The study interviewed 477 men, aged 18 to 29 years, of whom 43 had received money or drugs in exchange for sex in the preceding 30 days and were categorized as sex traders. Psychological distress was measured using the Brief Symptom Inventory (BSI). Sex traders scored significantly higher than non-sex traders on the General Severity Index and on all nine subscales of the BSI. According to multivariate analysis after adjusting for perceived HIV (human immunodeficiency virus) risk, current regular crack cocaine use, and homelessness, sex traders scored 0.173 units higher on the General Severity Index. More of the sex traders tested positive for HIV (41 percent versus 19 percent). The alarmingly high HIV seroprevalence rate in sex traders in this sample underscores the need to redouble HIV prevention efforts for this population. The article suggests that the high levels of psychological distress and crack cocaine dependence among sex traders may undermine their ability to adopt safer sex behaviors and should be considered in intervention designs. Tables, references