P116 Factors associated with exchange sex among women and men who inject drugs – 23 US cities, 2018
Year: 2021
Type: conference-abstract
Abstract: Background People who inject drugs (PWID) and exchange sex face disproportionate burdens of HIV and sexually transmitted infections (STIs). Studies examining risk factors for exchange sex are limited among PWID, especially men, and could help tailor prevention efforts. Methods We used 2018 National HIV Behavioral Surveillance data to assess prevalence of exchange sex among PWID, specifically women and men with a history of sex with men (MSM). Exchange sex included receiving money/drugs for sex from ≥1 male partner(s) during the past year. We conducted bivariate analyses that accounted for each respondent’s city and network size to examine associations between exchange sex and sociodemographic characteristics, risk behaviors, and HIV/STI diagnoses. Results Among 4,657 PWID (3,391 women; 1,266 MSM), over one-third reported exchange sex (women: 36.2%; MSM: 34.8%). Women who exchanged sex (WES) tested HIV-positive more frequently (8.0% vs. 4.8%, P=0.005) and reported more frequent recent bacterial STIs (13.4% vs. 5.1%, P<0.001) than other women. Men who exchanged sex with men (MESM) showed similar trends (HIV: 17.5% vs. 14.6%, P=0.181; STIs: 12.7% vs. 6.1%, P<0.001). WES and MESM were more likely to be uninsured (women: 45.7% vs. 33.3%, P<0.001; MSM: 43.3% vs. 31.6%, P=0.002) and recently homeless (women: 41.8.4% vs. 25.2%, P<0.001; MSM: 39.6% vs. 17.2%, P<0.001). WES also reported higher frequencies of unemployment (37.2% vs. 29.2%, P=0.001) and incarceration (42.5% vs. 33.4%, P<0.001) than other women. WES and MESM were more likely to engage in polydrug use and risky sexual behaviors (e.g. number of condomless anal sex partners). Conclusion Men are often overlooked in interventions for PWID who exchange sex; however, we found women and MSM had similar frequencies of and risk factors for exchange sex among PWID. Interventions for PWID should be available for women and men who report exchange sex, while integrating opportunities for HIV/STI testing and preventative care.
Source: Poster presentations
Authors: J Rushmore, K Buchacz, D Broz, C Agnew-Brune, M Johnson Jones, S Cha
Institution: Centers for Disease Control and Prevention
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3182683340