Abstract
ObjectiveThis study sought to determine the prevalence of transactional sex among university students in Uganda and to assess the possible relationship between transactional sex and sexual coercion, physical violence, mental health, and alcohol use.MethodsIn 2010, 1954 undergraduate students at a Ugandan university responded to a self-administered questionnaire that assessed mental health, substance use, physical violence and sexual behaviors including sexual coercion and transactional sex. The prevalence of transactional sex was assessed and logistic regression analysis was performed to measure the associations between various risk factors and reporting transactional sex.ResultsApproximately 25% of the study sample reported having taken part in transactional sex, with more women reporting having accepted money, gifts or some compensation for sex, while more men reporting having paid, given a gift or otherwise compensated for sex. Sexual coercion in men and women was significantly associated with having accepted money, gifts or some compensation for sex. Men who were victims of physical violence in the last 12 months had higher probability of having accepted money, gifts or some compensation for sex than other men. Women who were victims of sexual coercion reported greater likelihood of having paid, given a gift or otherwise compensated for sex. Respondents who had been victims of physical violence in last 12 months, engaged in heavy episodic drinking and had poor mental health status were more likely to have paid, given a gift or otherwise compensated for sex.ConclusionsUniversity students in Uganda are at high risk of transactional sex. Young men and women may be equally vulnerable to the risks and consequences of transactional sex and should be included in program initiatives to prevent transactional sex. The role of sexual coercion, physical violence, mental health, and alcohol use should be considered when designing interventions for countering transactional sex.
Highlights
Transactional sex is defined as an exchange of money, favors or gifts in exchange for sexual relations [1,2]
More men than women (23% vs. 18.5%) reported heavy episodic drinking (HED), while being victims of physical violence in last 12 months was similar among men (10.7%) and women (9.8%)
Missing cases analysis showed a higher proportion of men than women (41.7% vs. 34.3%) who did not answer the questions on transactional sex and sexual coercion
Summary
Transactional sex is defined as an exchange of money, favors or gifts in exchange for sexual relations [1,2]. Transactional sex is a contributing factor to the HIV pandemic, among young girls in sub-Saharan Africa [2,4,5]. It often coexists with other risky sexual behaviors like an early sexual debut, multiple concurrent sexual partnerships, and inconsistent condom use [5,6,7,8]. There is considerable evidence linking transactional sex to undesirable sexual and reproductive health outcomes including sexually transmitted infections (STIs), unintended pregnancies, unsafe abortions and gender-based violence [8,9]. Previous studies have indicated that transactional sexual relationships involve a number of power dynamics such as age disparities and unequal access to resources, which may lead to unsafe and coercive sexual practices [2,7,10,11]
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