# Presentation: 683041

## 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 

- <date/time>

***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

- 31st Street

- Gunner

- Mile Square

- Lakeview

- Roseland

- Englewood

- 60601

- 60605

- 60608

- 60609

- 60612

- 60613

- 60614

- 60615

- 60616

- 60617

- 60618

- 60619

- 60620

- 60621

- 60622

- 60623

- 60624

- 60625

- 60626

- 60628

- 60629

- 60630

- 60631

- 60632

- 60633

- 60634

- 60635

- 60637

- 60638

- 60639

- 60640

- 60641

- 60643

- 60646

- 60647

- 60649

- 60651

- 60652

- 60653

- 60655

- 60656

- 60657

- 60658

- 60659

- 60671

- 60701

- PS Syphilis Cases

- More than 10

-   (11)

- 6

-  to

- 10

-   (11)

- 1

-  to

- 5

-   (17)

- 0

-  to

- 0

-   (45)

## 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 |

## Slide 8

| Primary Drug | N | % |
| --- | --- | --- |
|      Heroin | 18 | 32% |
|      Cocaine | 27 | 47% |
|      Methadone | 12 | 21% |
|  |  |  |
| Last STD Exam  |  |  |
|      Jail | 10 | 23% |
|      Treatment Center | 13 | 30% |
|      Public Clinic / ER | 14 | 32% |
|      Don’t know/remember      | 5 | 11% |
|      Other | 2 | 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