South Africa is facing an established epidemic of
methamphetamine, known locally as ‘‘tik.’’ Globally, methamphetamine
has been linked to high rates of sexual risk behaviors,
including sex trading. The goal of this study was to qualitatively
examinetheexperiencesofsextradingamongmethamphetamine
users in CapeTown, South Africa. Individualin-depth interviews
were conducted with 30 active methamphetamine users (17 men
and 13 women) recruited from the community. Interviews were
conducted in local languages using a semi-structured guide that
included questions on sex trading experiences and perceptions of
sex trading among methamphetamine users. Interviews were
audio-recorded, transcribed, and analyzed using analytic memos
and coding with constant comparison techniques. The data
revealed that in a setting of high levels of addiction and poverty,
sex was an important commodity for acquiring methamphetamine.
Women were more likely to use sex to acquire methamphetamine,butmenreportedopportunisticcasesoftradingsexfor
methamphetamine. Four models of sex trading emerged: negotiated
exchange, implicit exchange, relationships based on
resources, and facilitating sex exchange for others. The expectation
of sex trading created a context in which sexual violence
against female methamphetamine users was common. Multiple
sexual partners and inconsistent condomuse in acts of sex trading
put methamphetamine users at high risk of HIV. Interventions in
this setting should address addiction, which is the primary driver
of sex trading among methamphetamine users. Harm reduction
interventions may include education about HIV and other sexually
transmitted infections, availability of condoms and HIV
testing, and sexual violence prevention.