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Victims & Offenders An International Journal of Evidence-based Research, Policy, and Practice

ISSN: 1556-4886 (Print) 1556-4991 (Online) Journal homepage: https://www.tandfonline.com/loi/uvao20

The Recursive Relationship between Substance Abuse, Prostitution, and Incarceration: Voices from a Long-Term Cohort of Women

Ronet Bachman, Samantha Rodriguez, Erin M. Kerrison & Chrysanthi Leon

To cite this article: Ronet Bachman, Samantha Rodriguez, Erin M. Kerrison & Chrysanthi Leon (2019) The Recursive Relationship between Substance Abuse, Prostitution, and Incarceration: Voices from a Long-Term Cohort of Women, Victims & Offenders, 14:5, 587-605, DOI: 10.1080/15564886.2019.1628146

To link to this article: https://doi.org/10.1080/15564886.2019.1628146

Published online: 22 Jul 2019.

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The Recursive Relationship between Substance Abuse, Prostitution, and Incarceration: Voices from a Long-Term Cohort of Women Ronet Bachmana, Samantha Rodrigueza, Erin M. Kerrison b, and Chrysanthi Leona

aDepartment of Sociology and Criminal Justice, University of Delaware, Newark, Delaware, USA; bSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA

ABSTRACT Relying on interview data from a cohort of drug-involved women originally released from prison in the 1990s and interviewed between 2010 and 2011, this paper examines the role that prostitution played in their lives. These women were arrested an average of 16 times in their lives, and their criminal records prevented them from obtaining legitimate employment, which resulted in nearly half of the sample engaging in “survival prostitution.” Consistent with the Identity Theory of Desistance, narratives from those who successfully exited prostitution reveal the cognitive transformations that began when they envisioned their “feared self” (e.g. dying on the street). This research illuminates the complexities inherent in the desistance pro- cess for a contemporary sample of drug-involved adult women entrenched within the criminal justice system.

KEYWORDS Desistance; prostitution; female offenders; addiction

Introduction

At the end of 2016, there were nearly 112,000 adult women in state or federal correctional facilities and thousands more in jails or on parole or probation (Bureau of Justice Statistics, 2018). Across racial and ethnic groups, a large percentage of this population were also drug users (Bronson, Stroop, Zinner, & Berzofsky, 2017).1 Unfortunately, many of these women cycle in and out of prison for illicit substance possession charges, violations of the conditions of their parole or probation, or for committing other low- level offenses, including prostitution (Bachman, Kerrison, O’Connell, & Paternoster, 2013). Society and criminal justice policy makers alike have only recently begun to investigate the factors that impact the desistance process for women, and these findings remain equivocal at best.

One of the problems that limits consensus on the factors related to desistance for women stems from differences in observed samples and in the operationalization desis- tance. For example, some research has relied on community samples of female adolescents who were not embedded in an adult correctional system (Giordano, Seffrin, Manning, & Longmore, 2011; Kreager, Matsueda, & Erosheva, 2010), while others studies have been based on samples of women who have all been detained in adult correctional facilities, sometimes on multiple occasions (Bachman, Kerrison, Paternoster, O’Connell, & Smith,

CONTACT Ronet Bachman [email protected] Department of Sociology and Criminal Justice, University of Delaware, Newark, DE 19711, USA. Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/uvao.

VICTIMS & OFFENDERS 2019, VOL. 14, NO. 5, 587–605 https://doi.org/10.1080/15564886.2019.1628146

© 2019 Taylor & Francis Group, LLC

2015; Brown & Bloom, 2009; Robbins, Martin, & Surratt, 2009). This sample variability is also true for research examining the factors related to leaving prostitution. Studies that have examined desistance from prostitution have relied on several divergent samples including, adolescents (Reid & Piquero, 2014), individuals seeking services from “prosti- tute service organizations,” (Oselin, 2014, p. 3), or participants from specialized prostitu- tion courts or other specialized court programs (Sallmann, 2010; Shdaimah & Leon, 2015).

Defining desistance is also a precarious business, especially when most official and self- reported offending data indicate that many individuals intermittently engage in criminal behavior (Carlsson, 2013; Piquero, 2004), especially for those battling addictions (Bachman et al., 2013). This makes operationalizing desistance extremely problematic as someone may not be counted as crime- and substance-free for the past year, but would be counted as desisting if the threshold of observation had been six months.

The results from the extant literature on desistance from prostitution are as varied as the samples and definitions of desistance. Moreover, virtually no research has examined the road to desistance over a long time period for women generally, or for a diverse sample of women leaving prostitution specifically.2 Our study of persistence in and desistance from self-reported prostitution relies on in-depth interviews with a cohort of drug-involved women who were surveyed when they were originally released from a state prison in the early 1990s, and then interviewed again between 2010 and 2011. Thus, our study offers insight into the long-term patterns of entry into and desistance from this form of sex work. Results indicate the inherent complexities in this cyclical process when battling addiction, along with the barriers to desistance placed in front of those re-entering society with a criminal record and a history of stigmatized sexual conduct.

