Abstract
BackgroundSex motivated by economic exchange is a public health concern as a driver of the Sub-Saharan African HIV epidemic. We describe patterns of engagement in transactional sexual relationships and sex with women in prostitution of South African men, and suggest interpretations that advance our understanding of the phenomenon.MethodsCross-sectional study with a randomly-selected sample of 1645 sexually active men aged 18–49 years who completed interviews in a household study and were asked whether they had had sex with a woman in prostitution, or had had a relationship or sex they took to be motivated by the expectation of material gain (transactional sex).Results18% of men had ever had sex with a woman in prostitution, 66% at least one type of transactional sexual relationship, only 30% of men had done neither. Most men had had a transactional relationship/sex with a main partner (58% of all men), 42% with a concurrent partner (or makhwapheni) and 44% with a once off partner, and there was almost no difference in reports of what was provided to women of different partner types. The majority of men distinguished the two types of sexual relationships and even among men who had once-off transactional sex and gave cash (n = 314), few (34%) reported that they had had sex with a ‘prostitute’. Transactional sex was more common among men aged 25–34 years, less educated men and low income earners rather than those with none or higher income. Having had sex with a woman in prostitution varied little between social and demographic categories, but was less common among the unwaged or very low earners.ConclusionsThe notion of ‘transactional sex’ developed through research with women does not translate easily to men. Many perceive expectations that they fulfil a provider role, with quid pro quo entitlement to sex. Men distinguished these circumstances of sex from having sex with a woman in prostitution. Whilst there may be similarities, when viewed relationally, these are quite distinct practices. Conflating them is sociologically inappropriate. Efforts to work with men to reduce transactional sex should focus on addressing sexual entitlement and promoting gender inequity.
Highlights
Sex motivated by economic exchange is a public health concern as a driver of the Sub-Saharan African HIV epidemic
Material gain is sometimes the only factor sustaining a relationship, but it is more common for multiple factors to be involved and it can be difficult to distinguish between male fulfilment of a traditional provider role and relationships that could not be sustained if that provider role was not fulfilled
Our findings suggest that research with women on the commodification of sex in Southern Africa may not translate when studying the role of men
Summary
Sex motivated by economic exchange is a public health concern as a driver of the Sub-Saharan African HIV epidemic. Transactional sex is open to multiple definitions, and many authors fail to define it [8,10]. This is essential in quantitative research, and the definition used in such work has generally been sex that is predicated on actual or anticipated material gain (instrumental support such as transportation or a place to sleep, material goods or cash) [6]. A further area of definitional contestation is the intersection between transactional acts and transactional relationships The former may occur within relationships that are predominantly based on other factors, which may include love, marriage, emotional support, habit or social expedience. In South Africa, the conceptualisation of ‘transactional relationships’, whether with main partners (ie women who are not legally considered as wives but who in effect enjoy some of the status and benefits) or makhwapheni [plural, a term in Nguni languages for an indigenous category of secondary concurrent partners], may shift
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