To describe the prevalence and nature of sex trade in a clinic-based sample of young women and to evaluate associations with sexual and reproductive health. Overall, 8. Sex trade was associated with unintended pregnancy adjusted risk ratio [ARR] 1. Of the women ever involved in sex trade, 12 Approximately 1 in 12 participants had been involved in sex trade, illustrating the presence of patients with this history within the family-planning clinical setting.
Sex trade was associated with multiple indicators of poor sexual and reproductive health. Family-planning clinics may represent an underused mechanism for engaging this high-risk population. Women who trade sex for money, drugs, and other resources consistently demonstrate health concerns spanning substance use, mental health problems, violence, and sexually transmitted infection STI βincluding HIV [ 1 - 4 ]. These complex intersections are likely to reflect an interaction and accumulation of social vulnerability.
Research to date has used varied terms for the experience, including transactional sex [ 5 , 6 ], survival sex [ 7 ], sex trade [ 8 , 9 ], sex work [ 10 , 11 ], and prostitution [ 2 , 12 ].
Given the documented health risks, the dearth of clinic-based investigation of sex trade experiences is surprising. Transactional sex has also been noted among prenatal clinic patients in South Africa [ 6 ].
Moreover, little comparative investigation has sought to compare the health of women involved in sex trade with similar women without such a history. The majority of health-related research in this area draws solely on women involved in commercial sex, prostitution, or sex work [ 2 , 14 - 16 ] and lacks a comparison group. Thus, the extent to which sex trade experiences should be considered a unique sexual and reproductive health threat remains unclear.
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