Inaccurate information not only creates confusion but also endangers the most vulnerable communities globally. Complicating this threat is the role of social media, which has expedited and expanded the spread of information. The World Health Organization has recognized this as a public health issue and defined our current global state as an infodemic, or “too much information including false and misleading information” (1). Misinformation refers to fake or misleading information that is disseminated unintentionally. Disinformation refers to fake or misleading information that is intentionally disseminated (2).

Unfortunately, the anti-trafficking movement is no stranger to the role of misinformation and disinformation. Historical misconceptions have long underpinned public perception of human trafficking and continue to influence our policies, headlines, and biases. Inaccurate information exacerbates the disproportionate attention and resources dedicated to addressing the most sensational and “media-worthy” cases of human trafficking but overlook the spectrum of trafficking exploitation within the global landscape (3). Experts describe the deleterious impact this has on survivors of trafficking and increases marginalization of and lack of resources for migrant workers and those engaged in commercial sex 3. One particularly egregious example of this phenomenon are the conspiracy myths that lie at the foundation of the disinformation propagated by the QAnon campaign. Our goal within this manuscript is to (1) describe the large-scale mechanisms used by the QAnon campaign to spread disinformation, (2) illustrate how these mechanisms adversely affect the anti-trafficking movement on a population level, and (3) provide systems-level recommendations for the health sector to combat disinformation while addressing root causes of trafficking.

The QAnon campaign began in 2017 when an anonymous writer—under the name “Q”—began posting a series of coded messages on the website 4chan that implicated the involvement of “deep state” democrats, celebrities, media personnel, and political officials in a worldwide satanic domestic minor sex trafficking ring (4, 5). This then progressed to multiple anonymous imageboard sites by the names of 4chan, 8chan, and 8kun also weaponizing these messages to recruit following for conspiracy theories (6). Studies have found that accessibility of the internet, availability of social media, and abundant disinformation sources all catalyzed the grown of the QAnon campaign to an unprecedented threat level (7). With the unveiling of Jeffrey Epstein's involvement in the commercial sex industry, these conspiracy theories began infiltrating mainstream social media as well as public discourse. It migrated and integrated into larger online platforms such as YouTube and Reddit. Once efforts began mobilizing off-line, these theories were picked up via news coverage, which then broadened the message even further (8). Today, “QAnon has transformed from a bizarre conspiracy theory circulating only in the dark corners of cyberspace to a mainstream phenomenon advocated by politicians and media figure alike” (6, 9–11). Mobilization of this campaign has launched hundreds of #SaveTheChildren rallies across the United States (4). By late 2020, nearly 50% of Americans have heard QAnon conspiracy theories with surveys showing almost 14% of polled Americans identify themselves as “QAnon believers” (5, 12).

QAnon's large-scale beliefs are rooted in extremism identifying one absolute enemy, typically individuals with elite power, driving domestic minor sex trafficking (13). As is the case for most extremist theories, radicalization “discourages the navigation of differing perspectives required in a pluralistic society, and the dehumanizing effects of conspiracy which are important for supporting radicalization” (14). In the case of QAnons's campaign within the context of the anti-trafficking movement, their sensationalized theories around domestic minor sex trafficking propagate a simplified representation of exploitation that distracts energy and resources from the multi-systemic causes that ultimately give rise to human trafficking.

QAnon mobilizes gendered, racist, and xenophobic manifestations of trafficking victimization as well as problematic heroism responses to trafficking. “The ‘white slave' panic in Europe and the United States at the turn of the twentieth century” was driven by “those who fomented the white slavery scare of the time” and “sought to expose precisely the mobile yet highly organized net of the underworld lurking below the surface of society” (15). This is replicated in QAnon's panic regarding “the procurement, by force, deceit, or drugs, of a white woman or girl against her will, for prostitution” (15). The ways in which QAnon profiles victims of human trafficking simultaneously strengthens the conflation of human trafficking with exclusively sex trafficking despite other forms of trafficking exploitation having been found more prevalent globally. This systemic devaluing of trafficked individuals ignored by QAnon's profiling—people of color, immigrants, people who identify as gender non-binary—underpins historic structural inequities that have been built into the United States' response to human trafficking (16). At the core of both, we see “racialized and gendered roles of feminine helplessness and protection by traditional (i.e., masculine) institutions” (14).

QAnon's public messaging carries adverse implications for survivors and the anti-trafficking movement. Resources invested in inaccurate information divert resources and effort from supporting victims and survivors (17). In fact, QAnon's campaign could threaten the bipartisan support extended to this issue, driving potentially ineffective and dangerous policies based upon inaccurate information. By invalidating the narratives of people with lived experience and drowning out the voices of survivor-advocates, victims themselves may be less likely to self-report (17). Service providers will also be impacted through QAnon's efforts that perpetuate systemic biases and ultimately reinforce inequitable funding cycles, screening efforts, and care coordination.

Healthcare providers are key actors in the anti-trafficking response for both identification of trafficked persons as well as connections to care. With that said, providers are also exposed and susceptible to the disinformation tactics employed within the current sociopolitical landscape. There are several ways health systems and professionals can leverage their educational and advocacy power to combat trafficking disinformation and invest in addressing the root causes of human trafficking (35).

First, it is vital that those with lived experience, from a diversity of demographics, shape health sector efforts on trafficking. Clinician educators should avoid sources that incorporate sensationalized language within discourse regarding human trafficking (e.g., avoid imagery of victim in restraints). Information alleging complex conspiracy theories without supporting evidence should be avoided. Medical educators must also be cautioned against using information disseminated by organizations that (1) promote racial, ethnic, or religious stereotypes and (2) claim to “rescue” trafficked “victims.” Health professionals should be trained on the diversity of people who experience trafficking, especially counter-stereotypical examples of trafficking, in order to combat structural and institutional biases that impact identification and intervention efforts for this population. Further, rather than “screening for trafficking,” providers can educate their patients about their rights as workers and connect them to resources because many victims may not self-identify (35).

Health systems should develop policies that identify and respond to individuals who have experienced any form of human trafficking, inclusive of labor and sex trafficking. They can disseminate accurate information about trafficking exploitation and worker rights to counter disinformation. Health professionals and health systems can advocate for policies that address social determinants of health that are also systemic vulnerabilities to human trafficking such as access to housing, social, legal, and/or employment support. Health systems should also advocate for an end to discriminatory practices against immigrants and communities of color.

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

JP: investigation, methodology, writing—original draft, and writing—review and editing. HS: conceptualization, investigation, methodology, resources, supervision, validation, and writing—review and editing. TE: conceptualization, resources, supervision, validation, and writing—review and editing. All authors contributed to the article and approved the submitted version.

This work was funded by NIH NIDA SBIR R44DA051106 and R44DA051106-02S1.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.