title: Impact of substance-use disorder treatment on women involved in prostitution: substance use, mental health, and prostitution one year after treatment.
abstract: OBJECTIVE
  Prostitution is common among women with substance-use disorders (SUDs). However, little is known about the outcomes of SUD treatment for women involved in prostitution relative to their peers or the impact of SUD treatment on subsequent prostitution.
  
  
  METHODS
  Participants were 1,287 women from a national study of SUD treatment sites. Women completed a baseline interview at entry to SUD treatment and a follow-up interview roughly 1 year after discharge. We compared the substance-related and mental health outcomes at follow-up of women involved in prostitution and women not involved in prostitution, and determined if prostitution declined significantly at follow-up. Among women reporting prostitution at baseline (n = 533), we examined whether receipt of specific ancillary services (medical, mental health, psychosocial) was associated with cessation of prostitution and whether cessation of prostitution was associated with better substance-related and mental health outcomes.
  
  
  RESULTS
  Women reporting prostitution at baseline had more frequent drug and alcohol use, reduced abstinence rates, and more mental health symptoms at follow-up compared with their peers. However, the rate of prostitution declined from baseline to follow-up. Receipt of more mental health and psychosocial services during treatment was associated with the cessation of prostitution at follow-up, and cessation of prostitution was associated with lower substance use, higher rates of abstinence, and fewer mental health symptoms at follow-up.
  
  
  CONCLUSIONS
  Comprehensive services may be needed to effect significant reductions in substance use and mental health symptoms among women engaged in prostitution.
authors.affiliation: Sierra Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California 94304, USA. burnette@psych.rochester.edu
authors.forename: Mandi L
authors.initials: ML
authors.lastname: Burnette
authors.forename: Renee
authors.initials: R
authors.lastname: Schneider
authors.forename: Christine
authors.initials: C
authors.lastname: Timko
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008603:Mental Health / Q000706:statistics & numerical data; D012307:Risk Factors; D011477:Sex Work / Q000523:psychology / Q000706:statistics & numerical data*; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome