Predictors of Stable Housing for Homeless Women Leaving a Sex Work-Exiting Program

Background and Purpose: Women who have experienced homelessness while engaging in sex work have complex service needs. In many U.S. cities, comprehensive programs have been developed to address these needs and assist women in exiting the cycle of homelessness, sex work, and co-occurring problems such as substance abuse. However, little is known about the effectiveness of sex work-exiting programs and in particular there is scant research examining the housing outcomes achieved by homeless/precariously housed women who participate in such programs. The purpose of this study was to better understand predictors of obtaining stable housing for homeless women exiting a residential supportive program for sex workers. Based on the available literature, it was hypothesized that a combination of demographic, sex work-related, and participant need factors as well as the amount of time spent in the program would be associated with the likelihood of participants obtaining stable housing at program exit.

Methods: Administrative data from a residential program for women engaged in sex work in a Midwestern city was used to conduct the analysis. Descriptive statistics were calculated for the sample of 263 adult women who exited the program between 2007-2012. Participants’ destinations at program exit were analyzed to create a dichotomous outcome variable representing obtaining stable housing (e.g. subsidized or unsubsidized rental housing, permanent housing with friends or family).  A series of bivariate logistic regressions was conducted with the dichotomous housing variable and participant characteristics including age; race; income; age when first entered sex work; prior engagement in street-based sex work; criminal justice system involvement; medical, mental health, or substance abuse diagnoses; and number of days in the program. Characteristics that were significant or approached significance at p < .10 in the bivariate analyses were included in a final multivariate logistic regression model. 

Results: Nearly half (45%) of participants obtained permanent stable housing at program exit. Several predictors were significant in the bivariate analysis. Age, a reliable income source, and entering sex work at an older age were all associated with greater odds of obtaining stable housing, while participants with a mental health diagnosis or who were on probation were less likely to locate housing. In the multivariate analysis, only length of stay in the program was statistically significant. For each day that participants remained in the program, the odds of obtaining stable housing increased by 2%.

Conclusions and Implications: Because homelessness and sex work are strongly interlinked, securing stable housing is a key step for women who wish to exit sex work and make other changes in their lives. This analysis provides insight into some of the factors that affect housing outcomes for women leaving a residential sex work-exiting program. Given the importance of the length of stay variable in this analysis, future research should explore how programs can develop evidence-informed interventions to support vulnerable women (e.g. trauma-informed care, especially for women who entered sex work at younger ages) to maximize length of stay and provide greater opportunities for women to access programmatic services, including assistance securing housing.