Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection
AbstractSex workers have long been considered a high-risk group for HIV infection, but to date little quantitative research has explored the association between HIV risk and exchange of sex for material gain by women in the general population. The objective of this study was to estimate the prevalence of such transactional sex among women attending antenatal clinics in Soweto, South Africa, to identify demographic and social variables associated with reporting transactional sex, and to determine the association between transactional sex and HIV serostatus. We conducted a cross-sectional study of women seeking antenatal care in four Soweto health centres who accepted routine antenatal HIV testing. Private face-to-face interviews covered socio-demographics, sexual history and experience of gender-based violence. 21.1% of participants reported having ever had sex with a non-primary male partner in exchange for material goods or money. Women who reported past experience of violence by male intimate partners, problematic substance use, urban residence, ever earning money, or living in substandard housing were more likely to report transactional sex, while women who reported delayed first coitus, were married, or had a post-secondary education were less likely to report transactional sex. Transactional sex was associated with HIV seropositivity after controlling for lifetime number of male sex partners and length of time a woman had been sexually active (OR=1.54, 95% CI: 1.07, 2.21). Women who reported non-primary partners without transactional sex did not have increased odds of being HIV seropositive (OR=1.04, 95% CI: 0.75, 1.43). We conclude that transactional sex may place women at increased risk for HIV, and is associated with gender-based violence, substance use and socio-economic disadvantage. Research, policy and programmatic initiatives should consider the role of transactional sex in women's HIV risk, with attention to the intersecting roles of violence, poverty, and substance use in shaping women's sexual behaviour.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 59 (2004)
Issue (Month): 8 (October)
Contact details of provider:
Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description
You can help add them by filling out this form.
CitEc Project, subscribe to its RSS feed for this item.
- Leigh Johnson & Rob Dorrington & Debbie Bradshaw & Victoria Pillay-Van Wyk & Thomas Rehle, 2009. "Sexual behaviour patterns in South Africa and their association with the spread of HIV: insights from a mathematical model," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 21(11), pages 289-340, September.
- Leach, Fiona, 2006. "Researching gender violence in schools: Methodological and ethical considerations," World Development, Elsevier, vol. 34(6), pages 1129-1147, June.
- Stadler, Jonathan & Delany-Moretlwe, Sinead & Palanee, Thesla & Rees, Helen, 2014. "Hidden harms: Women's narratives of intimate partner violence in a microbicide trial, South Africa," Social Science & Medicine, Elsevier, vol. 110(C), pages 49-55.
- Robinson, Jonathan & Yeh, Ethan, 2008.
"Transactional Sex as a Response to Risk in Western Keny,"
7350, University Library of Munich, Germany.
- Jonathan Robinson & Ethan Yeh, 2011. "Transactional Sex as a Response to Risk in Western Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 35-64, January.
- Robinson, Jonathan & Yeh, Ethan, 2009. "Transactional sex as a response to risk in western Kenya," Policy Research Working Paper Series 4857, The World Bank.
- Burke, Marshall & Gong, Erick & Jones, Kelly, 2011.
"Income shocks and HIV in Sub-Saharan Africa:,"
IFPRI discussion papers
1146, International Food Policy Research Institute (IFPRI).
- Durevall, Dick & Lindskog, Annika, 2012.
"Economic Inequality and HIV in Malawi,"
Elsevier, vol. 40(7), pages 1435-1451.
- Hirsch, Jennifer S., 2014. "Labor migration, externalities and ethics: Theorizing the meso-level determinants of HIV vulnerability," Social Science & Medicine, Elsevier, vol. 100(C), pages 38-45.
- Watt, Melissa H. & Aunon, Frances M. & Skinner, Donald & Sikkema, Kathleen J. & Kalichman, Seth C. & Pieterse, Desiree, 2012. "“Because he has bought for her, he wants to sleep with her”: Alcohol as a currency for sexual exchange in South African drinking venues," Social Science & Medicine, Elsevier, vol. 74(7), pages 1005-1012.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.