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Objectives. We examined correlates of trading sex for money, drugs, and shelter, or food among drug-using men who have sex with men (MSM).

Methods. Audio computer-assisted self-interviewing questionnaires were completed by 387 MSM. The association of predictors with sex trading was assessed with χ² tests and multiple logistic regression.

Results. Sex-trading prevalence was 62.5% (95% confidence interval=57.7%, 67.4%). Sex trading was associated with crack use, injection drug use, childhood maltreatment, nongay self-identification, and homelessness (adjusted odds ratios=3.72, 2.28, 2.62, 2.21, and 1.88, respectively).

Conclusions. Multiple risk factors are associated with sex trading among MSM. Interventions may need to address crack and injection drug use, homelessness, and childhood maltreatment and target non–gay-identified MSM who engage in sex trading.