Chapter 9 The Logic of Exchange Sex Among Women Living in Poverty

Exchange sex, defined as having sex in exchange for money or for commodities such as food, shelter or drugs, is linked to poverty and HIV risk. Drawing on data from HPTN 064, this chapter outlines participants’ perspectives on exchange sex and the economic and practical logic behind decisions regarding exchange sex. Women who engage in exchange sex often do so out of a need for money, food, and shelter for themselves and their children, and some engage in exchange sex for drugs and personal gain. Despite the many potential adverse outcomes, for those who live in poverty, lack alternatives for income generation, or are involved in drugs, exchange sex is a logical way to meet immediate needs or obtain basic life necessities.