Framing sexual negotiation through sexual economics theory

Background: Innovative approaches are necessary to address high rates of unintended sexual health outcomes like sexually transmitted infections (STIs), human immunodeficiency virus (HIV), and unintended pregnancy, which follow trends of socioeconomic disadvantage. The theory of sexual economics acknowledges the socioeconomic link in sexual relationships, recognizing sex as a form of capital that can be leveraged for economic, social, or emotional gain. Consequently, the power to negotiate sexual behavior and intended outcomes may be associated with variations in capital between sexual partners. Purpose: The purpose of this analysis is to explore the influence of sexual economics on sexual negotiation and the sexual risks associated with decreased capital and negotiating power. Methods: I conducted a systematic literature review using 5 multidisciplinary databases. The search returned 1227 publications, 28 of which were relevant for analysis. Publications included in the analysis presented quantitative, qualitative, or theoretical findings about sexual and social exchanges in heterosexual unmarried human relationships. Studies that focused on commercial sex work or exchanges of sex for drugs were excluded. Results: Inequities in capital between partners were consistent with inequitable ability to negotiate sexual behaviors like condom use. However, current conceptualization of sexual economics as explicit exchanges of sex for money discounts similar dynamics of negotiation that occurs in implicit exchanges of sex for intangible resources. Conclusions: Sexual economics should be redefined as an interaction pattern within social, intimate, or economic relationships whereby sex is implicitly or explicitly exchanged for economic, social, or emotional gain based on normative expectations of reciprocity.