Literature review

While many terms have been used to describe prostitution, the vast majority of contem- porary research uses the terms prostitution, survival prostitution, or sex work, although most studies rely on the term, sex work. In fact, scholarly definitions of each term are relatively similar. For example, the National Institute of Justice defines prostitution as, “the offering of something of value in exchange for sexual activity. By definition, prostitu- tion is a form of commodification” (Moses, 2006, note 6). Sex work has been defined as “encompassing an exchange of a wide variety of sexual services for money or in-kind goods or services such as shelter, drugs, or clothing … . ‘sex work’ also indicates that sex work is a form of employment, thus acknowledging its legitimacy as a choice by which people earn a living and sustain themselves with dignity” (Hail-Jares, Shdaimah, & Leon, 2017, p. 9). However, others contend that the term sex work implies an occupational choice, which many involved in street-level prostitution did not make (Shdaimah & Leon, 2015). In the effort to present an authentic account of the stories shared by the voices from our sample, we will defer to their authority and use the terms sex work, prostitution, and survival prostitution interchangeably, as they did.

In the United States, prostitution is only legal in parts of Nevada. After the U.S. Congress passed the Trafficking Victims Protection Reauthorization Act in 2008 to combat human trafficking, more pressure was placed on local jurisdictions to criminalize “pimping, pandering, prostitution, and commercial sex” (U.S. Department of Justice, 2014). As a result, sex work is largely relegated to underground economies and remains

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hidden from mainstream exposure, except when individuals are arrested for either solicit- ing, pimping, or prostituting. Due to the hidden nature of this work, it is extremely difficult to validly estimate the prevalence of individuals who make a living from sex work. In fact, prior to increased global attention given to human trafficking, there was little research investigating either the prevalence or the etiology of sex work. In the past decade, however, the increased demand for research on human trafficking specifically, has pro- vided the research community with substantially more knowledge about sex work more generally (Finn, Muftić, & Marsh, 2015; Kempadoo, Sanghera, & Pattanaik, 2015).

Sex work encompasses a broad array of activities including high-end escort services, erotic massage parlors, commercial stripping, and street and internet solicitations (Dank et al., 2014). Street-based sex work is at the low end of the earnings market, and is occupied by high percentage of drug-addicted workers who also face a greater risk of victimization than what workers are exposed to in other forms of sex work (Dalla, Xia, & Kennedy, 2003; Muftić & Finn, 2013). The use of the internet and other social media platforms have allowed many sex workers to move off the streets, increasing their invisibility and making prevalence estimates more elusive. To estimate the magnitude of the underground com- mercial sex economy (UCSE), Dank et al. (2014) utilized a very complicated econometric analysis to extrapolate its net worth in eight U.S. cities. Except for Atlanta, results indicated that the UCSE significantly decreased between 2003 and 2007. In 2007, estimates of the UCSE ranged from a high of $290 million in Atlanta to a low of almost $40 million in Denver (Dank et al., 2014, p. 281). Although the number of workers involved in this economy remains hidden, the monetary value of the UCSE indicates that it is a significant industry in many urban areas today.

The desistance process Theoretical speculation about the factors related to desistance began to emerge with the research by the Gluecks (Glueck & Glueck, 1950), but remained virtually dormant until Gottfredson and Hirschi (1990) and Sampson and Laub (1993) catalyzed interest in the topic in the early 1990s. Sampson and Laub's (1993) age-graded theory of informal social control, and its subsequent revision (Laub & Sampson, 2003), was based on the original Glueck Boys data, which they extended by conducting life-history narratives with a small group of the original sample. The backbone of their theory of desistance asserts that individuals quit crime when they establish strong conventional bonds through marriage, military service, and stable employment. The slightly revised theory developed in 2003 featured a broader set of contributing factors, including “the interplay of human agency and choice, situational influences, routine activities, local culture, and historical context” (Laub & Sampson, 2003, p. 9). Essentially, this life course perspective of desistance hypothesized that exogenously generated turning points such as finding the right partner, landing a stable and satisfying job, or serving a successful stint in the military could each produce a prosocial deflection in an individual’s previous criminal offending trajectory because it strengthened a weak social bond and gave them what Toby (1957) long ago called a greater stake in conformity.

Recent research relying on more contemporary samples indicate that Sampson and Laub’s age-graded informal social control theory (Laub & Sampson, 2003; Sampson & Laub, 1993) may be deficient when predicting desistance in the current cultural and economic climate (Bachman et al., 2015; Giordano, Cernkovich, & Rudolph, 2002;

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Giordano, Schroeder, & Cernkovich, 2007; Maruna, 2001, 2004; Maruna & Roy, 2007). The sample of men upon which much of Sampson and Laub’s theory was based featured a cohort of young White males who came of age in the 1950s when well-paying industrial jobs were available and who, as a result, appear to have been amenable to changing their criminal behavior via prosocial routes such as employment and good marriages. The applicability of a theory that explains desistance for an exclusively White male sample whose prosocial journeys were scaffolded by heteronormative marriage dynamics and the security of a booming industrial labor market has since come under scrutiny. Furthermore, recent theorizing about desistance has added to this structural background the psychological manifestations that appear to affect the success of the desistance process for actively criminally-involved individuals today.

