjects who are victims.In addition, with the passage of time, people who suffer from this type of event can lose control of themselves, accepting demeaning situations as the only alternative to stay alive, which generates high states of defenselessness and loss of confidence.(Namy et al. 2022).ISSN en línea: 2789-3855, abril, 2023, Volumen IV, Número 1 p 4241.
One aspect that focuses attention is related to the conditions of the victims, upon regaining freedom.In this regard, it can be noted a certain inability to reintegrate into society, due to the feeling of rejection by it, which stigmatizes, discriminates and offers minimum conditions and guarantees before the restitution and restoration of the different rights that have been violated.In the same way, illnesses and disorders worsen due to the impossibility of receiving health care immediately and according to the disorders evidenced.(Franchino-olsen et al. 2022) Also, it is necessary to mention how this type of crime sometimes remains silent, as a result of limited actions and strategies by governmental authorities for its dissemination and prevention.For this reason, it is striking how, despite the existence of policies and protocols in the different countries, this is an issue that still does not receive all the attention it deserves and that should become one of the priorities to be addressed at the national level, both politically and socially.(Al-asaf 2021).
Therefore, in the present investigation, we have proposed a bibliometric review, following the Prisma Declaration, regarding the psychological consequences that derive from the crime of people trafficking with the purpose of relating the psychological aspects of the victims and the traumas and disorders caused to mental health with the violation of human rights as a crime against humanity.By making evident the consequences derived from this crime, it contributes to make visible and to generate pressure for the decision-making of more severe international policies that propose the fight and eradication of this crime.(King et al. 2021).

METHOD
In carrying out the research, the quantitative method was used, focusing on the systematic review of the bibliometric type, as indicated by Otzen and Manterola (2017)who conceive research in the globalized world as a permanent need for scientific evidence that responds to the questions of needs.For this reason, the main characteristic is the description of the elaboration process which includes the selection, evaluation and analysis of the scientific documents that are found as primary sources, through the inclusion criteria.The information that is obtained through the approach of the Boolean equations responds to a screening of the data according to the categorization of the variables studied to, finally, expose the results of the research study in detail.
Due to the aforementioned, the systematic review was carried out under the PRISMA statement.Page, McKenzie, and Bossuyt (2021)that allows documenting the contributions of the authors based on the methodological advances proposed in the scientific articles, taking as a starting point the checklist proposed from the methodology, generating contributions of advanced knowledge in the field of study, by addressing the investigative problems that are taken from the variables and categories of analysis.
The search, as well as the processing and subsequent analysis of the information, focused on three study variables: first, the psychological aspects of the victims of human trafficking; secondly, trauma and disorders in the mental health of the victims and thirdly, the violation of human rights in the crime against humanity of human trafficking.The sample consisted of 27 research reports published in open access journals, in an observation period of the last five years, in English and Spanish.

Inclusion criteria
For the development of the research, the research results from primary sources were included, published in Open Journal System (OJS) journals, which facilitated the search for data in the scientific documents reported and submitted to peer review, through which It had as its principle the condensation of the information, based on the variables studied, as well as being published in the last five years in the period from 2018 to 2022.Likewise, the documents that included LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades, Asunción, Paraguay.
ISSN en línea: 2789-3855, abril, 2023, Volumen IV, Número 1 p 4242.Articles resulting from gray literature, clinical trials, case reports, books, book chapters, reflection papers, and documentation outside the observation window considered in the last five years were excluded.

Search strategies
The search was carried out in three databases such as Clarivate (WoS), Springer and Pubmed, being selected according to thematic relevance in contributions of interest regarding the analysis of the variables of this study.The keywords that are pertinent in the development of the approach of the Boolean equations based on the thematic relationship between the psychological aspects in the victims of the crime of trafficking in persons were included.
Table 1 Information search terms "Variables" and "psychological" or "trafficking" not "protocol" "Factors" and "mental" or "trafficking victims" not "judicial" "Crimes" and "sexual" or "trafficking" not "asylum" "Trafficking persons" and "protection" or "human rights" not "practices" "Crime" and "lesa humanity" or "trafficking persons" not "penalties" "Victimology" and "humans" or "trafficking" not "migrants" "Slavery" and "sexual" or "human trafficking" not "marital" "Violence" and "sexual" or "persons" not "marriage" "Abuse" and "psychological" or "trafficking victims" not "conflict" As explained above, the search for the information to be selected and subsequently analyzed was carried out in three databases that, due to their relevance and thematic relevance and by applying the specific Boolean equations for each database (see table 2), so that each one was adjusted to the search requirements of the databases so that they could answer the question posed in this research study.
Table 2 Search equations

Data Collection Process
Starting from the PRISMA list, systematic reviews have been founded as a tool that allows to delve into the study of research findings, from a retrospective look in which evidence-based conclusions are made.That is why, once the Pubmed, WOS and Springer databases were selected, the initial search for information was made based on the equations in accordance with the study variables, covering areas of knowledge such as psychology, social sciences and Law because they are the disciplines that have made contributions to the topic studied.
Subsequently, the documents were retrospectively screened, taking into account the methods used in the investigations, the search was focused through the application of filters, such as observation window, complete and open access studies, as well as finally the studies that met the proposed study variables, eliminating those documents that isolated at least one variable.

