1. YANA: You Are Never Alone Reaching Out to Women Engaged in Street Prostitution Political and Social Influences on Women’s Health APHA Annual Meeting 2001

2. Evaluation of the YANA Project Alison M. Trinkoff, RN, ScD Principal Investigator Lyn Stankiewicz Murphy, MS, MBA, RN Project Director Marla T. Oros, MS, RN Susan G. Dorsey, MS, RN Funded by Open Society Institute

3. YANA’s Mission The mission of YANA is to reach out in love to women involved in prostitution, offering alternatives to those who are ready for change. Core philosophy starts with the belief that street prostitution is often linked with childhood sexual abuse and exploitation.

4. Operating Principles Rapport development occurs before change happens. Every women and girl has strengths which can be called upon to help exit “the life”. YANA Place is a safe haven where women are welcomed and accepted for who they are, not judged or put down for what they do. Community advocacy is essential to wider change and should be approached globally.

5. The YANA Intervention Street & Community Outreach Case Management Counseling Medical Services Support Services Job Training and Placement

6. Evaluation of YANA Place Collaborative effort of OSI and the University of Maryland School of Nursing. Effectiveness of the YANA approach in reducing negative health outcomes and risk behaviors. Descriptive statistics, cross-tabulation and logistic regression were used to obtain the results.

7. Methods Created a 189-item data collection tool. Retrospective study of past and current clients of YANA Place (N=206). Those who were 18-years old+, and with two or more visits to YANA were included in the study (N=135). Data were collected and entered into the database. Data were analyzed and results interpreted.

8. Limitations of the Study Missing data. The number of women responding to a specific question will be designated in the form of (n=__). Allows reporting of results in an objective manner by indicating that the findings occurred in a small subgroup and should be interpreted with caution.

9. Review of the Literature Sexually Transmitted Diseases Drug Use Physical Abuse / Violence Health and Well Being Issues

10. Violence and Abuse Drug Use Health and Well-being Issues Women engaged in prostitution Sexually Transmitted Diseases

11. Violence and Abuse Drug Use Health and Well-being Issues Sexually Transmitted Diseases Women engaged in prostitution

12. Age (N=135)

13. Race (N=93)

14. Education Level (N = 69)

15. Employment Status (N = 105)

16. Source of Employment (n = 43)

17. Reasons for Coming to YANA (N = 131)

18. Abuse and/or Violence ( N = 42)

19. Type of Abuse ( N = 42)

20. Suicide ( N = 48)

21. Prostitution Activity ( N = 102)

22. Drug Use ( N = 130)

23. Drug of Choice (N = 108)

24. HIV Status (N = 95)

25. Outcome Results: Prostitution The likelihood that the women were currently prostituting significantly decreased as the number of YANA visits increased. (T = -3.60, p < 0.01). The more times the women visited YANA & interacted with the staff, the less likely they were prostituting.

26. Outcome Results: Drugs The likelihood that the women were engaging in drug use significantly decreased as the number of YANA visits increased. (OR = 1.36, CI = 1.03 – 1.79, p, 0.03). The more times the women visited YANA & interacted with the staff, the less likely they were using drugs.

27. Outcome Results: HIV Women with a greater number of YANA visits were significantly more likely to receive an HIV treatment referral to outside medical services, thus increasing the number of HIV positive women receiving care after initiating and maintaining YANA services. (  =0.3, t=2.2, p = 0.03).

28. Future Research The effect of the outreach. A prospective study of women engaged in prostitution. Publications to increase the awareness of YANA and of women engaged in prostitution.