Paternoster and Bushway (2009); Bushway & Paternoster, 2011, Bushway & Paternoster (2013)) offer one of the most recent theoretical formulations explaining desistance, called the identity theory of desistance (ITD). Individuals, Paternoster and Bushway (2009) contend, will retain an “offender” working identity as long as they perceive they are netting more benefits than costs from their behavior. While many may confront failure (e.g. getting arrested, going to jail), as long as they attribute these failures to “bad luck” or “the costs of doing business,” rather than their own behavior, they will most likely continue to commit crimes. The process of changing an offender identity is gradual and begins to occur when they begin to question that illusion. Specifically, Paternoster and Bushway contend that the process of change begins, “when perceived failures and dis- satisfactions within different domains of life become connected, and when current failures become linked with anticipated future failures” (2009, p. 1105). Baumeister (1991) referred to the linking of previously isolated dissatisfactions and senses of failure in life as the crystallization of discontent; the ITD proposes this discontent as part of a subjective process of self-interpretation or self-knowledge. Initial moves toward desistance may come about upon identifying a feared self, or an image of what a person does not want to be or fears becoming.

The feared self often provides the first steps toward desistance, but to maintain these initial steps, the criminally-involved individual must craft a new, more positive image of what they want to become – the possible law-abiding self. This newly emerging prosocial identity triggers a diminished preference for things like quick and easy money, and motivates a move to make one’s social network more prosocial as well. It is this internal change in identity and the recognition of the kind of person that one wants to be that both motivates behavior consistent with a prosocial identity (change in preferences, desire for legitimate work, and conventional friends) and sends a signal to others (like potential prosocial intimates and employers) that the person is making positive changes in their life.

According to IDT, it is this agentic change in identity that both explains the movement into conventional roles, and explains why those who had previously been involved in crime would be receptive to prosocial influences. In sum, IDT contends that identity change is essential for desistance in a way that satisfying intimate relationships and stable employment are not.

Recent research investigating contemporary samples of criminal justice-involved peo- ple, including both males and females, has found support for the need for identity change prior to desistance (Aresti, Eatough, & Brooks-Gordon, 2010; Bachman et al., 2015; Bachman, Kerrison, Paternoster, Smith, & O’Connell, 2016; Healy, 2013, 2014; Opsal,

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2012). Importantly for this paper, research examining the process of exiting sex work has also noted the importance of identity transformation. For example, results from a large- scale study of 4 “prostitute-serving organizations” (PSOs) within the United States led Oselin (2014) to conclude that having the motivation to exit sex work was “a necessary but not sufficient condition to this transition” (2014, p. 46). Unlike IDT, Oselin describes the phases of the prostitution career as “entrance, experience during, and then the process of role exiting … … [which] unfolds in three stages: initial exit, role distancing, and new role embracement and identity change” (2014, p. 18). However, when reading the narratives provided to illustrate the reasons sex workers gave for attempting to exit sex work, they clearly illuminate concepts from IDT, including notions of an undesired feared self. For example, when describing one respondent’s thought processes regarding exiting sex work, Oselin (2014) states:

Aretha, who engaged in prostitution for 28 years, also expressed that returning to prison was her biggest fear and caused her substantial worry. She espoused: “I had been to the peni- tentiary twice, one more arrest and I would have gone away for a long, long time. I became so scared of getting in a car with an undercover cop … that was a big fear for me. Because when you go to prison, you don’t really know if you’ll get out alive” (pp. 39-40).

Importantly, only a few women in Oselin’s sample had permanently exited sex work as the author reported, “most of the women in this sample are in the midst of role exiting” (2014, p. 19). Thus, it is not clear what the temporal order of identity change and desistance would be for those women in her sample who had maintained their exit for an extended period of time.

One of the issues that complicates our understanding of exiting sex work is that a large percentage of the population engaged in sex work, at least those working on the street, is also navigating a substance use disorder (Baker, Dalla, & Williamson, 2010; Sarteschi & Vaughn, 2010). While scholars lack agreement on the directionality of substance abuse and sex work, virtually all studies have found a strong association between the two (Inciardi & Surratt, 2001; Smith, 2017). Unfortunately, research investigating desistance from sex work has generally relied on the recall accounts of individuals from cross- sectional samples, with very few employing a longitudinal methodology that could validly measure the onset of either sex work or substance use (Potterat, Rothenberg, Muth, Darrow, & Phillips-Plummer, 1998; Young, Boyd, & Hubbell, 2000). For example, ethno- graphic and interview data collected from over 800 chronicled these deleterious effects, citing that crack, “was a great equalizer on the street, in that it forced most crack- dependent women – regardless of age, race/ethnicity, occupation, religion, or family background – into sex trading or commercial sex work in order to support their drug- taking” (Inciardi & Surratt, 2001, p. 384). Moreover, conducting research that investigated this issue in the late 1980s and early 1990s – at the height of the crack cocaine epidemic – is also problematic because of the highly addictive nature of crack and its effects on its users and their subsequent attrition from research participation (Claus, Kindleberger, & Dugan, 2002; Scott, 2004).

One recent study has been able to examine the temporal order of sex work and substance dependency using the Pathways to Desistance study of delinquent youth who were followed over a 7-year period (Reid & Piquero, 2014). This research found that substance use occurred several years prior to prostitution for the majority of the youth

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studied and that, “substance use may function as a ‘launch’ mechanism, starting youth off on a long-term course of problem behaviors” (Reid & Piquero, 2014, p. 255). It is important to note that the Pathways sample used for this research is relatively young, with a mean baseline age of 16 years. As a result, the temporal order with substance use and sex work may not be generalizable to older sex workers or to those who have been engaged in sex work for longer periods of time. However, after exploring the narratives of a sample of women working towards desistance from substance abuse and prostitution, Kerrison, Bachman, and Paternoster (2016) cited that for some of the women they interviewed, the repeated discontents associated with trading sex for drug use, coupled with the knowledge that sexually transmitted infection, unplanned pregnancy, and persis- tent victimization were likely inevitable fates, prompted a reprioritization of their desires and potential to secure enhanced wellbeing. Still, despite confronting this reality it was often years before they could disentangle themselves from both harmful behaviors.

