East St. Louis is a city of approximately 26,000 residents, located in St. Clair County, Illinois directly across the Mississippi River from St. Louis. Prostitution has a long history in the economically distressed city, at least since the 1930s in areas near the river and an area called The Valley where East St. Louis had a reputation for gangsters, prostituted persons, and ex-bootleggers. Street prostitution continues to be a persistent and visible problem in certain city neighborhoods, and has been linked to cases of child sex trafficking. There have also been at least two – and possibly three – serial killers that targeted prostituted women in East St. Louis. The Murder Accountability Project determined that there might be a serial killer at work in East St. Louis, based on an algorithm that organizes homicide reports into groups based on the victims’ gender, geographic location, and method of killing. The Murder Accountability Project is a nonprofit organization that studies homicides, especially unsolved killings and serial murders in the United States. In 2003-2006, the bodies of six women were found in East St. Louis, with most having criminal histories consistent with prostitution and drug abuse. The homicides remained unsolved into 2019. Besides the six dead women, there was also a missing woman from this same time period who had multiple arrests for prostitution. There have been at least two serial killers operating in East St. Louis before, but those cases were solved and the men were either dead or in custody by the time the 2003-2006 victims were killed. The arrest of Donald Younge in January 2002 cleared the murders of three women in late 1999 to 2000. Maury Travis was arrested in 2002, after confessing to killing 17 women and having disposed of at least four women in East St. Louis. Both Travis and Younge were unable to commit the later six murders; Travis was already dead and Younge was in the county jail when they began.

To address problems associated with commercial sex, the East St. Louis Police Department has partnered with the Illinois State Police to conduct periodic street-level reverse stings. Female state troopers have often been recruited from the ISP and sent undercover as decoys to stroll areas of the city known for commercial sex sales. While arrested sex buyers do not typically have their identities released to the public, they may have their vehicles seized and impounded, depending upon the circumstances of the arrest.