Background Globally, people engaged in sex work or who are trafficked for sex face heightened risk of violence. Most research on violent deaths among this population has focused on homicides, but depression, suicidality, and post-traumatic stress disorders are also prevalent among this group, increasing their risk for death by suicide.

Objective To epidemiologically describe suicide fatalities among decedents with a history of sex work or human trafficking using United States (US) National Violent Death Reporting System (NVDRS) data.

Methods The US Centers for Disease Control and Prevention (CDC) maintains the NVDRS, which collects incident-based multistate data on violent deaths in the country. We used restricted access NVDRS data from 2003–2021 to identify suicide deaths among individuals with a history of sex work or human trafficking. Demographic and circumstance variables and case narratives were used to identify fatalities meeting study eligibility criteria. Results are presented in frequencies and percentages.

Results During the study period, 166 suicide deaths among individuals with a known history of sex work were reported, with 32 decedents (19.3%) experiencing human trafficking. Decedents’ median age was 31 years (range: 15–69) and 87.4% were female. Most (76.5%) were White, non-Hispanic and 39.7% had at least some college education.

Among decedents, 17.2% were released from an institution (e.g., jail/prison, hospital) within the month prior to death and 6.2% were experiencing homelessness. Nearly one-half of deaths (45.6%) were attributed to hanging/strangulation/suffocation, 22.9% to poisoning, and 19.3% to firearms.

Most decedents had a mental health problem (64.2%) and 67.3% had a problem with drug(s) other than alcohol. Many had a history of suicidal thoughts (43.0%) or suicide attempts (41.2%), and 35.8% disclosed their intent to die by suicide. Relationship problems, criminal legal problems, and financial problems contributed to some deaths.

Nearly one-third of individuals with a history of sex trafficking experienced sexual abuse as a child (31.3%), and 34.4% were trafficked by someone they knew, often a current/former intimate partner, parent/guardian, or friend.

Conclusions Few studies have characterized suicide deaths among individuals with a history of sex work or human trafficking. These findings can inform suicide prevention efforts for this vulnerable population.