ArticleBMC public health2017
Young women's perceptions of transactional sex and sexual agency: a qualitative study in the context of rural South Africa.
Article in BMC public health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of cash plus or bundled interventions targeting adolescents in Africa to reduce HIV risk.BMC public health · 2024Pooled it
- Transactional sex among adolescent girls and young women enrolled in a cash plus intervention in rural Tanzania: a mixed-methods study.Journal of the International AIDS Society · 2022Trial
- Effect of Quality of Caregiver-Adolescent Relationship on Sexual Debut, Transactional Sex, and on Age-Disparate Relationships Among Young Women in Rural South Africa Enrolled in HPTN 068.Journal of acquired immune deficiency syndromes (1999) · 2022Trial
- Women's sexual scripting in the context of universal access to antiretroviral treatment-findings from the HPTN 071 (PopART) trial in South Africa.BMC women's health · 2021Trial
- 'It's because I like things… it's a status and he buys me airtime': exploring the role of transactional sex in young women's consumption patterns in rural South Africa (secondary findings from HPTN 068).Reproductive health · 2018Trial
- Article
- Couch-Surfing and HIV Risk Behavior Among Young Adults Experiencing Homelessness.AIDS and behavior · 2026Article
- Exploring the forced circumstances leading to early sexual debut among primary school learners in Musina, Limpopo.Journal of public health research · 2026Article
- Exploring relationship pathways to prevent intimate partner violence among young women in Malawi.Culture, health & sexuality · 2026Article
- Article
- Transactional sex and intersecting vulnerabilities: a multicountry cross-sectional study of pregnant and parenting adolescents in sub-Saharan Africa.BMJ public health · 2026Article
- Walking a tightrope: Social support in early adulthood in resource-constrained South Africa.Journal of social and personal relationships · 2025Article
- Does the Risk Premium Differ Between Women Engaging in Commercial and Transactional Sex? Evidence From Urban Cameroon.Health economics · 2025Article
- Article
- "We are mothers, sisters, and lovers too": Examining young Black women's experiences navigating sex and sexual health.American journal of community psychology · 2024Article
- 'You are looked upon as a luxury tool': Young Tanzanian women's perception of community norms supporting partner violence during transactional sex (Culture, health & sexuality · 2024Article
- The reasons for and influences of unintended teenage pregnancy in Kericho county, Kenya: a qualitative study.Reproductive health · 2024Article
- Transactional sex and age-disparate sexual partnerships among adolescent girls and young women in Tanzania.Frontiers in reproductive health · 2024Article
- The influence of gender-equitable attitudes on sexual behaviour among unmarried adolescents in rural Tanzania: a longitudinal study.Sexual and reproductive health matters · 2023Article
- Lessons From Implementing Ask-Boost-Connect-Discuss, a Peer-Delivered Psychosocial Intervention for Young Mothers Living With HIV in Malawi, Tanzania, Uganda, and Zambia.Global health, science and practice · 2023Article
Corrections and comments
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8 authors.
Funding
Abstract
backgroundEvidence shows that HIV prevalence among young women in sub-Saharan Africa increases almost five-fold between ages 15 and 24, with almost a quarter of young women infected by their early-to mid-20s. Transactional sex or material exchange for sex is a relationship dynamic that has been shown to have an association with HIV infection.
methodsUsing five focus group discussions and 19 in-depth interviews with young women enrolled in the HPTN 068 conditional cash transfer trial (2011-2015), this qualitative study explores young women's perceptions of transactional sex within the structural and cultural context of rural South Africa. The analysis also considers the degree to which young women perceive themselves as active agents in such relationships and whether they recognise a link between transactional sex and HIV risk.
resultsYoung women believe that securing their own financial resources will ultimately improve their bargaining position in their sexual relationships, and open doors to a more financially independent future. Findings suggest there is a nuanced relationship between sex, love and gifts: money has symbolic meaning, and money transfers, when framed as gifts, indicates a young woman's value and commitment from the man. This illustrates the complexity of transactional sex; the way it is positioned in the HIV literature ignores that "exchanges" serve as fulcrums around which romantic relationships are organised. Finally, young women express agency in their choice of partner, but their agency weakens once they are in a relationship characterised by exchange, which may undermine their ability to translate perceived agency into STI and HIV risk reduction efforts.
conclusionsThis research underscores the need to recognise that transactional sex is embedded in adolescent romantic relationships, but that certain aspects make young women particularly vulnerable to HIV. This is especially true in situations of restricted choice and circumscribed employment opportunities. HIV prevention educational programmes could be coupled with income generation trainings, in order to leverage youth resilience and protective skills within the confines of difficult economic and social circumstances. This would provide young women with the knowledge and means to more successfully navigate safer sexual relationships.
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