Selection of studies
The selection of the different articles was carried out taking into account the observation window of the last five years, also taking into account compliance with the variables studied, subsequently the studies that were duplicated or that did not meet the criteria were eliminated, additionally considered publications that were available in full text, eliminating abstracts and research notes (Hutton, Catalá-lópez and Moher 2016).

RESULTS
For the results, the data of three Boolean equations were crossed in the databases, for a total of 10,571 results.For the crosses in Pubmed, 2,888 were obtained, in Web of Science 4,849 and, finally, in Springer 2,834.Regarding the documents without access, a total of 7,369 identified articles were found.In the following filter, the documentation that was incomplete or that, in turn, was duplicated in the other databases was identified for a total of 3,078.Finally, the preselection of the studies resulted in 27 references that were used to process the information.Given the results obtained, these are presented in Table 4 and summarized in the flowchart of Figure 1.

Variable Category Analysis Mental Health and Trauma
Mental Health is recognized as a dynamic state through which behaviors and emotions are expressed in daily life that allow, in turn, to interact with others and deploy cognitive and mental resources.Levin (2017).In the same way, the transit of life in the different spheres is recognized, such as, for example, community, work, family social interaction, among others, which strengthen the ties in relationships, promoting the biopsychosocial well-being of people.(Lazzarino et al. 2022).
Violent events experienced by victims who are subjected to the criminal act of human trafficking in the context of sexual exploitation have been shown to have a post-traumatic psychological effect and can have lasting consequences on mental, physical and emotional health.McCabe and Eglen (2022).Victims are at high risk of developing mental health conditions, such as: anxiety disorders, depression, alcohol or drug abuse, personality disorders, post-traumatic stress disorders.This is increased because the process of social reintegration implies stigmatization, lack of empathy from their fellow citizens, few tools in the specific matter of trafficking of professionals (Motseki and Mofokeng 2020).

Psychological Aspects of Victims of Human Trafficking
Human trafficking with the purpose of sexual exploitation is highlighted as one of the crimes that threatens physical and psychological integrity, violating the dignity of human beings and the particularity of the subjects.No one is excluded from being a victim of these actions, regardless of the age or gender of these attacks, it has been possible to establish that 90% of the majority of the reports of this type of sexual exploitation are more directed towards the female gender.(Mansur 2017).
The psychological scars that a woman suffers when experiencing a case like this establish significant discomfort and sequelae over time.Within the symptomatic manifestations, the following can be identified: irritability and constant mood swings, extreme dependence, fractures in order to trust the other, states of agitation such as aggression, feelings of guilt, self-esteem problems, anxieties, fears, isolation, depression, desire to control everything, insomnia and changes in the eating process.In the same way, there is evidence of pathologies such as disorders that burden the subject such as stress, hyperprosexia, distancing from the opposite gender, and obstacles to managing the trauma experience.(Chambers et al. 2022) Likewise, there are certain preconditions of a social nature such as poverty, migration, gender, among others, that make trafficking with a certain type of person possible.But, in turn, the studies show that there is also a psycho-emotional predisposition in the victims such as dissatisfaction with the current situation, desire to succeed in another country, a feeling of not fitting in and relationships with certain types of people that open up possibilities of meeting with other people who mobilize in crime (Dahal and Kumar, 2015) Human Rights and Human Trafficking It is important to point out that, within the rules of human dignity, these are indivisible, they are for all human beings, related and do not exclude.Human Rights are also located within the civil scenario, within cultural and social processes, in addition to that within the political field of a country.Its main characteristic is the principles related to the dignity of people and the adaptation to the laws and respect for all human beings.Non-discrimination begins through alienation from this type of principles(Jagoe, Toh and Wylie 2022).
The rights of those who have been victims of this crime, within which they are transgressed in different ways, three ways in which rights are violated are recognized: countries that approve or generate these events that discriminate against women and do not allow some human beings manage to discover and deploy their particular abilities.Molodikova (2020).Also for those who deprive the victims of their dignity and human rights due to the negligence of the countries in pointing out and sentencing the traffickers, in addition to them the lack of protection for people who suffer a situation of trafficking.Lack of political will to support victims through interdisciplinary teams specifically prepared on the subject of human trafficking, as well as countries that look the other way on the issue of low-income people and lack of educational processes in the most vulnerable countries on these issues (Chaney 2020).

