The authors analysed in depth interviews of more than 13,000 adolescents taking part in a study tracking the long term health of adolescents across the country (National Longitudinal Study of Adolescent Health, waves I and II).
The prevalence of having ever exchanged sex for drugs or money was 3.5% among the sample. Almost two thirds who had done so were boys.
The likelihood of exchanging sex for drugs or money was higher among those who were of African American ethnicity, those who lived in a non-traditional family set up, and those whose parents had not gone on to further or higher education.
Compared with adolescents who had not exchanged sex for drugs or money, more of those who had had used drugs at some point in their life.
One in 10 said they had used cocaine in the past 30 days, compared with just one in 100 of those who had not exchanged sex for drugs or money. The odds of exchanging sex for drugs or money among those who had injected drugs recently was 34 times that of those who had not used injection drugs recently.
But the average number of exchanges was one, suggesting that many of the adolescents interviewed in this sample exchanged sex for reasons other than survival, say the authors.
Those who were depressed or who had run away from home in the past year were also significantly more likely to have sex for drugs or money.
Larger numbers of adolescents who had used sex in this way had had a same sex experience and had been diagnosed with a sexually transmitted infection.
One in 10 of the boys had forced someone else to have sex with them, while around one in six of the girls had been forced into sex.
"The present findings indicate that considerable numbers of youths in the general population have exchanged sex. The prevalence of exchanging sex reported here may be a conservative estimate," comment the authors.