Archives of Sexual Behavior

, Volume 24, Issue 3, pp 249–269 | Cite as

Crack, crack house sex, and HIV risk

  • James A. Inciardi


Limited attention has been focused on HIV risk behaviors of crack smokers and their sex partners, yet there is evidence that the crack house and the crack-using life-style may be playing significant roles in the transmission of HIV and other sexually transmitted diseases. The purposes of this research were to study the attributes and patterns of “sex for crack” exchanges, particularly those that occurred in crack houses, and to assess their potential impact on the spread of HIV. Structured interviews were conducted with 17 men and 35 women in Miami, Florida, who were regular users of crack and who had exchanged sex for crack (or for money to buy crack) during the past 30 days. In addition, participant observation was conducted in 8 Miami crack houses. Interview and observational data suggest that individuals who exchange sex for crack do so with considerable frequency, and through a variety of sexual activities. Systematic data indicated that almost a third of the men and 89% of the women had had 100 or more sex partners during the 30-day period prior to study recruitment. Not only were sexual activities anonymous, extremely frequent, varied, uninhibited (often undertaken in public areas of crack houses), and with multiple partners but, in addition, condoms were not used during the majority of contacts. Of the 37 subjects who were tested for HIV and received their test results 31% of the men and 21% of the women were HIV seropositive.

