Transcript Slides (PPS 1.0MB)

Syphilis and Prostitution:
A View from the Stroll
N.L. Winterbauer, M.S., Ph.D
Community Outreach and
Intervention Projects
University of Illinois, Chicago
P&S Syphilis, Chicago, by Year
2000
1999
% change
Males
163
166
-2%
Females
129
116
+11%
White
36
28
+28%
Hispanic
12
14
-14%
Black
224
220
+4%
Oth/Unk
20
20
P&S Syphilis Cases by Zip Code, 1999
60701
60626
60631
60646
60659
60630
60625
60656
60640
60613
60634
60641 60618
60657
PS Syphilis Cases
Lakeview
60635 60639 60647 60614
60622 60671
60651
6062460612
More than 10(11)
6 to 10
(11)
1 to 5
(17)
0 to 0
(45)
Gunner
60601
60605
Mile Square
60623 60608 60616
60632
60609
31st Street
60653
60615
60638
60629
60652
Englewood
60621 60637
60649
60620 60619
60617
60655 60643 60628
60658
Roseland
60633
Syphilis and Prostitution: Methods
• 57 Semi-structured, open-ended interviews
• Recruitment
– CDPH STD clinic (n=13)
– Street outreach (n=44)
• Key informant interviews
• Observations along strolls and other risk
venues
Syphilis and Prostitution:
“Punishment Stroll”
• Recruitment sites: > 90% African American
• Among Chicago’s highest concentration of:
–
–
–
–
–
–
People living below the poverty line
Unemployment
Persons receiving public aid
Births to mothers younger than 20
All cause mortality
Crime
Syphilis and Prostitution:
Sample Characteristics
N
%
Previous STD
28
64%
Previous Syphilis
8
18%
Education < HS
31
57%
Homeless
13
23%
Mean Years in Sex Work
6.1
Range: 0.5-16
Primary Drug
Heroin
Cocaine
Methadone
N
18
27
12
%
32%
47%
21%
Last STD Exam
Jail
Treatment Center
Public Clinic / ER
Don’t know/remember
Other
10
13
14
5
2
23%
30%
32%
11%
5%
The View from the Stroll
• Low levels of community awareness
• Little knowledge regarding:
–
–
–
–
–
Symptoms
Treatment
Cure
Reproductive health / biology
Local public health facilities
Syphilis and Prostitution: Barriers to
Prevention and Care
• Drug addiction – the drug addicted woman
is the most dependent person in the world
• Sex-trading as a survival strategy
• Low levels of education / awareness
• Little “where-with-all” – diminished
capacity
• Police presence on strolls
Police Presence on Strolls
“And I’m like, damn, look like they would,
you know, say that you better have a rubber
on. But it’s like if you have a rubber on
you, they fuck with you more. Yes. Yes.”
Syphilis and Prostitution: Conclusions
• Implications for Programs/Policy:
– Street-level reproductive health centers that target
drug-using women
– Collaboration with law-enforcement agencies to
develop alternatives to incarceration
– Collaboration with service organizations
• Implications for Research:
– Sex-trading as a survival strategy
– Understanding “triggers” for sex work