Recidivism Among Women Charged With Prostitution Who Participated In At Least Six Months Of Residential Rehabilitation Compared To Community Controls.

摘要

This study was designed to determine the efficacy of an intensive residential rehabilitation program for women charged with prostitution compared to women charged with prostitution in the same county who never participated in this program. Using Illinois State police records we compared what percent of women had any criminal charge following their participation in the rehabilitation program, and the time to that first charge, for the 16 women who completed the program versus 98 women who had never entered it. We found that 50% of the program vs 79% of the non-program participants had at least one criminal charge (p<0.05) corresponding to an incidence rate ratio of 0.43 (95% CI, 0.18 to 0.89) favoring the program. To our knowledge, this is the first comparative study of a program designed to help women leave prostitution. Background The lives and deaths of prostitutes have received very little academic study. Almost all rigorous analysis regarding prostitutes has focused on them being risk factors for others acquiring sexually transmitted diseases (STDs), some authors even call prostitutes 'vectors' of disease? 1 , a term usually used to refer to non-human hosts. Interventions directed at prostitutes almost only target containment of their STDs rather than helping them escape prostitution for their own physical and mental health benefits. To our knowledge, no studies have scientifically examined any intervention to help women leave prostitution. The purpose of this study was to examine the impact of a residential rehabilitation program on helping women leave prostitution and cease all criminal activity compared with those who did not participate in this program. Methods Hypothesis and study designThis is a retrospective closed cohort study where exposure is PORA (Positive Options Referrals and Alternatives) rehabilitation. Our hypothesis is that women who participated in PORA for at least 6 months have a lower rate of recidivism (regardless of the criminal charge) than a representative community sample.Given the anticipated small sample sizes we deliberately avoided doing subgroup or multivariable analysis of the subjects. This study was approved by the Springfield Research Committee Involving Human Subjects.InterventionPORA is a non-profit, single facility organization located in Springfield, IL (Sangamon County) that opened August 11 1997 and provides temporary residential rehabilitation to women trying to leave prostitution. Largely run by volunteers, women receive free boarding, meals, mental health counseling (including substance abuse), and support to complete their General Educational Development (GED) or other educational goals and referrals for community jobs.Subject definitions, data ascertainment and outcome measureThe exposed subjects were defined as those women who completed at least 6 months of residential rehabilitation at PORA. The unexposed (control) women were defined as all women who had at least one prostitution charge in Sangamon County from August 11 1997 through November 3 2008 but never entered PORA. In cooperation with the Sangamon County Clerk of the Circuit Court and the IL State Police, we received the official, comprehensive criminal charges on all PORA and non-PORA women from the early 1970s through Nov 3 2008. We and legal authorities confirmed the unique identity for each woman based on her full name, date of birth, State identification (ID) and cross-compared dates of criminal charges if there was suspicion for using pseudonyms. Because a woman with multiple charges may have one dropped during plea-bargaining, we a priori specified as our outcome any criminal charge, not just prostitution. For the PORA women we defined their graduation date as the onset of the observation period but since the non-PORA women were never enrolled we randomly assigned one of 7 dates to each in a proportion similar to the PORA women's graduation years (Table 1), refer to them as pseudo-graduation dates and used them