Correlates of Transactional Sex Among Black Men and Women Who Misuse Opioids

Shemeka Thorpe, Paige Orphé, Gabriella Pitcher, Kendall McCleod, Natalie Malone, Danelle Stevens-Watkins

Research output: Contribution to journalArticlepeer-review


The rise in opioid misuse coincides with increased sexually transmitted infection (STI) and HIV incidence. Transactional sex is an under-researched phenomenon among Black Americans who misuse opioids, and may increase their risk of STI or HIV transmission. Given the disproportionate impact of the opioid epidemic on Black Americans and the risks associated with opioid misuse, the current study aims to investigate sociostructural factors, history of violence, and sexual risk factors associated with transactional sex among Black men and women. A sample of n = 375 Black adult Kentuckians reporting opioid misuse completed a survey including transactional sex, sociostructural, violence history, and sexual risk measures. Results of chi-squares and independent samples t-tests revealed that compared to men who did not report engaging in transactional sex, men who engaged in transactional sex were less educated, reported being sexually assaulted or having an unwanted sexual experience in their lifetime, and were more likely to use opioids or cocaine before or during sex in the last year. Women who engaged in transactional sex had a history of violence, more structural barriers, higher psychological distress, and engaged in more sexual risk behaviors compared to women who did not engage in transactional sex. Implications for future research and interventions with this population are discussed.

Original languageEnglish
JournalHealth Education and Behavior
StateAccepted/In press - 2024

Bibliographical note

Publisher Copyright:
© 2024 Society for Public Health Education.


  • Black men
  • Black women
  • heterosexual
  • opioid use
  • transactional sex

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Public Health, Environmental and Occupational Health


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