From Survival to Glamour: Motivations for Engaging in Transactional Sex and Relationships Among Adolescent Girls and Young Women in South Africa

Zoe Duby,Catherine Mathews,Kealeboga Maruping,Caroline Kuo,Lieve Vanleeuw,Kim Jonas,Tracy Mcclinton Appollis

doi:10.1007/s10461-021-03291-z

Abstract

We explored transactional sex and relationships (TSR) among South African adolescent girls and young women (AGYW) using (1) survey data from 4,399 AGYW aged 15–24 years, and (2) qualitative data from 237 AGYW and 38 male peers. Ten percent of sexually active AGYW reported having ever had transactional sex; 14% reported having stayed in a relationship for money or material items. Factors associated with higher reporting of TSR included HIV positivity, higher food insecurity, and alcohol use. Those AGYW who were between the ages of 20–24 years (OR: 1.0; 95% CI: 0.81–1.24), had a sexual partner older than her by 5 years or more (OR: 1.89; 95% CI: 1.58–2.26), and had a transactional relationship in the past (OR: 61.1; 95% CI: 47.37–78.76) were more likely to report having transactional sex. AGYW qualitative narratives included both assertions of agency in choosing to engage in TSR, and power inequities resulting in condomless sex. Our findings can inform interventions to addressing transactional sex and relationships, critical to South Africa’s HIV response.

Highlights

The association of transactional sex and HIV risk in adolescent girls and young women (AGYW) in sub–Saharan Africa has been clearly demonstrated, with evidence showing increased susceptibility to HIV infection among AGYW who engage in transactional sex [1,2,3]
Interventions need to encourage AGYW to critically reflect on their own agency and choices in transactional sex and relationships, their aspirations for consumer items that symbolise a better life as motivation for sexual exchange, and the norms and beliefs that sustain gender inequality in transactional sex relationships [16]
‘Gender transformative interventions’ that aim to critically address shared societal expectations that women should have sex with men in return for their material/financial support, and work to challenge provider norms, masculinity and the concept of control of women in heterosexual relationships, should be combined with economic empowerment interventions for AGYW that may help to reduce the extent to which AGYW need to rely on male providers [29, 30]

Summary

Introduction

The association of transactional sex and HIV risk in adolescent girls and young women (AGYW) in sub–Saharan Africa has been clearly demonstrated, with evidence showing increased susceptibility to HIV infection among AGYW who engage in transactional sex [1,2,3]. The key feature used to distinguish transactional sex and transactional relationships (TSR) from other non–marital romantic/ sexual relationships, is that they are characterised by material exchange, but motivated by it [7]. An additional feature is that TSR are differentiated from, and judged by those who participate in the exchange to be more morally acceptable than formal sex work, primarily based on the fact that the exchange occurs within the context of a relationship (no matter how temporary or ambiguous its nature) [1, 8]. The distinction between transactional sex, sex work, and romantic/sexual relationships is challenging, as the boundaries are very blurred [9]

Methods

Results

Discussion

Conclusion