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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

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

TitleCorrelates of exchange sex among a population-based sample of low-income women who have heterosexual sex in Baltimore
Publication TypeJournal Article
Year of Publication2018
AuthorsSherman, SG, Hast, M, Park, JN, Decker, MR, Flynn, C, German, D
JournalAIDS Care
Volume30
Pagination1273-1281
Date PublishedOct
ISBN Number0954-0121
Accession Number29519143
Keywordsdrug use, HIV, sex work
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.

PMCID

PMC6085154