Download - Felini draft may 2010
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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
17th Annual Texas
HIV/STD Conference
May 27, 2010
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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
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September 11, 2001
changed the way we looked at truck
stops…..
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…the ‘what if’ scenario
• Response
• Magnitude of Problem
• Economic Nightmare
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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
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Back to the
drawing board
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Collaboration
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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
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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
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Services Provided On-Site
• STD screening and presumptive treatment
• ID Program
• Food and Clothing
• Advocacy
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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
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Impact on Crime in Beats
where Truck Stops Located
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I-40 Deaths Investigation
OK, AR, MS, TX
Margaret
Gardner
Sandra
Richardson
Casey
PipestemPatsy
Leonard
Unidentified Jennifer
HymanSandra
Beard
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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
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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)
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DESCRIPTIVE ANALYSIS
Martha Felini, PhD DC MPH
UNTHSC Epidemiology, SPH
Fort Worth, TX
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Team Effort
• Gabriela Cantu, MPH
• Lindsey Brown, MPH
• Gloria Mendoza, MD MPH
• Amy Abraham
• Raquel Hampton, PhD
• UNTHSC, Center for Community Health, and
PACE
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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
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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
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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
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Effects of Prostitution
• Individual
• Family
• Societal
• Public Health
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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
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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
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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
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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
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Self-reported health conditions
Physical health conditions
o Asthma
o High Blood Pressure
o Seizures
o Others: cancer, anemia, hepatitis, lupus,
arthritis, cirrhosis, COPD
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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%
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Proportion of Drug Use
0%
20%
40%
60%
80%
Statistics only include 370 participants and are not mutually exclusive
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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
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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)
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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
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Limitations
• Defining success
• Data quality
• Convenience sample
• Heterogeneity of prostitute population
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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
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STD DATA
Marisa Gonzales
STD Operations Manager
Dallas County Health and Human Services,
Dallas, TX
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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
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Thank you
www.pdinewlife.org
Contact information
Sgt. Louis Felini: [email protected]
Dr. Martha Felini: [email protected]
Marisa Gonzales: [email protected]