Journal of Urban Health

, Volume 81, Issue 4, pp 584–595

Predictors of initiation into prostitution among female street youths

  • Amy E. Weber
  • Jean-François Boivin
  • Lucie Blais
  • Nancy Haley
  • Élise Roy


Prostitution among female street youths represents an important risk factor for several health problems. Little is known about the incidence and determinants of prostitution in this vulnerable population, and no data have been previously reported based on a longitudinal follow-up study. The objective of this study was to determine predictors of initiation into prostitution among female street youths. Female youths aged 14 to 25 years were enrolled in the Montreal Street Youth Cohort. They completed a baseline and at least one follow-up questionnaire between January 1995 and March 2000. Girls who reported never having engaged in prostitution at baseline were followed prospectively to estimate the incidence and predictors of prostitution. Of the 330 female street youths enrolled as of September 2000 in the cohort, 148 reported no history of involvement in prostitution at baseline and completed at least one follow-up questionnaire. Of these 148 girls, 33 became involved in prostitution over the course of the study (mean follow-up 2.4 years), resulting in an incidence rate of 11.1/100 person-years. Multivariate Cox regression analysis revealed having a female sex partner (adjusted hazard ratio [AHR] 3.8; 95% confidence interval [CI] 1.6–9.1) was an independent predictor of initiation into prostitution after controlling for having been on the street at age 15 years or younger (AHR 1.8, 95% CI 0.9–3.8), using acid or phecyclidine (PCP; AHR 2.0, 95% CI 0.9–4.6), using heroin (AHR 1.9, 95% CI 0.7–5.5), the use of drugs greater than twice perweek (AHR 1.9, 95% CI 0.9–4.2), and injection drug use (AHR 0.8, 95% CI 0.3–2.4). The incidence of prostitution in female street youths was elevated. Having a female sex partner was a strong predictor of initiating involvement in prostitution.


