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SAMPLE GRANT PROPOSAL:  AIDS HIV PREVENTION
Crack cocaine use is a risk factor for syphilis (and therefore HIV), probably because it leads to risky
sexual practices.
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Sex Workers
Prostitution is a fact of life in high-poverty areas in Oakland. In 1992, 388 arrests were made
for prostitution.  58% of those arrested were African American.  While this does not imply that 58% of
sex workers in Alameda County are African American, it does suggest that the majority of sex workers
who solicit on the street are African American, because the street is the target of police surveillance.
17
And street-based sex workers are typically at higher risk for HIV infection than other sex workers.
Many have a crack cocaine addiction and spend much of their time seeking for ways to secure the drug,
including exchanging sex for crack.  This results in an atrophying of their social network and a tenuous
relation to health providers.  Furthermore, street sex workers tend to be poorer, and so more likely to
engage in high-risk sex in return for additional money. 
Although HIV/AIDS data are not tabulated for sex workers as a category, prostitution is cited
in the literature as a behavior of populations at high risk for HIV infection.  For example, gay/bisexual
men in the San Francisco Bay Area (including Alameda County), were more likely to engage in
unprotected anal sex if they had been paid for sex.
18
In addition, engaging in prostitution is highly correlated with injection drug use and crack
cocaine use.  A study of 182 San Francisco and Oakland sex workers revealed that 65.9% had used
crack.
19
  In 1995, Alameda’s HIV Prevention Planning Council surveyed 482 individuals to identify
prevalence of risk behaviors.  Of 67 women who self-identified as IDUs, in the past year 55% had
traded sex for drugs, 36% had traded unprotected sex for drugs, 55% had traded sex for money,
shelter or other material goods.  Of 77 men who self-identified as IDUs, in the past year 55% had
traded sex for drugs, 36% had traded unprotected sex for drugs, 55% had traded sex for money,
shelter or other material goods. A study of 182 sex workers in San Francisco and Oakland in 1990
16
Rolfs, R.T., Goldberg, M., Sharrar, R.G., “Risk factors for syphilis:  Cocaine use and prostitution,” American
Journal of Public Health, 80:853-857, 1990.
17
Ibid., Appendix B, p. 39.
18
Rhodes, F., Corby, N.H., Wolitski, R.J., “Risk Behaviors and Perceptions of AIDS among Street Injection Drug
Users,” Journal of Drug Education, 1990, 20(4):271-88.
19
Dorfman p. 29.
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