Regardless of the temporal order, it is clear that substance dependency is inextricably related to sex work, at least for those involved in low-echelon work on the streets. Moreover, there is likely a recursive relationship between drug use and sex work. As Young et al. (2000) explain, “[I]t is likely that prostitution and drug use is a self- perpetuating cycle in which the engagement in one leads to an increase in the other. Although women may start working as prostitutes in order to finance their drug habits, there are a number of aspects of prostitution that often cause psychological distress and trauma, which in turn may lead to increased drug use as a means of coping” (p. 795).

What is important to deduce from this literature is that exiting sex work is complicated by the nexus of sex work with substance addiction and conquering an addiction may be the first step in exiting sex work for many. For example, Oselin (2014) noted that all the women in her sample, except one, “admitted they were addicted to drugs while working in prostitution” and that they were not able to focus on desistance from the sex trade until they were sober (p. 49). Consistent with other research, this demonstrates that research examining the process of exiting sex work must also consider the role of substance abuse in that process (Baker et al., 2010; Dalla, 2006).

In sum, the extant literature has provided a great deal of insight into the complexities inherent in exiting sex work, particularly for those who are also contending with drug abuse. Although identity has been implicated in the process of this desistance, most of the work to date has not opened the black box of agentic identity change nor have results been placed within the broader theoretical discourse of desistance. To help fill this gap, this paper relies on a sample of 118 women who were surveyed upon release from prison at the height of the drug war in the early 1990s, rearrested on several occasions thereafter, and interviewed in 2010 and 2011. The goal of this paper is to examine the long-term patterns of entry into and desistance from sex work, identify how these patterns are shaped by drug addiction, and consider how the obstacles associated with a criminal record has on this process.

Methods

Sample

The data for this study come from a longitudinal analysis of serious drug-involved men and women who were originally surveyed upon release from the state of Delaware correctional

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system between the years 1990 and 1996, with a subsample re-interviewed between 2010 and 2011. The baseline study was designed to examine the effectiveness of a drug therapeutic community (TC), and consisted of 1,250 incarcerated men and women who were randomly assigned to enroll in the TC treatment condition (Inciardi, Martin, & Butzin, 2004). Subjects in the study were first interviewed while still incarcerated, approximately nine months prior to release (referred to throughout this paper as the baseline incarceration), and were re-inter- viewed after that baseline release at 6, 18, 42, and 60 months.

To determine patterns of desistance within this cohort, arrest histories for each individual that covered the years 1990 to 2008 were obtained from the Delaware Statistical Analysis Center, which records all arrests and imprisonments in the state of Delaware. These data were augmented by arrest data from the National Criminal Information Center in order to capture arrests that occurred outside the state of Delaware. With these data we amassed a count of the number of arrests for each person per year. Incarceration data were also collected for each individual since 1990 and included the entrance and exit data from prison for each sentence. This information was used to compute the number of days free per year, to control for the time the individuals were in a correctional setting. To illuminate the various paths of desistance for the original cohort, our analysis strategy began with the estimation of a group-based trajectory model for this arrest history data (Nagin, 2005). A graph of the offending trajectories for the five-groupmodel (all quadratic) that best fit the data is shown in Figure 1 (for a full discussion of the procedures used for this trajectory analysis, see Bachman et al., 2013). We present this model only because it was used as the sampling frame for the qualitative component of our study, which constitutes the primary data used for this paper.

Respondents from the original cohort were randomly selected from within each of the five trajectory groups depicted in Figure 1, which resulted in n = 304 who participated in intensive face-to-face interviews. The focus of this paper is exclusively on narratives provided by the 118 female respondents from this sample.3 The average age of this sample of females was 45 years and the mean number of arrests they had experienced at the time of their interview was 16.2. The purpose of these qualitative interviews was to illuminate

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Trajectories of Arrests 1990-2008

Mid-Level Desisters (21%) High-Level Desisters (15%) Low-Level Desisters (26%)

Low-Level Persisters (14%) High-Level Persisters (20%)

Figure 1. Trajectory model of arrest histories for original sample of 1,243 that was used as sampling frame for intensive interviews.

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the mechanisms for change in offending over time and allow the respondents to speak directly for themselves about what changes they felt they had undergone over the years since their baseline incarceration.

Interview methods

Respondents selected for interviews were first contacted by mail requesting that they call a research office phone number at a local university if they were willing to participate in the interview. Follow-up was needed in many cases, and was done first by mailing another letter, then by making phone calls, and finally by personal visits in a few cases. All interviews lasted from 1 to 3 hours and were digitally recorded. Respondents were compensated $100 for their time and travel expenses. Not surprisingly, sample attrition was a significant problem when attempting to contact this cohort almost 20 years after their baseline incarceration release. Approximately 11 percent of the original sample was deceased, 13 percent were still incarcerated, 3 percent were living out of state, and 7 percent were unreachable by any means.

