title: Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa.
abstract: South Africa has experienced a tremendous rise in methamphetamine use since the year 2000. Sex trading is a global phenomenon that has been observed in active drug users and has been associated with risks for HIV infection and violence.
  
  
  
  This paper describes and examines the correlates of sex trading among active methamphetamine users in Cape Town, South Africa.
  
  
  
  Through peer referral, 360 (201 male; 159 female) active methamphetamine users were recruited in a peri-urban township. Demographics, sex trading, drug use, trauma, and mental health were assessed by a structured clinical interview and computer survey. Logistic regression models were used to examine predictors of sex trading for men and women.
  
  
  
  In the past 3 months, 40% of men and 33% of women endorsed trading sex for methamphetamine or money. Among these, they reported trading with same sex partners (33%), high rates of inconsistent condom use (73%), and incidences of physical (23%) and sexual (27%) assault when sex trading. Increased drug use severity was correlated with sex trading. Women with experiences of violence and trauma were also more likely to trade sex. Conclusions/importance: The results stress a need for linkage to drug treatment, as addiction may be fueling sex trading. Targeted interventions geared towards safe sex practices may reduce risky sexual behaviors. Women need interventions that are attuned to their specific vulnerabilities. More research is needed to explore the experiences of men who have sex with men given their particularly high rates of sex trading behavior.
authors.affiliation: a Duke Global Health Institute, Duke University , Durham , North Carolina , USA.
authors.forename: Ryan R
authors.initials: RR
authors.lastname: Lion
authors.affiliation: b Department of Psychiatry & Behavioral Science , Duke University School of Medicine , Durham , North Carolina , USA.
authors.forename: Melissa H
authors.initials: MH
authors.lastname: Watt
authors.affiliation: c Substance Abuse Treatment Evaluations and Interventions, RTI International , Research Triangle Park , North Carolina , USA.
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
authors.affiliation: a Duke Global Health Institute, Duke University , Durham , North Carolina , USA.|b Department of Psychiatry & Behavioral Science , Duke University School of Medicine , Durham , North Carolina , USA.
authors.forename: Christina S
authors.initials: CS
authors.lastname: Meade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019969:Amphetamine-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D012737:Sex Factors; D011477:Sex Work / Q000523:psychology / Q000706:statistics & numerical data*; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D008694:Methamphetamine
keywords: HIV risk; South Africa; addiction; methamphetamine; sex trading