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VIOLENCE AGAINST WOMEN / October 2004

the incidence of abnormal Pap screens among women in prostitu- tion was several times higher than the state average (Parriott, 1994).

Comparing sexual assaults against prostituted women with sexual assaults against nonprostituted women, Canadian researchers found that the sexual assaults against those in prosti- tution were more physically violent and more frequently involved weapons (Efendov & Stermac, 2003).

It is sometimes assumed that young women in prostitution are knowledgeable about reproduction and sexual behaviors. This is not necessarily true. Often, women who enter prostitution as ado- lescents know very little about pregnancy, birth control, and STD. Although they may have been cautioned about HIV, adolescents in prostitution often have had no reliable education regarding sexuality, pregnancy, and contraception and may lack informa- tion about non-HIV-related STDs.

Traumatic brain injury (TBI) occurs in prostitution as a result of being beaten, hit, or kicked in the head, strangled, or having one’s head slammed into objects such as car dashboards. TBI has been documented in torture survivors (Jacobs & Iacopino, 2001) and battered women (Valera & Berenbaum, 2003). Half of a group of 100 Canadian women in prostitution reported violent assaults to their heads that resulted in alteration of consciousness (Farley, Lynne, & Cotton, in press). Likely sequelae of TBI reported by the Canadian women included trouble concentrating, memory prob- lems, headaches, pain/numbness in hands and feet, vision prob- lems, dizziness, problems with balance, and hearing problems. Many of these symptoms may be confused with other diagnoses commonly experienced by prostituted women, such as post- traumatic stress disorder (PTSD), depression, and substance abuse. TBI may be treatable but only after it is properly diagnosed.

Chronic health problems generally result from physical abuse and neglect in childhood (Radomsky, 1995), from sexual assault (Golding, 1994), battering (Crowell & Burgess, 1996), untreated health problems, and overwhelming stress and violence (Fried- man & Yehuda, 1995; Koss & Heslet, 1992; Rasmusson & Fried- man, 2002). Prostituted women suffer from all of these. Many of the chronic symptoms of women in prostitution are similar to the

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