Behavioral Surveillance of Heterosexual Exchange-Sex Partnerships in San Francisco: Context, Predictors and Implications
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Using San Francisco local data from the 2006 National HIV Behavioral Surveillance (NHBS), we initiated a study of male and female heterosexuals’ involvement in exchange sex (money or goods for sex). We examined risk factors for engaging in exchange sex and the prevalence of risk behaviors amongst exchange and non-exchange partnerships. Overall, 13.2% of women and 7.6% of men engaged in exchange sex in the past 6 months; 130 of 1,230 (10.6%) opposite-sex partnerships involved exchange. Women of low socioeconomic status and those who inject drugs were more likely to engage in exchange sex. Men involved in exchange sex were no different from those who did not by age, socio-economic status, marital status, drug use, or history of incarceration or sexually transmitted diseases. Within exchange partnerships, high or drunk sex was more common than unprotected sex. Exchange partnerships had fewer instances of risky sex. In comparison to exchange partnerships, non-exchange partnerships had four times as many episodes of unprotected vaginal sex and twice as many episodes of high or drunk vaginal sex. Prevention efforts addressing exchange sex need to address substance use. Future research and surveillance are needed to better understand the sources of HIV risk and measure and track trends in risk within sexual dyads and networks.
- Centers for Disease Control and Prevention. Estimates of new HIV infections in the United States. 2008. http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/pdf/incidence.pdf. Accessed 28 Jan 2009.
- Centers for Disease Control and Prevention. Women and HIV fact sheet. 2008. http://www.cdc.gov/hiv/topics/women/resources/factsheets/pdf/women.pdf. Accessed 27 Jan 2009.
- Essien EJ, Meshack AF, Peters RJ, Ogungbade GO, Osemene NI. Strategies to prevent HIV transmission among heterosexual African-American women. Int J Equity Health. 2009;4(1):4. CrossRef
- Cohan D, Kim A, Ruiz J, et al. Health indicators among low income women who report a history of sex work: the population based northern California young women’s study. Sex Transm Infect. 2005;81:428–33. CrossRef
- Lauby JL, Smith PJ, Stark M, Person B, Adams J. A community-level HIV prevention intervention for inner-city women: results of the women and infants demonstration projects. Am J Public Health. 2000;90(2):216–22. CrossRef
- Richards JE, Risser JM, Padgett PM, Rehman HU, Wolverton ML, Arafat RR. Condom use among high-risk heterosexual women with concurrent sexual partnerships, Houston, Texas, USA. Int J STD AIDS. 2008;19(11):768–71. CrossRef
- Copas AJ, Mercer CH, Farewell VT, Nanchahal K, Johnson AM. Recent heterosexual partnerships and patterns of condom use: a weighted analysis. Epidemiology. 2008;20(1):44–51. CrossRef
- Jones D, Irwin K, Inciardi J, The Multicenter Crack Cocaine and HIV Infection Study Team. The high-risk sexual practices of crack-smoking sex workers recruited from the streets of three American cities. Sex Transm Dis. 1998;25(4):187–93. CrossRef
- Kilmarx PH, Palanuvej T, Limpakarnjanarat K, Chitvarakorn A, St Louis ME, Mastro TD. Seroprevalence of HIV among female sex workers in Bangkok: evidence of ongoing infection risk after the “100% condom program” was implemented. J Acquir Immune Defic Syndr. 1999;21:313–6.
- Nemoto T, Operario D, Takenaka M, Iwamoto M, Le MN. HIV risk among Asian women working at massage parlors in San Francisco. AIDS Educ Prev. 2003;15(3):245–56. CrossRef
- Elifson KW, Boles J, Darrow WW, Sterk C. HIV seroprevalence and risk factors among clients of female and male prostitutes. J Acquir Immune Defic Syndr. 1999;20(2):195–200.
- Gallagher KM, Sullivan PS, Lansky A, Onorato IM. Behavioral surveillance among people at risk for HIV infection in the U.S.: the National Behavioral Surveillance System. Public Health Rep. 2007;122(Suppl 1):32–8.
- Heckathorn D. Respondent-driven sampling: a new approach to the study of hidden population. Soc Probl. 1997;44(2):174–99. CrossRef
- Johnston LG, Malekinejad M, Kendall C, Iuppa IM, Rutherford GW. Implementation challenges to using respondent-driven sampling methodology for HIV biological and behavioral surveillance: field experiences in international settings. AIDS Behav. 2008;12(4 Suppl):S131–41. CrossRef
- Kajubi P, Kamya MR, Raymond HF, et al. Gay and bisexual men in Kampla, Uganda. AIDS Behav. 2007;12(3):492–504. CrossRef
- Malekinejad M, Johnston LG, Kendall C, Kerr LR, Rifkin MR, Rutherford GW. Using respondent-driven sampling methodology for HIV biological and behavioral surveillance in international settings: a systematic review. AIDS Behav. 2008;12(4 Suppl):S105–30. CrossRef
- Raymond HF, Kajubi P, Kamya MR, Rutherford GW, Mandel JS, McFarland W. Correlates of unprotected receptive anal intercourse among gay and bisexual men: Kampala, Uganda. AIDS Behav. 2009;13(4):677–81. CrossRef
- Ruan S, Yang H, Zhu Y, et al. Rising HIV prevalence among married and unmarried men who have sex with men: Jinan, China. AIDS Behav. 2009;13(4):671–6. CrossRef
- Ruan S, Yang H, Zhu Y, et al. HIV prevalence and correlates of unprotected anal intercourse among men who have sex with men, Jinan, China. AIDS Behav. 2008;12(3):469–75. CrossRef
- R Development Core Team. R, version 2.8.1. Available at: http://cran.r-project.org/.
- Volz E, Wejnert C, Degani I, Heckathorn DD. Respondent-driven sampling analysis tool (RDSAT), version 5.6. Available at: http://respondentdrivensampling.org/.
- Risser JMH, Padget P, Wolverton M, Risser WL. Relationship between heterosexual anal sex, injection drug use among black men and women. Int J STD AIDS. 2009;20:310–4. CrossRef
- Behavioral Surveillance of Heterosexual Exchange-Sex Partnerships in San Francisco: Context, Predictors and Implications
AIDS and Behavior
Volume 15, Issue 1 , pp 236-242
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Exchange sex
- Condom use
- Substance use
- Industry Sectors