Correlates of exchange sex among a population-based sample of low-income women who have heterosexual sex in Baltimore

ABSTRACT

Sex exchange is associated with HIV and other morbidities yet has received little research, surveillance, and programmatic attention in the U.S. This study identified correlates of exchange sex and among low-income women in Baltimore, Maryland. Participants were recruited into the National HIV Behavioral Surveillance (NHBS) system in 2013 using respondent driven sampling (RDS) and completed a survey and HIV testing. The analytic sample (n = 253) consisted of women aged ≥18 years who had recent (past year) heterosexual sex. Multivariable logistic regression identified correlates of recent exchange sex. Independently associated with recent exchange sex were history of injection drug use (adjusted odds ratio (AOR) = 3.4, 95% CI: 1.1–10.3), recent prescription painkiller use (AOR = 3.7, 95% CI: 1.4–9.9), recent crack/cocaine use (AOR = 6.6, 95% CI: 2.1–20.9), recent arrest (AOR = 4.1, 95% CI: 1.2–14.8), and recent consistent condom use (AOR 1.1; 95% CI: 1.0–1.3). Women who exchanged sex exhibited heightened social and structural vulnerability and substance use. These data demonstrate the need for further research examining the context of exchange sex among low-income women and synergies between substance use and HIV risk.

KEYWORDS:

• Sex work
• HIV
• drug use

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Ju Nyeong Park http://orcid.org/0000-0001-6490-9887

Additional information

Funding

This study was funded through cooperative agreements from the Centers for Disease Control and Prevention and through contracts from the Maryland Department of Health. Dr. German was supported by an NIH Mentored Research Scientist Development Award (K01DA041259). This research was supported in part by a 2015–2016 developmental grant from the Johns Hopkins University Center for AIDS Research, an National Institutes of Health (NIH) funded program (P30AI094189), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH,NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.