In response to community concern about the growing street prostitution in the southern sector of Dallas, a novel diversion program operating at the intersection between health and the criminal justice system is bringing needed resources to the streets where these women experience the most barriers to care. In doing so, health professionals are reaching women in parts of the city that were previously inaccessible.

Women contacted through the Dallas Prostitute Diversion Initiative can be diverted to mental health and substance abuse treatment centers in lieu of jail. However, once in treatment, a substantial challenge has been linking residents to health care services. Preliminary data indicat...

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In response to community concern about the growing street prostitution in the southern sector of Dallas, a novel diversion program operating at the intersection between health and the criminal justice system is bringing needed resources to the streets where these women experience the most barriers to care. In doing so, health professionals are reaching women in parts of the city that were previously inaccessible.

Women contacted through the Dallas Prostitute Diversion Initiative can be diverted to mental health and substance abuse treatment centers in lieu of jail. However, once in treatment, a substantial challenge has been linking residents to health care services. Preliminary data indicate that these women are at especially high risk of cervical cancer with over half reporting co-occurring mental health and substance abuse disorders, and a shocking 32% testing positive for syphilis.

In contrast to the general population, cervical cancer is the most common cancer diagnosed among this group of women. The goal of this project is to provide cervical cancer screening for a high risk underserved population of indigent women with substance abuse and mental health disorders moving in and out of the criminal justice system. Activities will focus on providing a trauma-informed culturally sensitive healthy woman education program to 3360 women at Nexus Recovery Center, the largest substance abuse center in the Dallas-Fort Worth Metroplex and its surrounding counties. The education will specifically focus on cervical cancer, healthy screening behaviors, and well woman health. By partnering with AIDS Arms who has substantial experience working with extremely poor populations and women of violence, cervical screenings will be provided to a minimum of 1220 women.

We will also take the opportunity to screen for oral and anal cancer, conduct a manual breast exam, and test for HIV and hepatitis – both risk factors for cancer. The intervention will be the first step in creating a ‘home’ for screening health care services, developing trust with the same health care team as they re-enter the community, and establishing a plan for continued screening during their process of recovery.

Integrating screening care into an existing mental health and substance abuse treatment program will create comprehensive care for this vulnerable and underserved population. Integrating physical health services within substance abuse centers can be replicated and adapted according to each city’s unique population characteristics and existing resources.

There is an urgency to promote replication as the women on our streets are migratory and move across transportation corridors in Texas. To support sustainability, we will capitalize on the existing PDI collaborative of over 45 diverse community organizations to bridge the gap in accessing this high risk and underserved population.

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