A profile of high school students in rural Canada who exchange sex for substances.

The exchange of sexual activities for money, drugs, or other compensation is considered a form of sexual exploitation when it occurs among underage youth. Such practices have been associated with sexual behaviours that increase the risk of sexually transmitted infections. Much of the research on this issue has been conducted on homeless or street-involved youth while adolescents in regular schools have received less attention in this area. The present study examined the prevalence of and factors associated with the exchange of sex for drugs among substance-using students in rural western Canada. Our data source was the 2009 East Kootenay Adolescent Drug Use Survey, a census of students in grades 7-12, who had ever used alcohol, marijuana, or other illicit drugs. In the sample of 2,360 youth, 2% of boys and 3% of girls reported that they had ever exchanged sex for alcohol or drugs, i.e., "exploited" youth, the majority of whom (83% - 98%) were living with family members. The most frequent patterns of past-year substance use were "using alcohol only" for "non-exploited" youth, and using alcohol, marijuana, and other drugs for exploited youth. The exchange of sex was associated with the use of drugs other than alcohol in the past year and with a higher level of impulsivity. The odds of exchanging sex were lower among youth who reported positive family relationships. The findings suggest a need for in-school education about healthy relationships, sexual exploitation, substance use, and impulse control.