While we originally did not want to conduct interviews with those still in prison because the Department of Corrections did not allow the admittance of tape recorders on-site, three women who were in the “Persister” offending trajectories were interviewedwhile in custody in an effort to increase the sample size of respondents representing these persisting trajectory groups. Interviewer field notes were used to analyze the three interviews conducted in correctional settings as well as two digitally recorded interviews whose files were corrupted.

Because of the relatively small number of women from other race/ethnic groups in the original cohort, only Black and White women were selected for the sample. The response rate for those who were successfully contacted and living in Delaware was approximately 96 percent. The majority of the women were Black (73%), and had a mean age of 44 years at the time of the interview. In their baseline interview for the original study, 43% of this sample self-reported engaging in prostitution prior to being incarcerated. Prior to the interviews conducted in 2010 and 2011, over half of the women (54%) self-reported using drugs or alcohol and about 1 in 4 self-reported engaging in other criminal activity. Only a few were still actively engaging in prostitution, although a few others reported that they were being taken care of by “former Johns,” or were living with other men they “manipu- lated” to take care of them.

The goal of the interviews was to uncover what Agnew (2006) refers to as “storylines” in understanding criminal offending. A storyline is a “temporally limited, interrelated set of events and conditions that increase the likelihood that individuals will engage in crime” (2006, p. 121) or for our purposes, desist from it. The interview guide resembled an Event History Calendar (EHC) (partially displayed in Figure 2), which proved to be an extremely useful tool for collecting retrospective data on life events within different domains such as subjects’ relationship changes, medical history, and offending (Belli, Stafford, & Alwin, 2009). Another important tool we used in our interview guide to facilitate respondents’ recall was the placement of arrest and incarceration dates obtained from official data within the calendars, as well as key life events such as birthdays to be used as heuristic cues to aid recall. These cues were also useful for helping respondents recall both their offending histories as well as other salient life events. Despite the utility of the EHC-

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inspired interview guide, however, the interviews were primarily open-ended and resembled conversations rather than an exchange of formal survey questions and answers.

For each criminal and drug relapse event self-reported or obtained from official records, respondents were asked to recreate the event both perceptually and structurally, and inter- viewers probed for respondents’ cognitive decision making processes surrounding those events. All interviews were transcribed verbatim and imported into NVivo for coding (for a more detailed discussion of the interview and coding processes, see Bachman et al., 2014).

Although the interview guide did not specifically probe for performing sexual acts in exchange for money, drugs, or other services, self-reports of prostitution were often given when respondents were asked about criminal activity or arrests. However, the absence of a specific probe for this behavior is an obvious limitation of this paper. Importantly, the purpose of this paper is not to estimate the prevalence of prostitution for this sample, but to explore the effects it had on recidivism and desistance from substance abuse and other crime generally, and to explore the desistance of prostitution specifically.

Results

Getting into the business

Like previous research using drug-involved individuals entrenched in the criminal justice system, the majority of women in this long-term sample began to prostitute because they required money for drugs. Similar to the results found by Rosen and Venkatesh (2008), this choice was made with “bounded rationality,” or having to choose between undesirable options with little information and time to think critically. The women interviewed describe bleak contexts marked by having a criminal record, little education, and low job skills, which made employment elsewhere difficult at best. Hannah4 explained her road to the business:

Figure 2. A component of the event history calendar used as a heuristic device to enhance recall.

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“I started using cocaine casually, like 1 day a week, to 3 days, and then to 7 days … and it just took over. For 10 years I found myself not caring about anything but getting high … I started getting charges and then being on probation and then prostituting … I did everything I could to get money to get the drug.”

These women were typically introduced to sex work by friends who also made their living in the sex trade. For example, Chris, who became addicted to cocaine in her early 20s, worked as a flagger after her first release from prison. When she was laid off from that job, she could not live on her unemployment so she “hooked up with a crowd” who taught her “the ropes of how to find men who would pay.” Since then, she reported being “out there on the street since I was 25. Off and on being in and out of jail and prison.” For virtually all of those who self-reported engaging in sex work, the primary reason was for getting money for their drug habits, although several women reported that the money was spent both on drugs and caring for their children.

Several of the women in the sample had childhoods riddled by physical and sexual abuse, and as a result, self-medicated with drugs and/or alcohol, which in turn led to addiction and then the need for money for drugs. For these abused women, recalling anything about their childhoods was difficult except the onset of the abuse, and the chaos that followed for the majority of their adult lives. Donna recalled, “it was something that shouldn’t have been going on with a child. My mom’s boyfriend was molesting me and that’s why we don’t get along because I swear to God she knew, I really do … I was only 5.” Donna was molested for several years by her mother’s boyfriend and alleviated this trauma by drinking and using drugs. She was addicted to cocaine by the age of 13. While she was sent to various extended relatives after a juvenile arrest, her learned way of survival always led back to the streets to sex work, selling drugs, and substance abuse. The good times she recalls in her adult life were when she stopped using cocaine and her only addiction was heroin. With only a heroin addiction, she didn’t have to “hustle” so much and could almost make a living and secure her own drugs by selling them. At the time of her interview, she was still addicted to substances and trying to survive. She was currently awaiting adjudication for a shoplifting charge.

