CDC's Annual Epidemic Intelligence Service Conference
CDC's Annual Epidemic Intelligence Service Conference
May 03, 2019
2 min read

1 in 14 DC teens have exchanged sex

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Photo of Sara K. Head
Sara K. Head

ATLANTA — Research presented at the CDC’s Epidemic Intelligence Service Conference highlighted that approximately one in 14 high school students in Washington, D.C., have exchanged sex for housing, food and other items of value. Youth with unstable housing were nearly 11 times more likely to engage in this behavior.

Sara K. Head, PhD, MPH, an Epidemic Intelligence Service officer working with the District of Columbia Department of Health, said this is the first study to quantify exchange sex among youth in the city. Her research team noted that approximately 5% of people aged 11 to 27 years in the United States have exchanged sex.

Head and colleagues examined data from the 2017 D.C. Youth Risk Behavior Survey, which included 8,578 students in grades nine through 12. Previous exchange sex was identified by asking if the participant had ever been given money, a place to stay, food or something else of value in exchange for sex.

Of the high school students surveyed, 7.4% (95% CI, 6.6-8.2) had ever exchanged sex. Students were more likely to report exchange sex if they were male (adjusted OR = 2.5; 95% CI, 1.6-4) and if they had sexual contact with partners of both sexes (aOR = 2.4; 95% CI, 1.2-4.9) compared with those who had sexual contact with only the opposite sex.

Youth who were kicked out of the home, had run away or were abandoned in the past 30 days were more likely to exchange sex (aOR = 10.7; 95% CI, 7-16.3), as well as those who went hungry in the past 30 days (aOR = 2.2; 95% CI, 1.1-4.5). Students who used drugs — including synthetic marijuana (aOR = 2.6; 95% CI, 1.3-5) or cocaine, heroin, methamphetamines or ecstasy (aOR = 2.9; 95% CI, 1.6-5.3) — had more exchange sex compared with students who had never used drugs.

“At a time when the decline in annual HIV infections has stalled and STD infections — especially among youth — are on the rise, these findings are critical to informing HIV and STD prevention efforts in D.C. and perhaps in other urban centers throughout the U.S.,” Head said. – by Katherine Bortz


Head S, et al. Exchange sex among high school students — Washington, D.C., 2017. Presented at: Epidemic Intelligence Service Conference; April 29-May 2, 2019; Atlanta.

Disclosure: Head reports no relevant financial disclosures.