Needle-Using Practices within the Sex Industry

Abstract

The addicted prostitute faces a risk of AIDS from both her sexual practices and intravenous drug use. While the sexual practices of these women have been studied, much less is known about their needle-using practices. We suggest women in the sex industry are more enmeshed in the drug-using scene and occupy a more constricted set of social roles than other women. They will therefore lack the resources and have fewer opportunities to engage in safer behaviors compared to women who support themselves by other means. The analysis is based on 9,055 addicted women not in treatment. Women who trade sex for money and/or drugs are less likely to use new needles on any consistent basis or to clean old needles. They are more likely to share needles with others compared to women who support themselves by other means. Three identifiable patterns of needle-using practices emerge: indiscriminate sharing, monogamous sharing with a sexual partner, and exclusive use of new needles. To reach those engaged in promiscuous sharing, needle-swapping programs must be particularly "user friendly." Where needle-using behaviors reflect an intimate relationship, the spouse/sex partner must be engaged if change is to take place. Finally, policymakers and practitioners should capitalize on the strengths and strategies of those who report they consistently use sterile needles.

Women, sex, and HIV: Social and contextual factors, meta-analysis of published interventions, and implications for practice and research.

“…Exchanging sex for drugs or money has been particularly associated with alcohol and crack use (Chiasson et al, 1991; E. Cohen, Navaline, & Metzger, 1994; Forney, Inciardi, & Lockwood, 1992; Iguchi et al, 1992; Kail, Watson, & Ray, 1995; Larrat & Zierler, 1993; Lewis & Watters, 1991; Logan & Leukefeld, 2000a; Logan et al, 1998; Marx et al., 1991; McCoy & Inciardi, 1995). For example, Scheidt and Windle (1995) found that 43% of women in alcohol treatment reported trading sex for drugs or money.…”

Gender Differences in Drug Use Behavior in People with Serious Mental Illnesses

“…Compared to men, women are more vulnerable to alcohol‐induced organ pathology such as liver disease and substance‐related neurocognitive damage 15–17 . Additionally, women substance abusers are more susceptible to HIV infection 1,18–20 …”