Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan;27(1):51-64.
doi: 10.1007/s10461-022-03743-0. Epub 2022 Jun 25.

Factors Associated with Exchange Sex Among Cisgender Persons Who Inject Drugs: Women and MSM-23 U.S. Cities, 2018

Julie Rushmore  1   2 , Kate Buchacz  3 , Dita Broz  3 , Christine B Agnew-Brune  3 , Michelle L Johnson Jones  4 , Susan Cha  3 ; NHBS Study Group
Collaborators, Affiliations

Factors Associated with Exchange Sex Among Cisgender Persons Who Inject Drugs: Women and MSM-23 U.S. Cities, 2018

Julie Rushmore et al. AIDS Behav. 2023 Jan.

Abstract

Persons who inject drugs (PWID) and exchange sex face disproportionate HIV rates. We assessed prevalence of exchange sex (receiving money/drugs for sex from ≥ 1 male partner(s) during the past year) among cisgender PWID, separately for women and men with a history of sex with men (MSM). We examined factors associated with exchange sex, including sociodemographic characteristics, sexual and drug use behaviors, and healthcare access/utilization. Over one-third of the 4657 participants reported exchange sex (women: 36.2%; MSM: 34.8%). Women who exchanged sex (WES) were significantly more likely to test HIV-positive than other women. Men who exchanged sex with men (MESM) showed a similar trend. WES and MESM shared many characteristics, including being uninsured, experiencing recent homelessness, condomless sex, polydrug use, and receptive/distributive needle sharing. These findings highlight a need to strengthen prevention interventions and address structural determinants of HIV for WES and MESM, particularly PWID who exchange sex.

Keywords: Exchange sex; HIV risk; Injection drug use; STI risk; Sex work.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Alpren C, Dawson EL, John B, et al. Opioid use fueling HIV transmission in an urban setting: an outbreak of HIV infection among people who inject drugs—Massachusetts, 2015–2018. Am J Public Health. 2020;110(1):37–44. - PMC - PubMed
    1. Hodder SL, Feinberg J, Strathdee SA, et al. The opioid crisis and HIV in the USA: deadly synergies. Lancet. 2021;397(10279):1139–50. - PubMed
    1. Board A, Alpren C, Hernandez B, et al. A qualitative study of injection and sexual risk behavior among unstably housed people who inject drugs in the context of an HIV outbreak in Northeast Massachusetts, 2018. Int J Drug Policy. 2021;95: 103368. - PubMed
    1. Peters PJ, Pontones P, Hoover KW, et al. HIV infection linked to injection use of oxymorphone in Indiana, 2014–2015. N Engl J Med. 2016;375(3):229–39. - PubMed
    1. Centers for Disease Control. HIV Surveillance Report, 2018 (Updated). 2020;31.