With cases of personal sexual servitude, the lines between trafficker, recruiter, and buyer are blurred and largely depend on how the victim views each perpetrator. Personal sexual servitude takes various forms, and the payment is not always cash. In addition, the line between ongoing sexual abuse and personal sexual servitude is complex, and different survivors may define their experiences differently. Personal sexual servitude can occur when a woman or girl is permanently sold, often by her family to settle a drug debt, to an individual buyer for the explicit purpose of engaging in periodic sex acts over a long period of time. It can also occur within a commercial non-consenting marriage situation, primarily involving adult foreign national women and their families or U.S. spouses. In some of these forced marriages, the survivors can possess K-1 (fiancé) visas. Some victims are forced to do domestic work. Runaway homeless youth and LGBTQ minors without a third-party facilitator may also be victims of personal sexual servitude when they are coerced to engage in sex on an ongoing basis in order to receive basic needs such as shel- ter, food, and medications.