Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD...

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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

Transcript of Dallas Police Department's Prostitute Diversion Initiative_Felini & Gonzales Texas HIV STD...

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

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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)

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

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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

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]