Exchange of Sex for Drugs or Money in Adolescents and Young Adults: An Examination of Sociodemographic Factors, HIV-Related Risk, and Community Context.

HIV infection risk factors; SEXUALLY transmitted disease risk factors; BISEXUALITY; BLACK people; COMMUNITIES; CONFIDENCE intervals; DRUGS of abuse; ECONOMICS; FISHER exact test; HISPANIC Americans; LESBIANS; MULTIVARIATE analysis; SEX work; RESEARCH funding; SEXUAL intercourse; STATISTICS; SUBSTANCE abuse; UNEMPLOYMENT; LOGISTIC regression analysis; SOCIOECONOMIC factors; DRUG abusers; HUMAN services programs; ACQUISITION of data; HUMAN research subjects; PATIENT selection; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio

The goal of this research was to examine associations among sociodemographic factors, HIV risk, and community context (e.g., economic insecurity, job training, housing instability, crime victimization, and perceived community norms) in adolescents and young adults who ever exchanged sex for drugs or money. Anonymous survey data were collected using ACASIs at community venues where adolescents and young adults congregate in resource-challenged, STI prevalent, urban, US neighborhoods. Conventional descriptive statistics, Fisher's exact tests, and generalized estimating equations approaches were used to examine associations. Participants (1818, 95.5 % of those screened eligible) were, on average, aged 21.0 years; 42.2 % were males, and 4.6 % were transgender. Almost one-third (32.1 %) identified as gay or lesbian, 18.1 % identified as bisexual; 66.2 % were Black and 21.0 % were Hispanic; 1.3 % was 'living on the street'. A sizeable proportion reported HIV-related risk: 16.3 % exchanged sex, 12.6 % had sex with someone they knew to be HIV-infected, 7.8 % had sex with someone who injected drugs, and 1.3 % injected drugs. Multivariate comparisons identified a number of variables (e.g., being male or transgender, homelessness, sex with a partner who has HIV, STI history, unemployment, job training access, housing instability, crime victimization, perceived community norms) that were significantly associated with exchange of sex ( p < 0.05). This research contributes to the knowledge-base regarding exchange of sex among adolescents and young adults, particularly as it relates to community context. Longitudinal studies to describe the trajectory of social, health, and physical risks and consequences are needed for development of effective evidence-based prevention strategies. [ABSTRACT FROM AUTHOR]

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