ArticleAIDS (London, England)2018
Transactional sex and incident HIV infection in a cohort of young women from rural South Africa.
Article in AIDS (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 3 of them syntheses 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
61 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- HIV incidence among women engaging in sex work in sub-Saharan Africa: a systematic review and meta-analysis.The Lancet. Global health · 2024Pooled it
- Differentiating the incidence and burden of HIV by age among women who sell sex: a systematic review and meta-analysis.Journal of the International AIDS Society · 2022Pooled it
- Cash transfers for HIV prevention: A systematic review.PLoS medicine · 2021Pooled it
- Developmental Trajectories of Transactional Sex and Age-Disparate Relationships During Adolescence: An HPTN 068 Analysis.AIDS and behavior · 2024Trial
- 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
- Intimate Partner Violence (IPV) and Associated Factors in HPTN 071 (PopART) Study Communities in Zambia and South Africa-A Comparison by HIV Status.AIDS and behavior · 2022Trial
- Transactional Sex, HIV Testing and Receipt of Results Among Adolescents and Young Women: A Comparative DHS Analysis of the Four Major Regions in Uganda.AIDS and behavior · 2026Article
- Sexual Relationship Typologies, Multilevel Determinants, and HIV Among Adolescent Mothers in Eastern and Southern Africa: A Multilevel Latent Class Analysis.AIDS and behavior · 2026Article
- Loss to Follow-Up and Visit Nonadherence in an HIV Incidence Cohort in Kisumu, Kenya.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Prevalence and factors associated with modern and dual contraceptive use among women living with HIV in Cross River State, Nigeria: a cross-sectional study.Contraception and reproductive medicine · 2026Article
- HIV incidence among sexually active young males and females in Kisumu County, Western Kenya.PloS one · 2026Article
- Identifying sexual behavioural choices when commencing pre-exposure prophylaxis: Findings from a public health facility in eThekwini, KwaZulu-Natal, South Africa.Southern African journal of HIV medicine · 2026Article
- Article
- Predictors of multiple sexual partnerships and condom use among men engaged in transactional sex: a recursive bivariate probit analysis of Demographic and Health Surveys from 26 Sub-Saharan African countries.Tropical medicine and health · 2025Article
- Changes in incidence of HPV-related cancers in South Africa (2011-21): a cross-sectional analysis of the South African National Cancer Registry.The Lancet. Global health · 2025Article
- Profiles of Sexual Economic Exchanges among Women in Kisumu, Kenya: A Latent Class Analysis.Archives of sexual behavior · 2025Article
- Stress-responsive biomarkers and sexual behaviors among young women in rural South Africa.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Article
- Article
- '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
- Correlates of Transactional Sex Among Black Men and Women Who Misuse Opioids.Health education & behavior : the official publication of the Society for Public Health Education · 2024Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveIn sub-Saharan Africa, young women who engage in transactional sex (the exchange of sex for money or gifts) with a male partner show an elevated risk of prevalent HIV infection. We analyse longitudinal data to estimate the association between transactional sex and HIV incidence.
designWe used longitudinal data from a cohort of 2362 HIV-negative young women (aged 13-20 years) enrolled in a randomized controlled trial in rural, South Africa who were followed for up to four visits over 6 years.
methodsThe effect of transactional sex on incident HIV was analysed using stratified Cox proportional hazards models and cumulative incidence curves. Risk ratios were estimated using log-binomial models to compare the effects across visits.
resultsHIV incidence was higher for young women that reported transactional sex (hazard ratio 1.59, 95% confidence interval 1.02-2.19), particularly when money and/or gifts were received frequently (at least weekly) (hazard ratio 2.71, 95% confidence interval 1.44-5.12). We also find that effects were much stronger during the main trial and dissipate at the postintervention visit, despite an increase in both transactional sex and HIV.
conclusionTransactional sex elevates the risk of HIV acquisition among young women, especially when it involves frequent exchanges of money and/or gifts. However, the effect was attenuated after the main trial, possibly due to the changing nature of transactional sex and sexual partners as women age. These findings suggest that reducing transactional sex among young women, especially during adolescence, is important for HIV prevention.
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