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Correlates of transactional sex among high-risk heterosexuals in Baltimore

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Susan Sherman, PhD, MPH , Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Marisa Hast , National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Colin Flynn , Center for HIV Surveillance, Epidemiology and Evaluation, Maryland Department of Health and Mental Hygiene, Baltimore, MD
David Holtgrave, PhD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Danielle German, PhD, MPH , Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: Women who exchange sex for money, food, and/or goods are disproportionately infected with HIV/STIs. There is a dearth of research among these women despite the persistence of elevated HIV/STIs among them.

Objectives: We examined correlates of TS (transactional sex) among women in the CDC’s National HIV Behavioral Surveillance (BESURE) study in Baltimore, MD.

Methods: Between August-December 2010, a sample was recruited using respondent driven sampling (RDS) from neighborhoods characterized by high poverty and HIV/STIs for a behavioral survey and HIV testing. Eligible participants were 18–50 years old, Baltimore residents, and reported heterosexual sex in the past year. We examined correlates of TS through bivariate and multivariate analyses, among females (N=198).

Results: 23% reported having engaged in TS in the past year. Women engaged in TS (vs. those not) were significantly (p<0.05) more likely to: be older (38 years vs. 33); identify as bisexual (42% vs. 22%); earn <$15,000/year income (80% vs. 70%); report recent homelessness (60% vs. 34%); and recently inject drugs (62% vs. 30%).  In an adjusted model, women engaged in TS (vs. those not) had elevated odds of being bisexual (AOR: 1.7, 95%CI: 1.15-2.6); low-income (<$15,000/year, AOR: 1.3, 95%CI: 1.1-2.1) and recently homeless (95%CI: 1.2-5.4). Among these women, HIV prevalence was 2% and they reported unprotected vaginal sex with an average of 33 trade partners in the last year.

Conclusions: Women engaged in TS are characterized by socioeconomic disadvantages and have high rates of HIV/STI risk behaviors, necessitating tailored and multifaceted interventions for treatment and care.

Learning Areas:

Epidemiology
Social and behavioral sciences

Learning Objectives:
Discuss correlates of transactional sex among the high risk heterosexuals who are a part of the National HIV Behavioral Surveillance in Baltimore, MD.

Keyword(s): Sex Workers, HIV Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a behavioral scientist who has worked for the past 15 years with populations at a high risk for HIV/STIs, primarily sex workers and drug users. Iconceptualized the analysis and wrote the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4093.0: Privilege, power and partnership: Sexual identity, public safety and transactional sex