Homelessness Predictors Prostitution Street youths Women 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Anderson JE, Freese TE, Pennbridge JN. Sexual risk behavior and condom use among street youth in Hollywood. Fam Plann Perspect. 1994;26:22–25.CrossRefPubMedGoogle Scholar
  2. 2.
    Greenblatt M, Robertson MJ. Life-styles, adaptives strategies, and sexual behaviours of homeless adolescents. Hosp Community Psychiatry. 1993;44:1177–1180.PubMedGoogle Scholar
  3. 3.
    Kipke MD, O’Connor S, Palmer R, MacKenzie RG. Street youth in Los Angeles: profile of a group at high risk for human immunodeficiency virus infection. Arch Pediatr Adolesc. 1995;149:513–519.Google Scholar
  4. 4.
    Pfeifer RW, Oliver J. A study of HIV seroprevalence in a group of homeless youth in Hollywood, California. J Adolesc Health. 1997;20:339–342.CrossRefPubMedGoogle Scholar
  5. 5.
    Sullivan T. Juvenile prostitution: a critical perspective. Marriage Fam Rev. 1988;12:113–134.CrossRefGoogle Scholar
  6. 6.
    Yates GL, MacKenzie R, Pennbridge J, Cohen E. A risk profile comparison of runaway and non-runaway youth. Am J Public Health. 1988;81:208–210.Google Scholar
  7. 7.
    Clements K, Gleghorn A, Garcia D, Katz M, Marx R. A risk profile of street youth in northern California: implications for gender-specific human immunodeficiency virus prevention. J Adolesc Health. 1997;20:343–353.CrossRefPubMedGoogle Scholar
  8. 8.
    Forst ML, Harry J, Goddard PA. A health-profile comparison of deliquent and homeless youths. J Health Care Poor Underserved. 1993;4:386–400.PubMedGoogle Scholar
  9. 9.
    Johnson TP, Aschkenasy JR, Herbers MR, Gillenwater SA. Self-reported risk factors for AIDS among homeless youth. AIDS Educ Prev. 1996;8:308–322.PubMedGoogle Scholar
  10. 10.
    Rotheram-Borus MJ, Mahler KA, Koopman C, Langabeer K. Sexual abuse history and associated multiple risk behavior in adolescent runaways. Am J Orthopsychiatry. 1996;66:390–400.PubMedGoogle Scholar
  11. 11.
    Simons RL, Witbeck LB. Sexual abuse as a precursor to prostitution and victimization among adolescent and adult homeless women. J Fam Issues. 1991;12:361–379.CrossRefGoogle Scholar
  12. 12.
    deMatteo D, Major C, Block B, et al. Toronto street youth and HIV/AIDS: prevalence, demographics and risks. J Adolesc Health. 1999;25:358–366.CrossRefPubMedGoogle Scholar
  13. 13.
    Roy É, Haley N, Leclerc P, et al. Prevalence of HIV infection and risk behaviours among Montreal street youth. Int J STD AIDS. 2000;11:241–247.CrossRefPubMedGoogle Scholar
  14. 14.
    Barrett D. Reaching out to child prostitutes. Nurs Stand. 1999;13:22–23.Google Scholar
  15. 15.
    Penna Firme T, Grinder RE, Simao Linhares Barreto M. Adolescent female prostitutes on the streets of Brazil: an exploratory investigation of ontological issues. J Adolesc Res. 1991;6:493–504.Google Scholar
  16. 16.
    Greene JM, Ennett ST, Ringwalt CL. Prevalence and correlates of survival sex among runaway and homeless youth. Am J Public Health. 1999;89:1406–1409.PubMedGoogle Scholar
  17. 17.
    Ward H, Day S, Weber J. Risky business: health and safety in the sex industry over a 9 year period. Sex Transm Infect. 1999;75:340–343.PubMedGoogle Scholar
  18. 18.
    Farley M, Barkan H. Prostitution, violence, and posttraumatic stress disorder. Women Health. 1998;27:37–49.CrossRefPubMedGoogle Scholar
  19. 19.
    Earls CM, David H. Early family and sexual experiences of male and female prostitutes. Canada’s Mental Health. 1990;38:7–11.Google Scholar
  20. 20.
    Earls CM, David H. Male and female prostitution: a review. Ann Sex Res. 1989;2: 5–28.CrossRefGoogle Scholar
  21. 21.
    Seng MJ. Child sexual abuse and adolescent prostitution: a comparative analysis. Adolescence 1989;24:664–675.Google Scholar
  22. 22.
    Zierler S, Feingold L, Laufer D, Velentgas P, Kantrowitz-Gordon I, Mayer K. Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. Am J Public Health. 1991;81:572–575.PubMedGoogle Scholar
  23. 23.
    Schissel B, Fedec K. The selling of innocence: the gestalt of danger in the lives of youth prostitutes. Can J Criminol. 1999;41:33–56.Google Scholar
  24. 24.
    Nadon SM, Koverola C, Schludermann EH. Antecedents to prostitution: childhood victimization. J Interpers Violence. 1998;13:206–221.Google Scholar
  25. 25.
    Potterat JJ, Phillips L, Rothenberg RB, Darrow WW. On becoming a prostitute: an exploratory case-comparison study. J Sex Res. 1984;21:329–335.Google Scholar
  26. 26.
    Potterat JJ, Rothenberg RB, Muth SQ, Darrow WW, Phillips-Plummer L. Pathways to prostitution: the chronology of sexual and drug abuse milestones. J Sex Res. 1998;35:333–340.CrossRefGoogle Scholar
  27. 27.
    McClanahan SF, McClelland GM, Abram KM, Teplin LA. Pathways into prostitution among female jail detainees and their implications for mental health services. Psychiatr Serv. 1999;50:1606–1613.PubMedGoogle Scholar
  28. 28.
    Spatz Widom C, Kuhns JB. Childhood victimization and subsequent risk for promiscuity, prostitution, and teenage pregnancy: a prospective study. Am J Public Health. 1996;86:1607–1612.Google Scholar
  29. 29.
    Roy É, Haley N, Boivin J-F, Fappier J-Y, Claessens C. HIV infection among Montreal street youth. Montreal: Unité de santé publique-Division des maladies infectieuses; 1996.Google Scholar
  30. 30.
    Hankins C, Blanchette C, Alary M, Parent R, Claessens C, Surv UDI Working Group. Comparative HIV risk profiles of women who have sex with women (WSW) and inject drugs in the Surv UDI Study. Paper presented at: Canadian Conference on HIV/AIDS Research; 2002; Winnipeg, Canada.Google Scholar
  31. 31.
    Marrazzo JM, Kousky LA, Handsfield HH. Characteristics of female sexually transmitted disease clinic client who report same-sex behaviour. Int J STD AIDS. 2001;12: 41–46.CrossRefPubMedGoogle Scholar
  32. 32.
    Semple L. Sexually transmitted infections and risk behaviors in women who have sex with women. Sex Transm Infect. 2001;77:79.CrossRefPubMedGoogle Scholar
  33. 33.
    Bevier PJ, Chiasson MA, Hefferman RT, Castro KG. Women at sexually transmitted disease clinic who reported same-sex contacts: their HIV seroprevalence and risk behaviours. Am J Public Health. 1995;85:1366–1371.PubMedGoogle Scholar
  34. 34.
    Kiple MD, Montgomery SB, Simon TR, Iverson EF. “Substances abuse” disorders among runaway and homeless youth. Subst Use Misuse. 1997;32:969–986.Google Scholar
  35. 35.
    Stricof RL, Kennedy JT, Nattell TC, Weisfuse IB, Novick LF. HIV seroprevalence in a facility for runaway and homeless adolescents. Am J Public Health. 1991;81:S50–S53.Google Scholar
  36. 36.
    Silbert MH, Pines AM, Lynch T. Substance abuse and prostitution. J Psychoactive Drugs. 1982;14:193–197.PubMedGoogle Scholar
  37. 37.
    Bagley C, Young L. Juvenile prostitution and child sexual abuse: a controlled study. Can J Community Mental Health. 1987;6:5–26.Google Scholar
  38. 38.
    Kandel DB, Logan JA. Patterns of drug use from adolescence to young adulthood: 1. Periods of risk for initiation, continued use, and discontinuation. Am J Public Health. 1984;74:660–666.PubMedCrossRefGoogle Scholar
  39. 39.
    Potter K, Martin J, Roman S. Early developmental experiences of female sex workers: a comparative study. Aust N Z J Psychiatry. 1999;33:935–940.CrossRefPubMedGoogle Scholar

Copyright information

© The New York Academy of Medicine 2004

Authors and Affiliations

  • Amy E. Weber
    • 4
  • Jean-François Boivin
    • 1
    • 2
  • Lucie Blais
    • 3
  • Nancy Haley
    • 2
  • Élise Roy
    • 1
    • 2
  1. 1.Joint Departments of Epidemiology and Biostatistics and Occupational HealthMcGill UniversityMontréalCanada
  2. 2.Direction de la Santé Publique de Montréal-CentreMontréalCanada
  3. 3.Faculté de pharmacieUniversité de MontréalMontréalCanada
  4. 4.British Columbia Centre for Excellence in HIV/AIDSVancouver

Personalised recommendations