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Dallas Police Department’s Prostitute Diversion Initiative The key to unlocking a new life” Sgt. Louis Felini, Dallas Police Department Dallas, TX 17 th Annual Texas HIV/STD Conference May 27, 2010

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Page 1: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Dallas Police Department’s

Prostitute Diversion

Initiative

“The key to unlocking a new life”

Sgt. Louis Felini,

Dallas Police Department

Dallas, TX

17th Annual Texas

HIV/STD Conference

May 27, 2010

Page 2: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Presentation Outline

• Impetus for developing a prostitution

diversion program in Dallas, TX

• Demonstrate the need for a new approach to

the problem of prostitution

• Overview of PDI program

• A look at the data

Page 3: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

September 11, 2001

changed the way we looked at truck

stops…..

Page 4: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

…the ‘what if’ scenario

• Response

• Magnitude of Problem

• Economic Nightmare

Page 5: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Problem Identified

• Inadequacy of conventional approach to address changing dynamics of truck stops and address both local and national concerns

Prostitution

Robbery

Fraudulent

documents

Drug

traffickingHuman

traffickingTheft

ASSAULTS

HOMICIDES

Page 6: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010
Page 7: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010
Page 8: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Back to the

drawing board

Page 9: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Collaboration

Page 10: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Mission

• Offer concrete long-term services for

victims of sex industry and options for

exit

….while this mission is similar to other diversion

programs, the PDI is unique in that it:

• Law enforcement led

• Brings services to the streets

• Provides long-term intelligence strategy

Page 11: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

DPD

Mobile Command Post

Dallas

County

Health

Dept.

Sheriff’s Department

Mobile Command Post/Community Court

DPD

Vice

Mobile

Command

Post

12

3

4

TRIAGE

Lancaster Blvd.

Cherry Valley Street

Interstate 20

PDI: Schematic Representation of Site

5

Page 12: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Services Provided On-Site

• STD screening and presumptive treatment

• ID Program

• Food and Clothing

• Advocacy

Page 13: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Continuation of Services in

Treatment – New Life

• Shelter and food

• Medical and mental health treatment

• Child care

• Job skills training

• Out-patient counseling for lifetime

• Opportunity for resolution of pending legal issues

upon completion of program

Page 14: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Impact on Crime in Beats

where Truck Stops Located

Page 15: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

I-40 Deaths Investigation

OK, AR, MS, TX

Margaret

Gardner

Sandra

Richardson

Casey

PipestemPatsy

Leonard

Unidentified Jennifer

HymanSandra

Beard

Page 16: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

High Risk Potential Victims

DNA Database

• Highway Serial Killers

• FBI’s ViCAP Unit, Dallas County

Sheriff’s Office, and Dallas Police

Department

• University of North Texas Health Science

Center’s DNA Forensics Laboratory

Page 17: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Vision of long term return

• Development of informants

• Post-mortem identification of prostitutes

• Serve as model for other cities

• Prostitute Solicitation School

• Salvation Army Support Group

• PDI/New Life 501c3

• Resume’ Building (Thistle Farms Program)

Page 18: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010
Page 19: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

DESCRIPTIVE ANALYSIS

Martha Felini, PhD DC MPH

UNTHSC Epidemiology, SPH

Fort Worth, TX

Page 20: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Team Effort

• Gabriela Cantu, MPH

• Lindsey Brown, MPH

• Gloria Mendoza, MD MPH

• Amy Abraham

• Raquel Hampton, PhD

• UNTHSC, Center for Community Health, and

PACE

Page 21: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Objectives

1) To describe basic characteristics and health

status of sex workers contacted by the PDI

program

2) To assess the efficacy of the PDI

Page 22: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Background

• Diversion programs becoming more popular

• Limited resources

• Over 500 diversion programs in US

• Majority are post-booking diversion

• PDI – pre-booking diversion

• No known data on truck-stop prostitutes

• Unknown base population

• Migratory

Page 23: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Background(Potterat et al. 2004)

