Prevalence and Factors Associated With Sex Trading Among High-Risk Substance-Involved Women Under Community Supervision in New York City
| Author | Louisa Gilbert,Xin Ma,Tina Jiwatram-Negrón,Stacey Shaw,Nabila El-Bassel |
| DOI | 10.1177/0093854819892932 |
| Published date | 01 May 2020 |
| Date | 01 May 2020 |
| Subject Matter | Articles |
research-article2019
Prevalence and Factors associated With
sex trading among high-risk substance-
involved Women under community
suPervision in neW york city
TINA JIwATRAM-NEgRóN
Arizona State University
STACEy SHAw
Brigham Young University
XIN MA
Emory University
NABILA EL-BASSEL
LOUISA gILBERT
Columbia University
This article examines the prevalence of and factors associated with sex trading among a high-risk sample of 337 substance-
involved women in community corrections enrolled in an HIV risk reduction study in New york City, using baseline data. Forty
percent of the sample reported trading sex for money, food, drugs, or other resources in the prior 90 days. Multivariate logistic
regression analyses showed significant associations among age, ethnic minority status, marital status, prior mental health hospi-
talization, binge drinking, and having recently been in jail/prison and sex trading (p and their partner recently (past 90 days) used crack/cocaine or that their partner recently used crack/cocaine were more likely to
report sex trading than women who reported that neither they nor their partner recently used crack/cocaine (p findings underscore an urgent need for multipronged intervention efforts that simultaneously address multilevel risk exposures.
Keywords: sex trading; sex work; community supervision; criminal justice
introduction
globally, the United States maintains the highest rate of incarceration and community
supervision, and the percentage of women in both systems is increasing (Kaeble, 2018;
walmsley, 2017). At the end of 2016, approximately 2 million people were incarcerated
authors’ note: This work was supported by the National Institute of Drug Abuse (NIDA) under grant
R01DA025878, awarded to Dr. El-Bassel. The authors would like to thank the women who participated in
Women on the Road to Health (WORTH) for sharing their time and experiences with us and the community
supervision sites that graciously hosted WORTH. We also want to thank the case managers who facilitated
WORTH as well as project research assistants. Note, the funders had no role in study design, data collection
and analysis, decision to publish, or preparation of the article. Correspondence concerning this article should
be addressed to Tina Jiwatram-Negrón, School of Social Work, Arizona State University, 411 N. Central
Avenue, Suite 800, Phoenix, AZ 85004; e-mail: jiwatram@asu.edu.
CRIMINAL JUSTICE AND BEHAVIOR, 2020, Vol. 47, No. 5, May 2020, 529 –546.
DOI: 10.1177/0093854819892932
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© 2019 International Association for Correctional and Forensic Psychology
529
530 CRIMINAL JUSTICE AND BEHAVIOR
(Kaeble, 2018) while an additional 4.5 million people were under community supervision
(Kaeble & Cowhig, 2018). Community supervision programs, including probation and
parole as well as alternatives to incarceration programs such as drug treatment, now repre-
sent the largest segment of the criminal justice system in the country. Although men make
up the largest proportion of incarcerated populations, rates of female incarceration are ris-
ing (Beyrer et al., 2016; walmsley, 2017) and ethnic minority women including African
American and Latina women are overrepresented. For example, research shows that African
American women are twice as likely to be arrested and incarcerated compared to women in
other ethnic minority groups and 3 times more likely to be arrested than white women
(Centers for Disease Control and Prevention [CDC], 2012). Research also suggests this
may in part be a result of inequitable arrest practices and sentencing (Pettit & western,
2004).
Among criminal justice–involved populations, HIV risks are intensified. HIV infection
among criminal justice–involved women is disproportionately high, with a prevalence of
1.7%, or more than 3 times the rate of non-incarcerated populations (CDC, 2012, 2014).
