Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa


Focus Areas: Health & Wellness

BACKGROUND: South Africa has experienced a tremendous rise in methamphetamine use since the year 2000. Sex trading is a global phenomenon that has been observed in active drug users and has been associated with risks for HIV infection and violence.

OBJECTIVES: This paper describes and examines the correlates of sex trading among active methamphetamine users in Cape Town, South Africa.

METHODS: Through peer referral, 360 (201 male; 159 female) active methamphetamine users were recruited in a peri-urban township. Demographics, sex trading, drug use, trauma, and mental health were assessed by a structured clinical interview and computer survey. Logistic regression models were used to examine predictors of sex trading for men and women.

RESULTS: In the past 3 months, 40% of men and 33% of women endorsed trading sex for methamphetamine or money. Among these, they reported trading with same sex partners (33%), high rates of inconsistent condom use (73%), and incidences of physical (23%) and sexual (27%) assault when sex trading. Increased drug use severity was correlated with sex trading. Women with experiences of violence and trauma were also more likely to trade sex.

Conclusions/importance: The results stress a need for linkage to drug treatment, as addiction may be fueling sex trading. Targeted interventions geared towards safe sex practices may reduce risky sexual behaviors. Women need interventions that are attuned to their specific vulnerabilities. More research is needed to explore the experiences of men who have sex with men given their particularly high rates of sex trading behavior.

Lion, R. R., M. H. Watt, W. M. Wechsberg and C. S. Meade (2017). "Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa." Subst Use Misuse 52(6): 773-784.


Wendee Wechsberg

“We must listen to the communities, the local people, to understand culturally what is going to fit and what is going to be the language of the research, and not just say we know what to do here.”