Exchange Sex and Condom Use Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Social and Sexual Networking Technologies

Abstract

The practice of sex work or exchange sex (having sex in exchange for money, drugs, shelter, or other things) and the risks for HIV and sexually transmissible infections (STIs) associated with it differ based on the venues where partners meet (e.g., streets, agencies, or the Internet). Although there is evidence that gay, bisexual, and other men who have sex with men (MSM) use social media and dating/hookup applications and websites to find exchange sex, little is known about this phenomenon. We used online survey data collected among MSM in New York City recruited through social/sexual networking technologies to learn more about the practice of exchange sex in this population. Overall, 28.8% of participants had ever exchanged (sold) sex, including 8.4% who had done so in the prior three months. Almost half (46.4%) of those who had ever exchanged sex had met their first client through a social/sexual networking app/website (that was not a website dedicated to sex work), and the majority (88%) of those who had exchanged sex in the prior three months had done so with a client met through these technologies. In multivariable analyses, those who had exchanged sex in the prior three months reported at least twice the number of condomless anal sex partners in that period (compared to those who never exchanged sex) after controlling for covariates (incidence-rate ratio [IRR] = 2.08, 95% confidence interval [CI] 1.52–2.84). Social/sexual networking technologies are important venues for finding exchange sex among MSM, a practice that may present high risk for HIV and/or STI transmission.