You are evaluating a 17 year-old female in your outpatient clinic. She has a history of upper respiratory infection and is accompanied by her boyfriend.
On physical exam you notice this tattoo:*
You ask the patient about the tattoo, but she clearly does not want to talk about it. When you ask about her living circumstances, you get vague responses from her boyfriend. She is paying for the exam out of pocket.
You are concerned about sex trafficking.
- The tattoo looks trafficking-specific.
- The answers to your questions are vague or the patient doesn’t want to answer your questions (guarded historian).
- The patient is accompanied by a boyfriend who is speaking for her.
*Image shows the back of a young person's neck with a bar code and numbers above it. Very much like a product label.