Impact of substance-use disorder treatment on women involved in prostitution: substance use, mental health, and prostitution one year after treatment.

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.
METHOD: 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.