Female sex workers have disproportionately high rates of HIV compared to the general population due to unique behavioral and structural risk factors. While there are well established risk factors associated with HIV, there is a lack of US population-based studies due to the transient and illegal nature of exchanging sex for survival or for drugs and money. A secondary analysis of 1138 women in substance use treatment and with histories of sex exchange was conducted using data originally collected from 2012-2016 through a street level cervical cancer prevention services program in Dallas, Texas. Using a cross-sectional study design, we assessed self-reported behavioral risk factors (number of sexual partners, condom use, injection drug use), mental health history, and sociodemographics (age, race, and homelessness) by HIV screening status. The prevalence of HIV was 0.99%, 11 of 1116). HIV prevalence was statistically different between race/ethnicity groups (p = 0.001), number of sex partners (p <0.0001), and STI positive screens (p <0.0001). Considering the observed HIV prevalence rate against the female US population and female sex worker population in the US, findings demonstrate the need for development of targeted HIV screening and prevention efforts in this high-risk population.