• Mortality rates 200x that of women of

similar age and race

• 18 times more likely to be murdered

• Nearly half have attempted suicide

Page 24: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Effects of Prostitution

• Individual

• Family

• Societal

• Public Health

Page 25: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Services needed to exit

prostitution, (Farley, 1998)

• Safe place/home

• Job training

• Health care

• Individual counseling

• Peer support

• Legal assistance

• Drug and alcohol treatment

• Self-defense training

• Childcare

• Physical protection from pimp

Page 26: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Study Design & Analysis

• Cross-sectional study -- convenience sample

• Eligibility criteria: Adult sex workers

contacted throughout Dallas the first

Wednesday of each month

• Descriptive statistics: univariate and bivariate

analysis

Page 27: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

PDI: Preliminary Evaluation

(October 2007- May 2010)

• 491 contacted on the streets

• Majority by arrest / 27 walk ups

• 1 juvenile, 3 pimps excluded= 487

• 54 repeaters

• 246 eligible for immediate diversion

• 50% opted for treatment

Page 28: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Demographic characteristics of

prostitutes contacted (n=487)

o African-American (75%),

o Female (97%),

o Late 30’s (average: 37, range: 17-63 ),

o Caretaker (59%)*

o High school education or higher (53%)*

*among 370 participants

Page 29: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Self-reported health conditions

Physical health conditions

o Asthma

o High Blood Pressure

o Seizures

o Others: cancer, anemia, hepatitis, lupus,

arthritis, cirrhosis, COPD

Page 30: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Distribution of self-reported

mental health conditions

Mental health conditions

54% self-reported having a mental condition

Nearly 2/3 of these reported having more than one

* Data do not reflect mutually exclusive persons

Condition reported Proportion (n=370)

Suicide Attempt 20%

Bipolar Disorder 30%

Schizophrenia 16%

Major Depression 31%

Page 31: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Proportion of Drug Use

0%

20%

40%

60%

80%

Statistics only include 370 participants and are not mutually exclusive

Page 32: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Diagnostic AssessmentAmerican Psychological Association DSM criteria

• Axis I = 84%• Details mental health and substance abuse disorders

• Axis III = 37%• Details medical conditions

• Axis V = 66%• Global assessment of functioning

32% assessed with three axis

34% assessed with two axis

26% assessed with one axis

8% no axis designated

* Data do not reflect mutually exclusive persons

Page 33: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Disposition

0 100 200 300 400 500

Eligible Ineligible

Entered

treatment

(n=122)

Opted to not

enter treatment

(n=124)

Jail

(n=211)

Opportunity

to enter

program in

pre-trial

releaseNOTE: 3 ineligibles missing

Tx

(n=21)

Page 34: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Participant Success

• 25% of participants completed initial

treatment program

• 65% completing initial treatment program

remain abstinent and in supportive services

with no subsequent re-arrests in Dallas

County

Page 35: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Limitations

• Defining success

• Data quality

• Convenience sample

• Heterogeneity of prostitute population

Page 36: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

What the data teaches us

• Prevalent substance abuse (95%) is self-medication

to co-exist with multiple mental health conditions

and cope with risky behaviors

• Feasibility of community organizations partnering

with law enforcement agencies to bring needed

resources directly to the streets where vulnerable

populations often experience barriers to care

Page 37: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

STD DATA

Marisa Gonzales

STD Operations Manager

Dallas County Health and Human Services,

Dallas, TX

Page 38: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010
Page 39: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010
Page 40: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010
Page 41: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

South China

11% (n=362)

China

14% (n=966)

Germany

9% (n=561)

Spain

3% (n=66)

Congo

16% (n=502)

Indonesia

8% (n=200)

New Guinea

32% (n=407)

Senegal

29% (n=274)

Dallas, TX

30% (n=423)

Summary of studies: Proportion of

prostitutes testing positive for syphilis

Page 42: Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD Conference 2010

Thank you

www.pdinewlife.org

Contact information

Sgt. Louis Felini: [email protected]

Dr. Martha Felini: [email protected]

Marisa Gonzales: [email protected]