Key words

crack crack houses HIV prostitution 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bowser, B. P. (1989). Crack and AIDS: An ethnographic impression.J. Nat. Med. Assoc. 81: 538–540.Google Scholar
  2. Carmen, A., and Moody, H. (1985).Working Women: The Subterranean World of Street Prostitution Harper & Row, New York.Google Scholar
  3. Cohen, J. B., and Wofsy, C. B. (1989). Heterosexual transmission of HIV. In Levy, J. A. (ed.),AIDS: Pathogenesis and Treatment Marcel Dekker, New York, pp. 135–137.Google Scholar
  4. Cohen, P. T., Sande M. A., and Volberding, P. A. (1987).The AIDS Knowledge Base Massachusetts Medical Society, Waltham, MA.Google Scholar
  5. Des Jarlias, D. C., and Friedman, S. R. (1988). Intravenous cocaine, crack, and HIV infection.J. Am. Med. Assoc. 259: 1945–1946.Google Scholar
  6. Evans, H. (1979).Harlots, Whores and Hookers: A History of Prostitution Dorset Books, New York.Google Scholar
  7. Fischl, M. A. (1988). Prevention of transmission of AIDS during sexual intercourse. In DeVita, V. T., Hellman, S., and Rosenberg, S. A. (eds.),AIDS: Etiology, Diagnosis, Treatment, and Prevention J. B. Lippincott, Philadelphia, PA, pp. 369–374.Google Scholar
  8. Fischl, M., Fayne, T., Flanagan, S., Leda, M., Stevens, R., Fletcher, M., La Voie, L., and Trapido, E. (1988). Seroprevalence and risks of HIV infection in spouses of persons infected with HIV. Paper presented at the Fourth International Conference on AIDS, June, Stockholm, Sweden.Google Scholar
  9. Fullilove, R. E., Fullilove, M. T., Bowser, B. P., and Gross, S. A. (1990). Risk of sexually transmitted disease among black adolescent crack users in Oakland and San Francisco, California.J. Am. Med. Assoc. 263: 851–855.Google Scholar
  10. Goldstein, P. J. (1979).Prostitution and Drugs D.C. Heath, Lexington, MA.Google Scholar
  11. Grinspoon, L., and Bakalar, J. B. (1976).Cocaine: A Drug and Its Social Evolution Basic Books, New York.Google Scholar
  12. Guinan, M. E. (1989). Women and crack addiction.J. Am. Med. Women's Assoc. 44: 129.Google Scholar
  13. Heyl, B. S. (1979).The Madam as Entrepreneur: Career Management in House Prostitution Transaction Books, New Brunswick, NJ.Google Scholar
  14. Inciardi, J. A., Lockwood, D., and Pottieger, A. E. (1993). Women and Crack-Cocaine, Macmillan, New York.Google Scholar
  15. Johnson, A. M., and Laga, M. (1988). Heterosexual transmission of HIV.AIDS 2: S49-S56.PubMedGoogle Scholar
  16. Kaslow, R. A., and Francis, D. P. (1989).The Epidemiology of AIDS: Expression, Occurrence, and Control of Human Immunodeficiency Virus Type 1 Infection Oxford University Press, New York.Google Scholar
  17. Levy, J. A. (1989). The human immunodeficiency viruses: Detection and pathogenesis. In Levy, J. A. (ed.),AIDS: Pathogenesis and Treatment Marcel Dekker, New York, pp. 159–229.Google Scholar
  18. Ma, P., and Armstrong, D. (1989).AIDS and Infections of Homosexual Men Butterworths, Boston, MA.Google Scholar
  19. Mavligit, G. M., Talpaz, M., Hsia, F. T., Wong, W., Lichtiger, B., Mansell, P. W. A., and Mumford, D. M. (1984). Chronic immune stimulation by sperm alloantigens: Support for the hypothesis that spermatozoa induce immune dysregulation in homosexual men.J. Am. Med. Assoc. 251: 237–241.Google Scholar
  20. Miller, E. M. (1986).Street Women Temple University Press, Philadelphia, PA.Google Scholar
  21. Peterson, T. A. (1990). Facilitators of HIV transmission during sexual contact. In Alexander, N. J., Gabelnick, H. L., and Speiler, J. M. (eds.),Heterosexual Transmission of AIDS Wiley-Liss, New York, pp. 55–68.Google Scholar
  22. Redfield, R., Markham, P. D., Salahuddin, S. Z., Sarngadharan, M. G., Bodner, A. J., Folks, T. N., Ballou, W. R., Wright, D. C., and Gallo, R. C. (1985). Frequent transmission of HTLV-III among spouses of patients with AIDS-related complex and AIDS.J. Am. Med. Assoc. 253: 1571–1573.Google Scholar
  23. Rolfs, R. T., Goldberg, M., and Sharrar, R. G. (1990). Risk factors for syphilis: Cocaine use and prostitution.Am. J. Public Health 80: 853–857.PubMedGoogle Scholar
  24. Rosenbaum, M. (1981).Women on Heroin Rutgers University Press, New Brunswick, NJ.Google Scholar
  25. Schultz, S., Zweig, M., Sing, T., and Htoo, M. (1990). Congenital syphilis: New York City, 1986–1988.Am. J. Dis. Child. 144: 279.Google Scholar
  26. Sterk, C. (1988). Cocaine and HIV seropositivity.Lancet 1: 1052–1053.Google Scholar
  27. Trapido, E. J., Lewis, N., and Comerford, M. (1990). HIV-1 and AIDS in Belle Glade, Florida: A reexamination of the issues.Am. Behav. Sci. 33: 451–464.Google Scholar
  28. Vogt, M. W., Craven, D. E., Crawford, D. E., Witt, D. J., Byington, R., Schooley, R. T., and Hirsch, M. S. (1986). Isolation of HTLV-III/LAV from cervical secretions of women at risk for AIDS.Lancet 1: 525–527.PubMedGoogle Scholar
  29. Vogt, M. W., Witt, D. J., Craven, D. E., Byington, R., Crawford, D. S., Hutchinson, M. S., Schooley, R. T., Hirsch, M. S. (1987). Isolation patterns of the human immunodeficiency virus from cervical secretions during the menstrual cycle of women at risk for the acquired immunodeficiency syndrome.Ann. Intern. Med. 106: 380–382.PubMedGoogle Scholar
  30. Walters, J. M., (1980). What is ethnography? In Akins, C., and Beschner, G. (eds.),Ethnography: A Research Tool for Policy Makers in the Drug and Alcohol Fields National Institute on Drug Abuse, Rockville, MD, pp. 15–20.Google Scholar
  31. Weiss, R. D., and Mirin, S. M. (1987).Cocaine American Psychiatric Press, Washington, DC.Google Scholar
  32. Winick, C., and Kinsie, P. M. (1971).The Lively Commerce: Prostitution in the United States Quadrangle Books, Chicago.Google Scholar
  33. Wofsy, C. B., Cohen, J. B., Hauer, L. B., Padian, N., Michaelis, B., Evans, J., and Levy, J. A. (1986). Isolation of AIDS-associated retrovirus from genital secretions of women with antibodies to the virus.Lancet 1: 527–529.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • James A. Inciardi
    • 1
  1. 1.Center for Drug and Alcohol StudiesUniversity of DelawareNewarkUSA

Personalised recommendations