there is a strong relationship between mental ill - health , risk - taking behaviors , drug use and sexual behaviours among commercial sex workers . prostitution is associated with a host of psychosocial vulnerabilities , including exposure to childhood physical abuse , childhood sexual abuse , interpersonal violence in adulthood and substance uses . as described by medrano and gilchrist , prostitution is often linked with socio - demographic disadvantages like minority ethnic status , low income , homelessness and low education level . because of its complexity and multifaceted nature , prostitution poses significant challenges to clinicians and researchers . vanwesenbeeck showed that in a sample of 96 csws , the prevalence of depression was 73% , post - traumatic stress disorder was 30% when compared to those among female nurses being 53% . amanda r(2005 ) reported the presence of 87% depressive symptoms ranging between mild and severe while more than half ( 54% ) reported severe current depressive symptoms . ( 74% ) of the sample reported having ever thought about suicide , and less then half ( 42% ) reported having tried to kill themselves . bhat found a prevalence of neurotic disorders to be 45% in a sample of 82 csws attending a general health camp . aim : to evaluate psychological morbidity among female commercial sex workers with alcohol and drug abuse . sample : one hundred consecutive patients attending the psychiatry outpatient department of the victoria hospital , bangalore were assessed between january and august 2008 . assessments : 
 socio demographic profileclinical interview to confirm the clinical diagnosisgeneral health questionnaireabuse use disorder identification testrelevant clinical investigation . socio demographic profile clinical interview to confirm the clinical diagnosis general health questionnaire abuse use disorder identification test relevant clinical investigation . the marital status of our study populations was extremely good , 87% were married . in spite of most of them were home workers and their mean income per month was 6800 per month . the patients showed not good family support and 63 were hailing from a nuclear family . pattern of substance abuse and sexually transmitted diseases we found the remarkable percentage of 71% were suffering from depression . the depression is because of the profession and also the stresses faced being an alcoholic . the patients were not revealing their profession due to the consequence of being known to others . it was the consequence of being an alcoholic and also the stresses they faced being a commercial sex workers . seventy - eight percent were treated for various sexually transmitted diseases [ table 4 ] . our study shows that there could be significant mental health morbidity among csws who sought treatment for alcohol use problems . most of their husbands were alcoholics . which resembles number of studies on women 's drinking has found a positive association between women 's level of alcohol consumption and those of the partners . the strong influence of husbands on their wives drinking is consistent with the study of haavio & mannilas . pitiable circumstances , sad family background , a greater number of children to support suggests that commercial sex workers with substance abuse have poor social support . although 62 were from nuclear families , heavy burden of care in terms of cost , domestic work , economic responsibilities had lured them in to sexual business . fifty of the study population were illiterate , which is similar to study , the less well - educated individuals and those with lower occupational status drink less frequently than those with higher incomes , they tend to drink more at each session as reported in a study by caswell . 5000 - 10 , 000 per week . studies by morgan and hill have demonstrated the vulnerability of women to physical illness . in this study , 78 were having physical illness , of them 14 were suffering from alcohol - related liver damage . petersburg of russia described multiple sexual partners , low rates of condom use , concomitant use of intoxicants prior to sex , unsafe injecting practices , injecting in groups , borrowing / lending needles / syringes were the common causes of sexually transmitted disease . ninety - eight reported that they have been screened for hiv , out of them two were diagnosed and on treatment for hiv . reza - paul found that 26% of sex workers in the city of mysore were hiv - positive but this study had only two positive cases . ( the reasons could be majority were reported to be using condoms , and the sample size was very small ) . , they were anxious of their identity about them to their family members , police , clients , physical illness and hiv . poor economic background , alcoholic husbands , domestic and sexual violence , premarital sex were the causes reported by the study population for their social dysfunction and adjustment problems . they were guilty of their profession and the stresses related to it were causing many somatic symptoms . significant past illness present history of mental illness was present in 16 cases of the study population were : dysthymia-7 , mdd-1 , bpad-4 , adjustment disorder-4 . number of studies have noted that alcohol and tobacco are the most frequently used substances , accounting for the vast majority of drug - related morbidity and mortality . preventive interventions includes : targeting alcoholism , drug consumption , reducing risk factors , stimulating healthier environments involving all social factors which can significantly modify their drug dependence and to help women save money to become economically independent . its under - representative due to the problems gaining access to sex workers and establishing trust . as a result , researchers are reliant on individuals who attend sexual health clinics voluntarily , who may be poor representatives of the local csw population , particularly the more vulnerable groups . secondly , there is likely to be reporting bias in response to questionnaires or structured interviews on drug habits . finally , csw represent an unstable population both temporally and geographically , which means prospective studies are difficult to conduct without the loss of significant numbers of subjects , which itself may in bias result . its under - representative due to the problems gaining access to sex workers and establishing trust . as a result , researchers are reliant on individuals who attend sexual health clinics voluntarily , who may be poor representatives of the local csw population , particularly the more vulnerable groups . secondly , there is likely to be reporting bias in response to questionnaires or structured interviews on drug habits . finally , csw represent an unstable population both temporally and geographically , which means prospective studies are difficult to conduct without the loss of significant numbers of subjects , which itself may in bias result .
introduction : substance abuse may act as precursors and also can form outcomes of sexual behaviors . 
 the confluence of drug use , mental stressors , poverty , sexually transmitted diseases , low self - esteem and high - risk partners forms a fertile ground for psychological morbidity.aim:to assess the psychological morbidity among female commercial sex workers ( csws ) who use alcohol and other substance abuse.materials and methods : one hundred consecutive csws with alcohol and drug abuse patients attending the psychiatric opd at victoria hospital were assessed clinically . 
 relevant investigations were also carried out . 
 general health questionnaire and substance use disorder identification tests were administered.results:a total of 100 cases between 30 - 40 years of age were taken up for the study . 
 all were abusing alcohol with tobacco chewing or smoking being ( 64 ) . 
 eighty - seven were married . 
 fifty of them being illiterate . 
 seventy - eight were suffering from physical illness . 
 two were hiv patient on treatment . 
 seventy - eight were having psychological morbidity ( depression and adjustment disorder).conclusion : preventive interventions , targeting substance abuse and stimulating healthier - environments and providing economically independent .