DISCUSSION
Human trafficking is a social, psychological and legal phenomenon that implies a requirement for international protection, due to the fact that the victims present high levels of subjective vulnerability.Grönvall (2022).In many cases, the criminal actions of trafficking have been increased by the activities of terrorist groups such as ISIS, Boko Haram, self-defense groups, guerrillas, among others, which have led to a violation of human rights in terms of human trafficking in the world.with the objective of achieving sexual exploitation and in turn from the exclusion of labor, evidencing the conditions of gender inequality since the largest number of victims are women; likewise, exposure to different types of sexual violence and conditions of mistreatment and damage to human integrity (Brabant and Raynault 2012).
The foregoing indicates that within the findings reported in the different studies analyzed, human trafficking is an integral salutogenic problem at a universal level, due to the recruitment actions, together with the different forms of sexual exploitation of the prostitution of others, as well as such as servitude and even organ trafficking, to which people are subjected are legal indicators of violation of the dignity of human beings and the characteristic of their freedoms, as well as not submitting to some type of slavery(Gossling 2022); Therefore, it establishes that the violations of individuals are included within the binding conditions for torture, as well as the submission of degrading penalties against individuals.(Grose et al. 2021).
Consequently, this type of action that violates the integrity of the human being, from the field of psychology, has a negative impact on comprehensive mental health, due to the fact that the affectations over time that reveal cognitive, thought and of behavior that lead to significant mental deterioration, as well as being linked to the appearance of symptoms associated with the course and development of psychopathological disorders, where anxiety, depression, posttraumatic stress, panic disorders and ideas prevail.recurring deaths, product of the conditions to which they have had to be subjected(Hoddy and Gray 2022)

CONCLUSIONS
Based on the objectives proposed in the research, it was identified that the main affectations from the psychological point of view are the appearance of pathologies such as depression, anxiety, panic disorders and post-traumatic stress.Faced with which, the implications of the repercussions from the mental health of the victims and survivors who have been subjected to human trafficking and consequent forced sexual exploitation generate sequelae that are not remittable over time, due to the severity of the traumatic events to which they have been LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades, Asunción, Paraguay.ISSN en línea: 2789-3855, abril, 2023, Volumen IV, Número 1 p 4253.
subjected and the little comprehensive professional care they receive within the framework of psychosocial care.
On the other hand, within the reported findings it was identified that the authorities worldwide have generated strategies aimed at mitigating the phenomenon, but these are insufficient, due to the conditions of impunity in which the illegal armed groups act with often criminal acts and outside the law, in the territories of domination, due to the scant presence of the state and the link with other criminal networks that facilitate the fact of continuing to perpetrate criminal activities.Where the legal frameworks refer to the different modalities that are provided for by law such as the prostitution of others, servile marriage, sexual exploitation and the linking of actions against the will of people to carry out sexual acts without consent, among others.
Likewise, the characteristics that are presented in organized crime, regarding the crime of human trafficking, works under a hierarchical scheme, in which the criminal structure fulfills different roles that range from the recruitment, transfer and exploitation of the victims, and Their locations in different countries or continents make their apprehension and monitoring difficult, since it requires joint work at the international level by Interpol and other judicial bodies.
Finally, the adverse conditions of the victims' places of origin perpetuate the crime of trafficking in persons, since misinformation, poor access to education, gender inequality and the nonexistent opportunities for personal and economic improvement constitute ideal environments where human trafficking gangs find favorable conditions to violate the human rights of these people.
reports and therapeutic advances from the psychological point of view were considered in relation to victims of the crime of human trafficking Exclusion criteria

Figure 1 Flowchart
Figure 1 opportunities and substantial income, early marriage, low educational levels, poverty, lack of access to information, and the desire for quick wealth.22 Psychological aspects in the victims https://doi.org/10.1080/17440572.2014.979915The forms of psychological control applied by the traffickers include a) the victim as an object, b) the victim as a vehicle and c) the victim as a person.
doi.org/10.1332/204986020X15945756343791The current conditions that arise in relation to the relationship between prostitution and forced sexual slavery have generated debates about the violation of human rights, because this problem is part of human trafficking, a phenomenon that continues to increase without unified legislative control in the world.doi.org/10.1177/10982140211056913An evaluation protocol for shelter programs for victims of human trafficking must take into account a) the characteristics of the evaluation, b) the best methodological practices to guide the application of the protocol, and (c) the objectives of the evaluation. .Springer (Macy et al. 2021) LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades, Asunción, Paraguay.ISSN en línea: 2789-3855, abril, 2023, Volumen IV, Número 1 p 4251.

Table 4
Process of identification, elimination and selection of articles

Table 5 Results
/doi.org/10.1080/23322705.2019.1574476Victims of trafficking require the creation of methods of access to comprehensive multidisciplinary care in attention to legal and social areas.Unsatisfied basic needs play an important role in the victimization of people in the crime of human trafficking; however, this is not the trigger when it comes to adolescents but the relationship between the trafficker and the victim.