HIV Prevalence and Risk Behaviors Among African American Women Who Trade Sex for Drugs Versus Economic Resources

Dunne, Eugene M.; Dyer, Typhanye V.; Khan, Maria R.; Cavanaugh, Courtenay E.; Мельников, А. В.; Latimer, William W.

doi:10.1007/s10461-014-0710-6

Cited by 14 publications

(14 citation statements)

References 11 publications

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“…Although this study used an assessment with established psychometrics (Darke et al, 1991), women may underreport their involvement in high risk behaviors given the sensitive nature of the questions. In addition, women who trade sex for drugs may differ from women trading sex for money in their clinical characteristics and risk behaviors (Dunne et al, 2014; Kwiatkowski and Booth, 2000). For example, women who trade sex for drugs are less likely to use condoms and more likely to be HIV positive than women who trade sex for money (Dunne et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, women who trade sex for drugs may differ from women trading sex for money in their clinical characteristics and risk behaviors (Dunne et al, 2014; Kwiatkowski and Booth, 2000). For example, women who trade sex for drugs are less likely to use condoms and more likely to be HIV positive than women who trade sex for money (Dunne et al, 2014). This study assessed sex trading for drugs or money in a single question and is unable to examine whether women who trade sex for drugs differ in respect to their risk level, treatment response, or likelihood of continued involvement in sex trade from those who trade sex for money.…”

Section: Discussionmentioning

confidence: 99%

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A retrospective and prospective analysis of trading sex for drugs or money in women substance abuse treatment patients

Rash

Burki

Montezuma-Rusca³

et al. 2016

Drug and Alcohol Dependence

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Background Trading sex for drugs or money is common in substance abuse treatment patients, and this study evaluated prevalence and correlates of this behavior in women with cocaine use disorders initiating outpatient care. In addition, we examined the relation of sex trading status to treatment response in relation to usual care versus contingency management (CM), as well as predictors of continued involvement in sex trading over a 9-month period. Methods Women (N = 493) recruited from outpatient substance abuse treatment clinics were categorized according to histories of sex trading (n = 215, 43.6%) or not (n = 278). Results Women with a history of trading sex were more likely to be African American, older and less educated, and they had more severe employment problems and were more likely to be HIV positive than those without this history. Controlling for baseline differences, both groups responded equally to substance abuse treatment in terms of retention and abstinence outcomes. Fifty-four women (11.3%) reported trading sex within the next nine months. Predictors of continued involvement in trading sex included a prior history of such behaviors and achieving less abstinence during treatment. Each additional week of abstinence during treatment was associated with a 16% reduction in the likelihood of trading sex over the follow-up. Conclusions Because over 40% of women receiving community-based treatment for cocaine use disorders have traded sex for drugs or money and more than 10% persist in the behavior, more intensive and directed approaches toward addressing this HIV risk behavior are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A retrospective and prospective analysis of trading sex for drugs or money in women substance abuse treatment patients

Rash

Burki

Montezuma-Rusca³

et al. 2016

Drug and Alcohol Dependence

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“…Women living in poverty, often with drug or alcohol problems are at high risk for sexually transmitted diseases including HIV, unwanted pregnancies, abortions, discrimination, criminalization and abuse when engaging in transactional sex [34]. Studies from an urban emergency room and family planning clinic found that 8% of women reported recently trading sex for money [35, 36]. Although trading sex for drugs or money is most often discussed in the context of sex workers, poverty and economic insecurity can motivate sexual decision making and risk taking in general.…”

Section: Discussionmentioning

confidence: 99%

Gender-Related Risk Factors Improve Mortality Predictive Ability of VACS Index Among HIV-Infected Women

Cohen

Hotton

Hershow

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Adding gender-related modifiable characteristics or behaviors to the Veterans Aging Cohort Study (VACS) Index might improve the accuracy of predicting mortality among HIV-infected women on treatment. We evaluated the VACS Index in women with HIV, determined whether additional variables would improve mortality prediction, and quantified the potential for improved survival associated with reduction in these additional risk factors. Methods The VACS Index (based on age, CD4 count, HIV-1 RNA, hemoglobin, AST, ALT, platelets, creatinine and Hepatitis C status) was validated in HIV-infected women in the Women’s Interagency HIV Study (WIHS) who initiated antiretroviral therapy (ART) between January 1996 and December 2007. Models were constructed adding race, depression, abuse, smoking, substance use, transactional sex, and comorbidities to determine whether predictability improved. Population attributable fractions were calculated. Results The VACS Index accurately predicted 5-year mortality in 1057 WIHS women with 1 year on HAART with c-index 0.83 (95% CI 0.79–0.87). In multivariate analysis, the VACS Index score (adjusted hazard ratio [aHR] for 5-point increment 1.30; 95% CI 1.25–1.35), depressive symptoms (aHR 1.73; 95% CI 1.17–2.56) and history of transactional sex (aHR 1.93; 95% CI 1.33–1.82) were independent statistically significant predictors of mortality. Conclusions Including depression and transactional sex significantly improved the performance of the VACS Index in predicting mortality among HIV-infected women. Providing treatment for depression and addressing economic and psychosocial instability in HIV infected women would improve health and perhaps point to a broader public health approach to reducing HIV mortality.

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“…The groundbreaking study by Kwiatkowski and Booth (Kwiatkowski & Booth, 2000) introduced the paradigm of separating these three groups from each other for analysis purposes. This was followed-up by Dunne et al to the extent that they could with their small sample size (Dunne et al, 2014). We have tried to follow in this tradition, and we had a large enough sample that enabled us to introduce additional re-finements into this approach to the study of drug using sex traders.…”

Section: Discussionmentioning

confidence: 99%

“…They also found that women who exchanged sex for money only were more likely to inject. A second study done in Baltimore found that those who only traded for drugs were more at risk for HIV because of lower condom use (Dunne et al, 2014). Because the sample size was small ( n = 92), they were only able to compare those who traded for both compared to those who traded for drugs only.…”

Section: Introductionmentioning

confidence: 99%

Impulsiveness, and trait displaced aggression among drug using female sex traders

Clingan

Fisher

Pedersen

et al. 2016

Addictive Behaviors

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Objective This study compared women who sex trade for drugs, money, or both compared to neither (did not sex trade), and introduced the concept of trait displaced aggression to the literature on sex trading. Methods Female participants (n = 1055) were recruited from a low-income area of southern California. Measures included: the Risk Behavior Assessment (RBA), Barratt Impulsivity Scale (BIS), Eysenck Impulsiveness Scale (EIS), and the Displaced Aggression Questionnaire (DAQ). Results Women who traded sex for both drugs and money used crack cocaine, powder cocaine, and alcohol significantly more, scored higher on the BIS, and the EIS, and were significantly older. Those who only sex traded for drugs used more amphetamine, heroin, and injected drugs more days. They were also higher on the DAQ and all of the DAQ subscales. Those who traded for money only used marijuana more and were more likely to use marijuana before sex. Conclusions This study may help address specific issues unique to those who sex trade for different commodities in that the drugs used are different and the underlying personality characteristics are different.

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HIV Prevalence and Risk Behaviors Among African American Women Who Trade Sex for Drugs Versus Economic Resources

Cited by 14 publications

References 11 publications

A retrospective and prospective analysis of trading sex for drugs or money in women substance abuse treatment patients

A retrospective and prospective analysis of trading sex for drugs or money in women substance abuse treatment patients

Gender-Related Risk Factors Improve Mortality Predictive Ability of VACS Index Among HIV-Infected Women

Impulsiveness, and trait displaced aggression among drug using female sex traders

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