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Sara was a teenage runaway from a western Maine town looking to earn some money. She no longer trusted her mother and was becoming reliant on pills and alcohol. A friend from Lewiston introduced her to a madame, also called a female pimp. The madame sold 15 to 20 girls who regularly worked for her and a few other part-timers whom she advertised as massage therapists.

In reality she was selling sexual favors to men — or johns.

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Broke and with nobody to turn to, Sara ed the operation, placing her among the estimated to cases of sex trafficking in Maine per year. The BDN is not releasing her last name or other identifying information to protect her safety. Someone unfamiliar with Sara or the realities of sex trafficking victims might wonder why she turned to the madame. What are the reasons why some people find themselves in this world? The answers are not simple, but often they center on vulnerability.

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No one chooses to be trafficked, which by definition requires coercion. People may come to it through desperation, or are manipulated into it, perhaps psychologically or through threats, rape or starvation.

They may have grown up in the child welfare system, developed substance use and mental health histories, or experienced homelessness, according to a human trafficking needs assessment conducted by Hornby Zeller Associates for the Maine Coalition Against Sexual Assault. Painful pasts may have shattered their sense of trust and self worth.

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But studies estimate 65 to 95 percent of people who have engaged in sex work were sexually assaulted as children, according to the California-based organization Prostitution Research and Education. Sexual assault survivors have a 35 percent greater chance of being victimized again than non-victims, according to a report by the Vera Institute of Justice and the victim assistance organization Safe Horizon. Research suggests that traumatic experiences in childhood may initiate psychological changes that can make victims more likely to encounter potential offenders in the future and make them more vulnerable to continued abuse.

They may yearn to trust others, which non-trustworthy people may take advantage of; they may feel powerless and therefore not have the assertiveness or confidence to end an encounter safely; and a lasting negative self image may prompt them to pursue dangerous activities, such as abusing drugs, which may make them more vulnerable to harm, researchers stated.

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To be considered sex trafficking, prosecutors must prove that someone used force, fraud or coercion as part of a commercial sex operation. Federal and state law also consider it to be sex trafficking if the person performing the sex act is under age Sometimes traffickers are able to coerce victims into entering the sex trade because they offer them promises of a better life.

Elizabeth Hopper, director of a program that provides mental health services to sex trafficking survivors at the Trauma Center at Justice Resource Institute in Boston.

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Someone is concerned about them, interested in them. But that interest and those promises are lies deed to fuel a trafficking operation. In some cases traffickers kidnap or physically harm victims to get them in their sex trafficking ring. Elizabeth Goatley, an assistant professor at the Diana G. But most often traffickers find ways to prey on and exploit the vulnerabilities of their victims, using manipulation tactics.

Victims, who are often reliving past traumas when they are being exploited, are not weighing the potential outcomes. For many, especially vulnerable teens who often are homeless or have run away from home, they may consider their body as the one tool they have to get what they need, she said. Sara resorted to this tactic during the decade after leaving the madame, often having sex with or providing sexual favors to drug dealers for shelter and drugs.

Smooth-tongued pimps may lavish affection on victims, at first. They are experts at knowing what their victims want and need. Is it stability? They can give them that. Did someone hurt them? For older victims, traffickers may tell them they can open up new doors and opportunities for them. If they want to be in the entertainment industry, they say they can help them out, she said.

Sara was trafficked by the Lewiston madame for six months before she escaped. She spent the next decade living with further abuse, addiction, violence and exploitation.

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She performed sex acts on men at their homes six or seven times per day, day after day, she said. Some of those jobs lasted a half hour, sometimes an hour.

Other times she spent the night. Many of the johns were middle-aged working men — family men. Some were nice. The madame slept on a large bed in the living room. The other girls who worked for her hung idly in another room between sex calls. It was filled with the clothes they wore: mini skirts, lingerie and stiletto high-heeled shoes.

Some of the other girls looked to be in their teens as well, Sara said.

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Some were older. She spent most of her time at the homes of various johns. The madame told Sara to charge the john more if she had sex during a visit. If a john wanted two girls at once, he could get the second girl at a discount.

She had no resources, no one whom she felt cared for her. She knew of no services or programs that could have helped. I felt like I had no place to turn. And then the door will close just as quickly as it opened, leaving her feeling trapped once more, and this time even more convinced that this is the life she is destined to lead.

One common statement by Maine survivors, as part of the human trafficking needs assessmentwas that they did not know any services available to them. Victims who are able to escape may have no family, no skills for a job, and struggle to create an entirely new life. Some are dependent on drugs or alcohol.

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Other girls would only take their place. To survive, they had become so desensitized to what was happening to them. Drugs and alcohol aided the numbness. Sara also struggled after escaping the madam in Lewiston. Sex became a survival tool, allowing her to gain access to shelter, drugs and other necessities.

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She was manipulated by men who pretended they cared for her. One man sold her to a drug dealer in exchange for his drugs, she said. She lost her son to the state, and was raped and beaten by boyfriends.

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She was also held captive in Portland-area hotels. When she was 19, she said a pair of drug dealers convinced her to allow them to sell prescription pills and later crack out of her home. She developed a relationship with one of the men. At one point, however, they made her drive a rental car full of guns and drugs to a Fireside Inn in Portland, she said. When she got there, a group of four men told her she was not allowed to leave.

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Over the next three months they brought her from Portland-area hotel to Portland-area hotel, where they were living, never allowing her to leave their side. They got drunk and took turns raping her.

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This year, she spent two months in Cumberland County jail after violating the terms of her release on a charge of selling marijuana to minors. Facing nine months in prison, Sara reached out to a prison counselor for help. Today, Sara is finally receiving that help. The program is at an undisclosed location in Penobscot County that provides care to sex trafficking victims like herself. So far, the program has been helping her get off drugs, trust others again, learn to become a mother and finally focus on her future.

They may need to learn how to form healthy relationships, create boundaries, build a support system and develop a vision for the future.

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If you or someone you know might be a victim of sex trafficking, call the National Human Trafficking Resource Center Hotline at This free and confidential hour service is accessible from anywhere in Maine. Sara was one of the to people in Maine estimated to be victims of sex trafficking each year. They may be manipulated into it, perhaps through threats, rape or starvation.

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They often come from painful pasts, which shattered their sense of trust and self-worth. Often, like Sara, they were abused as children. Downtown Lewiston is pictured on August 30, The sun sets on the Portland skyline, Aug. Troy R. Bennett BDN. Subscribe to our mailing list Address. Sorry, your blog cannot share posts by .