Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas

Lauren E Lipira; Jennifer L Glick; Danielle German; Sara N Glick; Courtney Moreno; Dena Elimam; Meredith L Brantley; Latrice C Pichon; Narquis Barak; Meredith M Booth; Colin Flynn; Timothy Menza

doi:10.1007/s10508-023-02663-x

Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas

Arch Sex Behav. 2023 Nov;52(8):3313-3327. doi: 10.1007/s10508-023-02663-x. Epub 2023 Aug 23.

Authors

Lauren E Lipira^{1

2}, Jennifer L Glick³, Danielle German³, Sara N Glick^{4

5}, Courtney Moreno⁵, Dena Elimam⁶, Meredith L Brantley⁷, Latrice C Pichon⁸, Narquis Barak⁹, Meredith M Booth⁹, Colin Flynn¹⁰, Timothy Menza^{11

12}

Affiliations

¹ Regional Research Institute, Portland State University, Portland, OR, USA. Lauren.E.Lipira@dhsoha.state.or.us.
² Public Health Division, Oregon Health Authority, 800 NE Oregon St, Portland, OR, 97232, USA. Lauren.E.Lipira@dhsoha.state.or.us.
³ Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
⁴ Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA.
⁵ HIV/STD Program, Public Health-Seattle & King County, Seattle, WA, USA.
⁶ Epidemiology Section, Georgia Department of Public Health, Division of Health Protection, Atlanta, GA, USA.
⁷ HIV/STI/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA.
⁸ Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA.
⁹ CrescentCare, New Orleans, LA, USA.
¹⁰ Maryland Department of Health, Baltimore, MD, USA.
¹¹ Public Health Division, Oregon Health Authority, 800 NE Oregon St, Portland, OR, 97232, USA.
¹² Department of Medicine, Oregon Health & Science University, Portland, OR, USA.

PMID: 37612535
DOI: 10.1007/s10508-023-02663-x

Abstract

Exchange sex is associated with sexual risk behaviors and poor outcomes and different types may incur different levels of risk. We assessed risk profiles of different types of exchange sex among non-injecting cisgender men and women who participated in the 2019 National HIV Behavioral Surveillance project at six sites. Six percent of men and 19% of women reported exchange sex in the past year; most engaged in non-commercial exchange sex for drugs/money with smaller percentages reporting formal sex work or non-commercial exchange sex for goods or services other than drugs/money. Exchange sex was associated with sexual risk and prevention behaviors and psychosocial and sexual health outcomes and associations varied by type of exchange sex. Efforts to improve access to STI/HIV testing and PrEP may benefit from tailoring based on type of exchange sex. Findings indicate value in a broader definition of exchange sex with follow-up assessment of exchange sex typology.

Keywords: Exchange sex; HIV; Prevention; Transactional sex; Violence.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Female
HIV Infections* / epidemiology
Heterosexuality*
Humans
Male
Risk-Taking
Sex Work
Sexual Behavior / psychology

Abstract

Publication types

MeSH terms

Grants and funding