Although sex exchange among crack users is associated with risky sexual behavior, research suggests that there is a subgroup of crack users who do not engage in high-risk sex exchange. The purpose of this study is to understand differences among individuals with a history of crack use who have and have not engaged in sex exchange; and to better understand gender differences in the context of sex exchange. The study sample included 148 male (64.2% reported sex exchange) and 149 female heterosexual individuals with a history of crack use (59.1% reported sex exchange). Results suggest that HIV prevention interventions should incorporate gender specific information related to sex exchange for heterosexual crack users. Future research is needed to address the gap in understanding the transition into sex exchange practices for heterosexual male and female drug users.