This disparity is particularly present among ethnic minority women, who, in addition to
being overrepresented in the criminal justice system (CDC, 2012; glaze & Bonczar, 2010),
are 3 to 7 times more likely to be diagnosed with HIV than white women (CDC, 2012;
glaze & Bonczar, 2010; Spaulding et al., 2002, 2009). Additional evidence suggests an
even higher prevalence of HIV among female offenders under community supervision, with
rates as high as 17%, making this group a high priority target group for risk reduction
(Belenko et al., 2004). HIV risk among incarcerated populations has been shown to be
directly facilitated by substance use and sex trading for money, drugs, or other resources,
and indirectly facilitated by social and economic vulnerability (e.g., poverty, poor mental
health, and trauma; CDC, 2012; Harlow, 2003; Johnson, 2006; Kim et al., 2002; Metraux &
Culhane, 2004; Steadman et al., 2009). Studies examining sex trading among incarcerated
populations suggest heightened HIV vulnerability due to low condom use, multiple part-
ners, and injection drug use (Khan et al., 2008; Parvez et al., 2013). while co-occurring sex
trading and substance use among women in criminal justice settings (jails and prisons) have
previously been examined, few studies have examined sex trading among substance-
involved women in community supervision (CDC, 2012; Spaulding et al., 2002). Following
re-entry, criminal justice–involved women often face a number of challenges including
stigma and discrimination, which serve as barriers to accessing employment, affordable
housing, and linkage to medical treatment (Kulkarni et al., 2010; Salem et al., 2013). This
may increase their risk of engagement or re-engagement in sex trading and affect health
outcomes.
A study by Morash et al. (2017) underscores the tremendous economic and social vulner-
abilities among women released under community supervision and the negative effect of
unmet needs on recidivism. Through interviews with 345 women under community supervi-
sion in Michigan, Morash and colleagues (2017) found that women with unmet economic
needs (housing and monetary assistance) from the state (benefits) were more likely to recidi-
vate than women without unmet needs or whose needs were met. In addition, they found that
women with unmet economic needs were more likely to also report substance use and poor
mental health, pointing to a coalescence of risks. Although the focus of the study was exam-
ining the effect of varying state-level benefit policies on recidivism, the findings underscore
the critical nature of economic and social vulnerabilities among criminal justice–involved
Jiwatram-Negrón et al. / SEX TRADINg AMONg wOMEN IN COMMUNITy SUPERVISION 531
women, which are closely linked to sex trading. Research suggests engagement in sex trad-
ing is associated with many of the same risks: unmet needs, poor mental health, substance
use, homelessness, food insecurity, and un- or underemployment (Brown et al., 2012; Chettiar
et al., 2010; Duff et al., 2011; El-Bassel et al., 1997; Risser et al., 2006; Tyler, 2009; weber
et al., 2004). Additional qualitative research conducted by Shdaimah and Leon (2015) with
76 women in diversion programs due to prostitution charges further reinforces this linkage
between engagement in sex trading for economic survival and unmet social and economic
needs and challenges.
In New york State, approximately 122,000 people are on probation, roughly 20% of
whom are women (New york State Division of Criminal Justice Services [NyDCJS],
2010). Of all female parolees in New york, 26% were arrested on drug charges, the second
most common offense (New york State Department of Corrections and Community
Supervision [NyDCCS], 2014). New york State data indicate that the majority of female
detainees, parolees, and probationers are African American, and many have unmet service
needs, histories of drug use, high rates of unemployment, and low levels of education (no
high school diploma or equivalent [general Education Development certificate or gED];
NyDCCS, 2014), all of which may drive HIV- related risks through survival sex trading.
Despite data indicating a pattern of convergent risks among incarcerated ethnic minority
populations, limited data exist on the prevalence and correlates of sex trading among sub-
stance-involved women under community supervision. Drawing on the socio-ecological
theory (Bronfenbrenner, 1979, 1989), this article seeks to examine the prevalence and fac-
tors associated with sex trading (exchanging sex for money, food, drugs, or other resources)
among a sample of 337 high-risk, substance-involved women under community supervi-
sion in New york City enrolled into an HIV risk reduction randomized controlled trial
(RCT) study.
Bronfenbrenner’s (1979, 1989) ecological systems theory organizes our understanding
and calls our attention to the multitude of inter-related determinants that affect individuals,
their behaviors, and their well-being. Central to the theory is the focus on multiple system
levels of influence, which include both proximal and distal factors that shape individual
behavior, risk, and outcomes (Bronfenbrenner, 1979, 1989). From this perspective, sex
trading may be understood in the context of micro-level influences (e.g., partner violence),
mezzo-level influences (e.g., dyadic drug use), and structural-level influences...
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