Sex Exchange in the City: Risk of arrest and incarceration among young people exchanging sex in Detroit

Associations between criminal justice involvement and risky sexual behavior have been well-documented, from increased rates of HIV and other STDs among incarcerated populations to higher numbers of sexual partners and lower rates of condom use reported by previously incarcerated individuals. This study uses a unique dataset collected in Detroit using novel sampling approaches to reach young people exchanging sex on the street, in strip clubs, and at after-hours parties and social clubs to examine patterns of arrest and incarceration. Challenges of survey sampling and analysis in this economically vulnerable and residentially unstable group are briefly explored. Using multi-variable logistic regression, relationships between criminal justice involvement and patterns of sexual exchange, neighborhood characteristics, and individual demographics are explored. Each year of regular sex exchange confers a 12% increase in the odds of having experienced incarceration, regardless of whether individuals exchanged sex for drugs, cash, food or shelter. Neighborhood characteristics predict arrest, but not incarceration, supporting qualitative reports of differential policing. In addition, exchange venue, exchange frequency, racial identity, substance use, and perceived stress about police are examined in relation to arrest and incarceration. These results offer further evidence of the association between high risk sexual behavior and involvement in the criminal justice system, and also suggest that factors unrelated to illegal behavior predict arrest and incarceration, with potential long-term implications. They emphasize the clustering of poverty, sexual vulnerability, and criminal justice involvement, and highlight the need for public health interventions aimed at mitigating the impact of disproportionate risk for arrest and incarceration.