Similarly evidencing the role of childhood chaos and mistreatment, Dominique was put into foster care when she was 6 months old because her birth mother was an alcoholic. When she was 6 years old, her birth mother regained custody of Dominique and her older sister, despite still being addicted to alcohol. They lived in Section 8 housing and there were times when Dominique’s mother didn’t come home for weeks. Dominique started drinking alcohol, dating a man who was 15 years older than she – whom she called, “her child molester” – and was eventually placed in a juvenile detention center. She married an abusive man, had 2 children, and maintained an addiction to alcohol, which was her drug of choice. When the substance abuse led to her hospitalization, she called her aunt to take her children so she could be sure they were safe when she ended her marriage. This is when a “frenemy,” as she described them, introduced her to cocaine. Dominique described how her world changed thereafter:

“I cut ties with my kids and my husband and went directly into the drug world. I cut everybody off. That’s when I started picking up charges for possession, prostitution, stealing … .I was just self-destructing.”

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Dominique was in and out of prison, in and out of treatment programs, in and out of halfway houses, and on and off the streets for the next 20 years.

While a few of the women worked for a pimp, the majority of the women in this sample did not. For example, Manhattan was introduced to crack by an older man at a party, who eventually got her a hotel room where she would bring back tricks for money. After he started taking all the money, she and another woman “wised up and started doing it for ourselves.” When she needed more money, she would rob her “Johns.” After stabbing one man when he tried to get his money back, he called the police and told them he was just giving her a ride and she attacked him. “They’d [the police] look at me and they’d look at him, and my word didn’t stand for nothing.” For this, she was sentenced to 5 years in prison. She still used cocaine but the streets have changed and the quality of the available drugs can no longer be trusted, she warned, “It’s not the same. You don’t want it. It’s nasty. There’s so much stuff you don’t even know. It’s terrible.” Although she still occasionally had sex for money, she did not do it regularly and therefore perceived that “it is [not] the same prostitution that I’ve done.” Manhattan had episodes of being clean, sometimes as long as a year, but would eventually relapse again. Her most recent relapse was 4 months before her interview, and she was since prescribed medication for anxiety and ADHD, which she believed was helping to alleviate her symptoms.

Only a few of the women reported that prostitution came before drug addiction. For example, Brandy who self-reported a good childhood, fell in love with a man and they had two children together. When he left her for another woman, she started sex work to provide for her family. Substance use soon followed as she explains, “when you start taking your clothes off with dirty, ugly, nasty men that think you’re trash, you do drugs to forget. I had everything. Then I had nothing – just abuse.” Brandy grew up in a middle- class home but soon found herself responsible for two kids and engaging in behavior that was previously out of her realm of possibility. She explained, “If they said I would become a prostitute, I would have said, ‘you’re out of your fucking head.” Brandy had been surviving on the streets all of her adult life and was now in her late 40s. She still used drugs to self-medicate and was still self-sustaining day-to-day. When asked about her present life, she reported, “I still have morals. You may say, yes, but you take drugs, and sell your ass, but I still have morals.” When she is under correctional supervision, she reported using prescription drugs to avoid a parole violation, “When I’m on probation, I can’t use some drugs, but I can take Xanax or Percocet [which] will take my pain away [and won’t be detected]. I’m not Mother Theresa – I don’t know what is going to happen tomorrow. Today I feel good … .this money [from doing the interview] is going to get me groceries. I have a free ride waiting out there – it is a good day.” This narrative reflects the nuanced picture of “moral and rational choice-making” depicted by Shdaimah and Leon (2015) to describe the decision-making process of the sex workers in their sample. Brandy had few options, but made rational choices based on her circumstances and survival needs.

Despite operating with the instinct to survive reflected in narratives like Brandy’s, virtually all of the women who self-reported engaging in prostitution perceived a sense of shame about this behavior. In fact, a few did not disclose engaging in prostitution when probed about criminal activity, but eventually disclosed these histories at a later stage in the interview. For example, when asked about the biggest incentive for getting treatment for her addiction, Cherise stated:

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Cherise : I didn’t want to go to prison and I didn’t want to prostitute or none of that stuff no more.

Interviewer : So you had done that? You didn’t tell me about that. Cherise : Oh, I did say that.

Interviewer : Did you? Cherise : Yeah. I didn’t say it like “prostitution,” but I probably used a term like

“degrading my body” or tried to cover it up, make it sound good.

In sum, the primary reason for engaging in sex work for this sample of drug-involved and criminal justice immersed sample of women was economic necessity. While this need was most often related to satisfying their addictions, a nontrivial number of women also engaged in sex work for basic survival needs like food and shelter.

Although over half of the women we interviewed had used drugs and alcohol during the 12 months prior to our interview, only about 10% were still actively engaged in prostitution. As noted above, however, several others were living with “former Johns,” or with other men who “took care of them and their needs.” The majority of the women who were still using drugs had developed significant health issues, which required them to “slow down their use.” Several of these women were able to get off the streets when they were able to obtain medication-assisted treatment from Methadone and Suboxone clinics. Others used drugs “only when I can afford to,” and were able tomaintain their needs via their disability insurance income. However, the vastmajority of the womenwe interviewed who had actively engaged in prostitution had successfully exited the sex work trade.

