ArticleThe International journal on drug policy2021
"You need money to get high, and that's the easiest and fastest way:" A typology of sex work and health behaviours among people who inject drugs.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 21 citations in OpenAlex.
- Barriers and facilitators to condom use among People Who Inject Drugs in Georgia: A qualitative study guided by the COM-B model.PloS one · 2026Article
- A qualitative exploration of perceived risks, motivations, and risk management strategies among brothel-based female sex workers in Ibadan, Nigeria.BMC public health · 2025Article
- A typology of physician input approaches to using AI chatbots for clinical decision-making.NPJ digital medicine · 2025Article
- Correlates of recovery capital among women in jails: Leveraging a dimensional recovery framework.Addiction research & theory · 2025Article
- Exploring HIV Risk Among Sexual Minority Women by Identity and Behavior in a Population-Based Sample of Low-Income Heterosexually Active Women.LGBT health · 2025Article
- Typologies of Sex Work Practice and Associations with the HIV Risk Environment and Risk Behaviors in Kazakhstan.AIDS and behavior · 2024Article
- Considerations when prescribing opioid agonist therapies for people living with HIV.Expert review of clinical pharmacology · 2024Review
- Sexual practices, their influencers, and utilization of HIV services among female sex workers in Mombasa County, Kenya.The Pan African medical journal · 2024Article
- Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas.Archives of sexual behavior · 2023Article
- Selling sex in the context of substance use: social and structural drivers of transactional sex among men who use opioids in Maryland.Harm reduction journal · 2022Article
- A qualitative study exploring the impact of the COVID-19 pandemic on People Who Inject Drugs (PWID) and drug service provision in the UK: PWID and service provider perspectives.The International journal on drug policy · 2022Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundIn the United States, the criminalization and stigmatization of drug use and sex work contribute to infectious disease transmission and healthcare disengagement. People who inject drugs (PWID) and engage in sex work experience exacerbated HIV risk. In the context of the ongoing HIV and overdose epidemics little research describes why PWID engage in sex work and its relative HIV risk. To inform intervention needs, we aimed to create a typology of sex work among PWID with a focus on HIV risk and healthcare utilization behaviours.
methodsWe drew from in-depth interviews conducted across Massachusetts and Rhode Island from 2016-2019. Participants were ≥18 years old and self-reported past-month injection drug use and HIV-negative status. Using data from individuals reporting sex work experience (n=33/78), we utilized the framework method to develop a typology of perspectives on sex work engagement and attributes pertaining to HIV risk and healthcare utilization behaviours.
resultsWe uncovered varying perspectives on sex work and associated HIV risks and prevention needs. A typology included three groups who viewed their sex work engagement as a (1) consistent job, (2) income supplement, or (3) survival method to abate withdrawal symptoms. The first group described more consistent sexual and injection behaviours to mitigate HIV risk than the second group. The third group appeared particularly vulnerable to HIV, describing inconsistent condom use and frequent sharing of injection equipment, low healthcare utilization, and limited disclosure of sex work and injection drug use to healthcare providers.
conclusionFindings highlight distinct perspectives on sex work among PWID involved in it and corresponding perceptions of HIV risk and healthcare utilization behaviours. Understanding the nuances in sex work engagement among PWID can inform interventions to prevent infectious disease transmission, including efforts to further connect this marginalized population to harm reduction, health, and low barrier opioid treatment services.
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