Abstract

Introduction

Exchange sex places individuals with cocaine use disorder (CUD) at particularly high risk for deleterious safety and health outcomes. A substance use treatment provider who is aware of a patient’s exchange sex behavior is better able to provide appropriate screening, care, and/or referral to risk reduction services. However, little is known about exchange sex, especially purchasing, among treatment-seeking adults with CUD.

Method

The current study examined the prevalence and correlates of sex selling and sex purchasing among treatment-seeking men and women with CUD (n = 109; ClinicalTrials.gov #NCT02896712). Separate binary logistic regressions via backward elimination were used to identify best fitting models for sex selling and sex purchasing.

Results

Over 41% of participants endorsed exchange sex within the last 30 days; 20.2% reported selling sex and 30.3% reported purchasing sex. Sex selling and sex purchasing rates differed by gender and race. Number of sexual partners (OR = 5.83, 95% CI = 2.07–16.43), concern about contracting HIV/AIDS (OR = 2.01, 95% CI = 1.31–3.44), cumulative interpersonal trauma exposure (OR = 1.82, 95% CI = 1.20–2.77), years using cocaine (OR = 1.11, 95% CI = 1.03–1.20), drug-related problem days (OR = 1.07, 95% CI = 1.00–1.14), and sexual preference (OR = 9.50, 95% CI = .69–130.35) were retained in the final model estimating sex selling (Nagelkerke R² = .56). In the final sex purchasing model (Nagelkerke R² = .46), gender (OR = 36.17, 95% CI = 2.96–441.75), number of sexual partners (OR = 6.28, 95% CI = 2.69–14.66), number of convictions (OR = 1.13, 95% CI = 1.02–1.25), and drug-related problem days (OR = 0.96, 95% CI = .92–1.01) were retained.

Conclusion

Predictive models in this study identified distinct sets of variables related to sex selling and purchasing. Findings may be used to improve identification of exchange sex in the substance use treatment setting and referral to targeted interventions to reduce associated risk.

中文翻译：

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寻求可卡因使用障碍治疗的成年人中性交易和性购买的患病率和相关性

摘要

介绍

交换性行为使患有可卡因使用障碍 (CUD) 的人面临特别高的有害安全和健康后果风险。了解患者交换性行为的物质使用治疗提供者能够更好地提供适当的筛查、护理和/或转诊至降低风险的服务。然而，在寻求治疗的患有 CUD 的成年人中，人们对交换性行为知之甚少，尤其是购买行为。

方法

目前的研究检查了寻求治疗的 CUD 男性和女性中性交易和性购买的流行率和相关性（n  = 109；ClinicalTrials.gov #NCT02896712）。通过反向消除的单独二元逻辑回归用于确定性交易和性购买的最佳拟合模型。

结果

超过 41% 的参与者在过去 30 天内赞同交换性行为；20.2% 的人报告性交易，30.3% 的人报告性交易。性交易和性购买率因性别和种族而异。性伴侣的数量（OR = 5.83, 95% CI = 2.07–16.43），对感染 HIV/AIDS 的担忧（OR = 2.01, 95% CI = 1.31–3.44），累积的人际创伤暴露（OR = 1.82, 95% CI = 1.20–2.77)、使用可卡因年数 (OR = 1.11, 95% CI = 1.03–1.20)、药物相关问题天数 (OR = 1.07, 95% CI = 1.00–1.14) 和性偏好 (OR = 9.50, 95% CI = .69–130.35) 保留在估计性交易的最终模型中 (Nagelkerke R ² = .56)。在最终的性购买模型中（Nagelkerke R ²= .46)、性别 (OR = 36.17, 95% CI = 2.96–441.75)、性伴侣数量 (OR = 6.28, 95% CI = 2.69–14.66)、定罪次数 (OR = 1.13, 95% CI = 1.02-1.25）和药物相关问题天数（OR = 0.96, 95% CI = .92-1.01）被保留。

结论

本研究中的预测模型确定了与性交易相关的不同变量集。调查结果可用于改进物质使用治疗环境中交换性别的识别，并转诊至有针对性的干预措施以降低相关风险。