Exiting sex work

I’m going to die out here if I don’t quit The majority of the women in this sample continued to engage in sex work as long as they were substance addicted. For many of these women, their stated survival needs included maintaining their addiction, eating occasionally, and hopefully finding a place to sleep. Janice was addicted to heroin by the time she was 19 at a time when “they didn’t even know what an addiction was.”Her boyfriend was the first person to give her a shot of heroin and, “it was the best feeling in the world. That was it… I asked him what it was and he said, ‘it’s called heroin … ’ everybody had heroin.”Within a month Janice was addicted and woke up feeling sick and her boyfriend told her she was “heroin sick” and gave her another shot and she “was in the clouds in heaven.” In that moment she recalled thinking to herself, “Oh my God, I’m stuck.”

After her boyfriend left her, Janice “ended up on the streets prostituting for years after that … and the first time I went to jail for prostitution I was like 23… then my life was just crap. I shot drugs, prostituted, and was in and out of jail.” She used cocaine to get herself up to work, and then heroine so she could sleep. Years of this “hard living” eventually had severe health consequences for Janice. She ended up in the hospital with endocarditis of the heart from all of her drug use and heard the doctor say, “call her family. She’s not going to live 48 hours.” Janice was still alive six weeks later and the doctors “believed it was a miracle.” It was this incident that led to her crystallization of discontent, where she realized “I was going to die if I didn’t do something different.” Although Janice recalled that she had been “sick and tired of being sick and tired,” prior to this near death experience in the hospital, it was only after this incident

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that her feared-self emerged: “dying an addict.” Following this life event, Janice began the process of identity transformation by making decisions to change her life. After she was released from the hospital, she admitted herself to an in-patient treatment facility and had remained clean for almost two years.

While several of the women’s identity transformation was triggered by a traumatic event similar to Janice’s, the transformation for most of the other women was a slow and nonlinear decline into an abyss where they knew they would die if they didn’t change. Finding legitimate employment with a long criminal record was extremely difficult for many of these women, and finding a job that paid a living wage was virtually impossible. Sex work was one of the only methods for making money. For over two decades, many of these women maintained their addictions in survivalmode, while their bodies andminds suffered the deleterious consequences.

Because of their age, these women were very conscious of their declining market value on the street despite their attempts to remain attractive. The declining benefits obtained from sex work also served to increase the costs associated with their drug use, which facilitated the connection between past failures becoming future failures. These cognitive connections were described by many women, including Elizabeth, who was 54 at the time of our interview. Elizabeth described the illumination of her feared-self very graphically:

When I was getting older, I started seeing young girls prostituting in their 20s. I was in my middle 40s – come on now. Cars started passing me to go to the young ones. I still had my regulars but it was time to do something different … when I became 50, I knew I couldn’t prostitute forever … I had to accept scary rides that often didn’t end well … I knew I had to change or I would die out there.

At the time of her interview, Elizabeth had been in and out prison and in and out of treatment her entire life. It was not one incident that precipitated her desistance, but instead, she described the process of realizing that nothing was going to change unless she changed herself. She called her mother and promised her that if her mother helped her get into a treatment program, this time she would make it work. Elizabeth had been clean for almost three years but knew she had to remain vigilant about not aligning herself too closely with “those women” who are still “on the stroll” or she would end up back on the street. She noted:

If I pass the working girls now, I might wave if I know them but I don’t affiliate myself in that circle anymore … .sometimes if they call me from the streets [and I might let them] come over and take a shower … but this is not a hotel. That’s where I stand and I have to. If I don’t I could find myself right back on the streets.

Finding a savior among tricks

In addition to the few women who were actively engaged in sex work, a few other women were currently living with “former tricks,” and several others had moved in with clients at other times in their lives. For example, after over 20 years on the street, Tonya moved in with one of her “tricks” She said, “Brian made me his woman, but to me he was a trick. Once a trick, always a trick. I don’t feel anything for him … But I never want for anything.”

The other women who were currently living with former clients had similar stories. It is clear from the women’s narratives that the men in these accounts were truly benevolent actors, not simply doing it for sexual favors. For two of the women in this group, their

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families of origin had severed all ties with them because of their continued failed attempts at recovery. These women understood their abandonment as justified because they had “stolen from their family to buy drugs,” and “let them down so many times that they couldn’t take it anymore.” The older men who had taken them in clearly represented a surrogate parent. They provided them with food and shelter and although they wanted and encouraged them to get clean, they didn’t kick the women out when that was not possible. While providing much needed support and safety, respondents admitted that these men often did not provide the long-term platform for change needed for meaningful desistance from crime and substance abuse.

Conclusion

The interview narratives presented here offer several new insights into the pathways into and out of prostitution for women who are drug-involved and justice-impacted. Results indicate that substance addiction was the underlying factor that compelled the majority of the women in this sample to engage in street level prostitution. Moreover, when these women were arrested and incarcerated for drug possession or other offenses, the vast scope of collateral consequences attached to their offender status exacerbated reintegration hurdles and further distanced these women from pro-social ties and gainful, steady, and legitimate employment.

These women’s stories and arrest histories – captured both through self-report and official records – provide further evidence that drug addiction is a chronic lifetime disease characterized by relapses and behavior (e.g. survival prostitution) that appears undeterred by the threat of formal sanctions. This supports the contention that criminal justice sanctions are an inefficient intervention for deterring vulnerable individuals from pro- longed substance abuse or the survival prostitution that is associated with it. As noted by Hail-Jares, Shdaimah, and Leon (2015, p. 299), “[we must question] why criminal justice tools are the ones we most often use to address sex work, particularly the types that are most socially marginalized.” The many periods of incarceration experienced by this sample neither steered these women away from prostitution nor addressed the underlying motivations animating their decision to engage this world. Instead, the criminal justice apparatus only exacerbated their chances at healthy (re)integration and left them more vulnerable and reliant upon one of the only economies accessible to poor drug-involved women burdened with criminal records.

