Correlates Of Sex Trading Among Women In Intimate Relationships: A Risk Profile
Methods: We used baseline data collected from an HIV prevention randomized control trial (Project Connect Two), conducted in New York City with low-income, drug-using HIV-negative concordant couples. Data reported here is from the female partners (n=346). Couples were recruited via street outreach, homeless shelters, soup kitchens, word-of-mouth, and syringe exchange programs. We assessed for sex trading, mental health, partner violence, childhood sexual abuse, perceived social support, drug and alcohol use, sexual behaviors, incarceration, income, education, employment, and basic socio-demographics. We performed bivariate chi-square and t-tests and further analysis using modified Poisson regressions.
Results: 28% of the participants reported sex trading during the prior 90 days. Adjusting for age, ethnicity, education, marital status, housing and employment, modified Poisson Regression analyses revealed significant associations between physical/sexual intimate partner violence (1.65, p<0.05), prior mental health hospitalization (1.71, p<0.01), psychological distress (1.51, p<0.01), incarceration (1.58, p<0.05), drug use (crack, marijuana, and crystal meth, cumulative use, p<0.05), and unprotected vaginal and anal sex with non-main partners (p<0.05) and engagement in sex trading. Women who traded sex were also more likely to report childhood sexual abuse, unemployment, homelessness, and lower income, though these effects were not significant at the 0.05 alpha levels.
Conclusions: Key findings from this analysis indicate that women in intimate relationships who trade sex share many of the same risks and vulnerabilities as women who trade sex that are not in long-term intimate relationships. The findings underscore that HIV prevention for women in long-term relationships who trade sex for money needs to consider multiple risk factors Moreover, a couples-based approach may serve as an important HIV strategy to improve communication and safety in relationships and reduce sexual risk behaviors among women and their long-term sex partners.