Exchange Sex and HIV Infection Among Women Who Inject Drugs-20 US Cities, 2009.

J Acquir Immune Defic Syndr

*Division of HIV/AIDS prevention, Centers for Disease Control and Prevention, Atlanta, GA; and †Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

Published: July 2017

AI Article Synopsis

  • Women who inject drugs and exchange sex face a higher risk of HIV, yet there's limited data on them in the U.S.
  • A study using the 2009 NHBS data found that 39% of these women engaged in sex work for money or drugs, often exhibiting higher rates of unemployment, homelessness, and risky behaviors.
  • The findings highlight that these women are more likely to be unaware of their HIV-positive status, indicating a crucial need for targeted prevention and care services in this vulnerable group.

Article Abstract

Background: Women who inject drugs and who also exchange sex are at increased risk for HIV infection, but data on this population in the United States remain sparse.

Methods: This study assessed the prevalence of exchanging sex for money or drugs among women who inject drugs using data from the 2009 US National HIV Behavioral Surveillance (NHBS) system. Prevalence of being HIV-positive (testing positive in NHBS), HIV-positive-unaware (reporting being HIV-negative or unknown status but testing positive in NHBS), and risk behaviors and use of services were compared between women who did and did not exchange sex. The association between exchange sex and being HIV-positive-unaware of the infection was examined using multivariate Poisson models with robust standard errors.

Results: Among 2305 women who inject drugs, 39% reported receiving things like money or drugs from ≥1 male partners in exchange for oral, vaginal, or anal sex in the previous 12 months. Women who exchanged sex were more likely to be unemployed, homeless, lack health insurance, have multiple condomless vaginal or anal sex partners, and receptively share syringes. In multivariate analysis, exchange sex was associated with being HIV-positive-unaware (adjusted prevalence ratio 1.97, 95% confidence intervals: 1.31 to 2.97).

Conclusions: Prevalence of exchange sex was high in this population. Women who exchange sex were more likely to be socially disadvantaged, report sexual and injection risk, and be HIV-positive-unaware. They represent an important group to reach with HIV prevention, testing, and care services.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5681711PMC
http://dx.doi.org/10.1097/QAI.0000000000001408DOI Listing

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