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John J. Potterat, Devon D. Brewer, Stephen Q. Muth, Richard B. Rothenberg, Donald E. Woodhouse, John B. Muth, Heather K. In this study, the authors estimated overall and cause-specific mortality among prostitute women. They recorded information on prostitute women identified by police and health department surveillance in Colorado Springs, Colorado, from to The authors assessed cause-specific mortality in this open cohort of 1, women using the Social Security Death Index and the National Death Index, augmented by individual investigations.
In comparison with the general population, the standardized mortality ratio SMR , adjusted for age and race, was 1. Violence and drug use were the predominant causes of death, both during periods of prostitution and during the whole observation period. Deaths from acquired immunodeficiency syndrome occurred exclusively among prostitutes who admitted to injecting drug use or were inferred to have a history of it. Female prostitution is embedded in a context of felonious activity, illicit drugs, and violence 1 — 4 and is associated with premature mortality.
Two cohort studies have directly assessed mortality in prostitutes during short observation periods 5 , 6. No prior research has measured prostitute mortality during a long period or has verified it with vital statistics records.
For three decades, continuous, community-wide surveillance of prostitutes in Colorado Springs, Colorado, has generated information on a large cohort of prostitute women 8 , 9. These data and the availability of national mortality databases permitted assessment of cause-specific mortality among these women. US Census figures 10 show that in , Colorado Springs had a population of ,, of whom 94 percent were White including an unknown proportion of Hispanics , 5 percent were African-American, and 1 percent were of other races.
Enhanced monitoring of prostitution in Colorado Springs began in the s in response to a rapidly growing gonorrhea epidemic associated with prostitution 5 , 8. In mid, the health department instituted a mechanism for examining arrested prostitutes for sexually transmitted infections, termed the Health Hold Order 8.