A victim of trafficking for sexual exploitation and domestic servitude Leila feels too psychologically vulnerable to undergo a sexual health screening. She is living with the fear that she may have contracted a sexually transmitted infection, but is in a state of complete isolation and uncertainty. She also provides a history which suggests some physiological damage in the form of genital injury. These symptoms require investigation and possible treatment. However, their existence causes immense distress and embarrassment; to her they are a permanent reminder of the trauma she has endured. Time should be spent exploring specific fears about STI testing with victims of trafficking, particularly with those who have witnessed others dying from HIV/AIDS in their home countries and may therefore view HIV as a fatal illness. It can be explained to them that with antiviral drug regimes HIV can now be controlled reasonably successfully. Early diagnosis and treatment with anti-virals for hepatitis and HIV can improve the outcome for patients to the extent that life expectancy is hardly affected.110 Ideally victims of trafficking should be able to obtain referral to specialist STI clinics. However, if this is not possible, or they find that this is too daunting for them, referral to a general medical or gynecological practice is advised. For people who feel unable to proceed with examination at all, it may sometimes be appropriate to prescribe antibiotics without testing. HIV as a Chronic Disease, 98