Individual, network, and neighborhood correlates of exchange sex among female non-injection drug users in Baltimore, MD (2005-2007)

AIDS Behav. 2013 Feb;17(2):598-611. doi: 10.1007/s10461-012-0305-z.


The "HIV risk environment" has been characterized as a dynamic interplay between structural and network factors. However, most HIV prevention research has not examined the independent and combined impact of network and structural factors. We aimed to identify individual, network, and neighborhood correlates of exchange sex (≥1 exchange sex partner, past 90 days) among female non-injection drug users (NIDUs). We used baseline data from 417 NIDUs enrolled in a randomized HIV prevention trial in Baltimore (2005-2007). Surveys ascertained demographic variables, drug/sex risk behaviors, neighborhood perceptions, and social/sexual network characteristics. Correlates of exchange sex were identified with descriptive statistics and log-binomial regression. Our findings suggest that sex and drug relationships among female NIDUs are interlinked and may be difficult to modify without altering social norms. Strengthening ties that provide social support but not drug support and reducing ties that provide both drug and social support may facilitate reductions in individual-level HIV-risk behaviors.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Baltimore / epidemiology
  • Drug Users / statistics & numerical data*
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / prevention & control
  • Health Knowledge, Attitudes, Practice
  • Health Status Disparities
  • Humans
  • Middle Aged
  • Residence Characteristics
  • Risk-Taking
  • Sex Work / statistics & numerical data*
  • Sexual Behavior / statistics & numerical data*
  • Sexual Partners*
  • Social Support
  • Surveys and Questionnaires