HIV risk behaviours of current sex workers attending syringe exchange: theexperiences of women in five US cities

Existing research indicates that sex workers who inject drugs are vulnerabl e to HIV infection through both risky sexual and drug use practices. This s tudy is the first attempt to learn whether this increased risk persists amo ng current sex workers who participate in syringe exchange programmes (SEPs ). With data from interviews with randomly selected participants in five US cities, we compared the demographic characteristics, sexual risk behaviour s, drug use practices, emotional and physical health, and SEP utilization p atterns of currently active female sex workers who attend SEPs with female SEP participants who do not engage in sex work. Data indicate that women en rolled in SEPs who were currently trading sex typically reported greater HI V risk than women non-sex workers. Current sex workers reported higher leve ls of risk for every drug risk variable examined in bivariate analysis. The y were more likely than other women to inject with a syringe previously use d by someone else, to inject daily and to attend shooting galleries; they w ere less likely to use a condom with their primary partners and to report h igher levels of psychological distress than their counterparts. The relatio nship between sex work status and risky injection practices persisted when potential confounders were controlled for in multivariate analysis. SEPs ca n serve a pivotal role in providing sex workers with services and referrals which would help them reduce risk behaviours.