Transcript Drug Use

YANA: You Are Never Alone
Reaching Out to Women Engaged in
Street Prostitution
Political and Social Influences on
Women’s Health
APHA Annual Meeting 2001
Evaluation of the YANA Project
Alison M. Trinkoff, RN, ScD
Principal Investigator
Lyn Stankiewicz Murphy, MS, MBA, RN
Project Director
Marla T. Oros, MS, RN
Susan G. Dorsey, MS, RN
Funded by Open Society Institute
YANA’s Mission
The mission of YANA is to reach out in
love to women involved in prostitution,
offering alternatives to those who are
ready for change.
Core philosophy starts with the belief
that street prostitution is often linked
with childhood sexual abuse and
exploitation.
Operating Principles
Rapport development occurs before change
happens.
Every women and girl has strengths which
can be called upon to help exit “the life”.
YANA Place is a safe haven where women are
welcomed and accepted for who they are, not
judged or put down for what they do.
Community advocacy is essential to wider
change and should be approached globally.
The YANA Intervention
Street & Community Outreach
Case Management
Counseling
Medical Services
Support Services
Job Training and Placement
Evaluation of YANA Place
Collaborative effort of OSI and the
University of Maryland School of Nursing.
Effectiveness of the YANA approach in
reducing negative health outcomes and risk
behaviors.
Descriptive statistics, cross-tabulation and
logistic regression were used to obtain the
results.
Methods
Created a 189-item data collection tool.
Retrospective study of past and current
clients of YANA Place (N=206).
Those who were 18-years old+, and with two
or more visits to YANA were included in the
study (N=135).
Data were collected and entered into the
database.
Data were analyzed and results interpreted.
Limitations of the Study
Missing data.
The number of women responding to
a specific question will be designated
in the form of (n=__).
Allows reporting of results in an
objective manner by indicating that
the findings occurred in a small
subgroup and should be interpreted
with caution.
Review of the Literature
Sexually Transmitted Diseases
Drug Use
Physical Abuse / Violence
Health and Well Being Issues
Drug Use
Violence and
Abuse
Women
engaged in
prostitution
Health and Well-being
Issues
Sexually
Transmitted
Diseases
Drug Use
Violence and
Abuse
Women
engaged in
prostitution
Health and Well-being
Issues
Sexually
Transmitted
Diseases
Age
(N=135)
10
9
8
7
6
# of
5
women
4
3
2
1
0
18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52
Age
Race
(N=93)
60%
55%
50%
45%
40%
30%
20%
10%
0%
AA
White
Race
Education Level
(N = 69)
60%
51%
50%
40%
35%
30%
20%
10%
7%
4%
3%
0%
Elementary
Some HS
HS/GED
Education Level
Some College
College Grad
Employment Status
(N = 105)
53%
52%
52%
51%
50%
49%
48%
48%
47%
46%
Employed
Unemployed
Employment Status
Source of Employment
(n = 43)
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
84%
7%
Full
2%
Part
Prost
2%
Illegal
Activity
Type of Employment
2%
Other
Reasons for Coming to YANA
(N = 131)
80%
70%
67%
60%
50%
40%
30%
20%
11%
10%
8%
6%
5%
2%
1%
1%
Legal
HIV
Job
0%
Drug
Home
Med
Life
$
Abuse and/or Violence
( N = 42)
80%
79%
70%
74%
60%
50%
No
Yes
40%
30%
20%
21%
26%
10%
0%
Hx of Abuse
Current Abuse
Type of Abuse
( N = 42)
80%
75%
70%
60%
50%
51%
40%
40%
30%
25%
20%
10%
0%
9%
History
0%
Current
Physical
Emotional
Sexual
Suicide
( N = 48)
80%
73%
70%
60%
54%
50%
46%
40%
30%
27%
20%
10%
0%
Thoughts
Attempts
No
Yes
Prostitution Activity
( N = 102)
70%
65%
61%
60%
50%
40%
39%
35%
30%
20%
10%
0%
Past History
Currently Engaged
Prostitution
No
Yes
Drug Use
( N = 130)
120%
97%
100%
84%
80%
No
Yes
60%
40%
20%
16%
3%
0%
Past History of Use
Currently Using
Drug Use
Drug of Choice
(N = 108)
80%
70%
60%
50%
68%
40%
30%
20%
10%
0%
25%
Cocaine
Heroin
2%
5%
Marijuana
Alcohol
Drug Type
HIV Status
(N = 95)
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
44%
32%
24%
Negative
Positive
HIV Status
Unknown
Outcome Results: Prostitution
The likelihood that the women were
currently prostituting significantly
decreased as the number of YANA visits
increased.
(T = -3.60, p < 0.01).
The more times the women visited
YANA & interacted with the staff, the
less likely they were prostituting.
Outcome Results: Drugs
The likelihood that the women were
engaging in drug use significantly
decreased as the number of YANA visits
increased.
(OR = 1.36, CI = 1.03 – 1.79, p , 0.03).
The more times the women visited
YANA & interacted with the staff, the
less likely they were using drugs.
Outcome Results: HIV
Women with a greater number of YANA
visits were significantly more likely to
receive an HIV treatment referral to
outside medical services, thus
increasing the number of HIV positive
women receiving care after initiating
and maintaining YANA services.
(=0.3, t=2.2, p = 0.03).
Future Research
The effect of the outreach.
A prospective study of women
engaged in prostitution.
Publications to increase the
awareness of YANA and of
women engaged in prostitution.