Importantly, our research also supports previous work that has placed female crimin- ality within a larger context of a violent childhood and cycle of violent relationships (Chesney-Lind & Pasko, 2013; Inciardi & Surratt, 2001). Many of the women interviewed here acknowledged the use of drugs and alcohol as a salve or escape from these traumas, which included the trauma related to survival prostitution. Helping women heal from primary traumas would seem to go a long way to reducing recidivism, net of drug treatment programs. As Harrison noted over ten years ago, “Drug abuse is often regarded as a symptom of underlying problems, and those underlying problems must be treated for the individual to stop abusing drugs.” (Harrison, 2001, p. 474). Programs that fail to consider the auxiliary trauma endured by many females will inevitably fall short.

Another finding from this diverse sample of women is that several offered accounts of exiting prostitution work with the help of a partner who had committed to providing for

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them. However, the availability of the sort of savior identified in these scenarios is not a given for all women navigating this world, as even clients regard women engaged in sex work with varying levels of dignity and empathy, and against a hierarchical rubric of respectability (Grant, 2014; Hoang, 2015). Intersectional analyses suggest, too, that many racist and classist taxonomies of sympathetic sex works cast more privileged women as unwilling victims, and more marginalized women as undeserving law-breakers. In reality, many women come to occupy both constructions (Phillips, 2015; Wesely & Miller, 2018).

And finally, a novel finding in this research is the suggestion that women’s very identities as trapped and confined to this reality, are inextricably linked to their persistent offending patterns. Women who can neither imagine nor support an identity that chal- lenges the more dangerous fates known to many engaged in street-level sex work, regrettably continue to engage in the very practices that seal those fates. These data lend support for the Identity Theory of Desistance in that those who identified a feared self and then constructed a possible self who need no longer rely on more dangerous forms of street level prostitution, were the ones who were more likely to desist from committing those offenses and make moves towards substance abuse recovery. One therapeutic intervention that may accelerate this self-discovery process is cognitive-behavioral therapy (CBT). CBT is premised upon several principles including helping clients improve cog- nitive skills such as the skills necessary to identify problems, consider alternative courses of action to solve those problems, evaluate possible solutions before adopting a course of action, engage in critical reasoning and rational deliberation skills, focus on long-term planning, and the importance of taking the position of other people within one’s social environment (Latessa, Listwan, & Koetzle, 2013). Although the CBT model is not theore- tically based on the identity theory of desistance, the practices of this therapy appear to provide individuals with exactly those cognitive and rational skills that would enable them to more easily connect past and future events and realize that the life of an “offender” and “drug-abuser” will likely result in becoming their “feared self” (e.g. dying an addict). Such self-awareness would be instrumental in getting individuals ready to change, ready to adopt a new identity, and beginning the process of movement toward a non-offender identity. While CBT has been shown to be one of the more effective prison-based therapy programs in reducing recidivism (Latessa et al., 2013; Lipsey, Landenberger, & Wilson, 2007), study findings suggest that more can still be done to ensure that its merits can be enjoyed by a more diverse population of participants, the largest gulf of which exists for Black women in these treatment settings (Jemal, Gunn, & Inyang, 2019; Kerrison, 2018). As such, these programs would be most effective when combined with the trauma- informed therapies noted above and an earnest incorporation of effective acceptability structures for a diverse array of gender, racial, and cultural representations among treatment participants.

While the extant research, including findings presented here, have advanced our understanding of factors related to drug and criminal justice-involved individuals’ use of sex work as a means for survival, further research is needed to document the persistence and desistance experiences of marginalized groups of sex workers. These groups include foster and homeless youth, those from the LGBTQ community, undocumented indivi- duals, and those ensnared in sex trafficking. In the interim, these data suggest that drug- involved women’s entry to and exit from the sex work economy is only exacerbated by criminal justice intervention, and that more targeted service-providing and trauma-

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informed approaches are needed to ensure their safety and increase the likelihood of permanent recovery and desistance.

Notes 1. Importantly for the sample used in this paper, the percentage of the correctional population

serving sentences related to drug law violations increased dramatically after 1980. For example, drug law violators made up 22% of the federal prison population in 1980, but increased to 48% in 1990 (Bureau of Justice Statistics, 1991).

2. While both males and females engage in sex work, the present study will focus exclusively on females because there were too few males in this sample who self-reported engaging in sex work.

3. This research was approved the University of Delaware’s Institutional Review Board. 4. Names provided are pseudonyms and used to protect confidentiality.

Acknowledgements

We would like to thank the anonymous reviewers for their comments and suggestions for improve- ment to earlier drafts of this paper. Our deepest gratitude goes to the women who gave us their time, energy, and trust to share their stories.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The corresponding author for this paper is Ronet Bachman. This project was supported by grant number 2008-IJ-CX-0017 awarded by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice. Points of view are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice.

ORCID

Erin M. Kerrison http://orcid.org/0000-0003-1300-3983

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