ReviewJournal of acquired immune deficiency syndromes (1999)2019
Improving the Measurement of Transactional Sex in Sub-Saharan Africa: A Critical Review.
Review in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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Who cites it
45 citing papers in PubMed, 68 citations in OpenAlex.
- Trial
- The effect of protecting women against economic shocks to fight HIV in Cameroon, Africa: The POWER randomised controlled trial.PLoS medicine · 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
- 'When I have these kits … I have confidence' - HIV self-testing provides agency for women in their sexual decision-making.Global public health · 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
- Article
- When context matters: Multilevel determinants of self-reported sexually transmitted infections symptoms among men engaged in transactional sex in 26 Sub-Saharan African countries.BMC public health · 2026Article
- Transactional sex and intersecting vulnerabilities: a multicountry cross-sectional study of pregnant and parenting adolescents in sub-Saharan Africa.BMJ public health · 2026Article
- 'They were just enjoying love and she was making money': A qualitative analysis of UN peacekeeper sexual interactions in the Democratic Republic of Congo.Conflict and health · 2025Article
- The Association of Food Security Status with Transactional Sex Engagement Among Female Adolescents Aged 15-24: Evidence from Cameroon.Archives of sexual behavior · 2025Article
- Profiles of Sexual Economic Exchanges among Women in Kisumu, Kenya: A Latent Class Analysis.Archives of sexual behavior · 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
- Prevalence of Paid Sex and Associated Factors Among Women and Men Attending HIV Voluntary Counseling and Testing in Kinshasa, Democratic Republic of the Congo: A Prospective Cohort.Archives of sexual behavior · 2024Article
- Adolescent sexual and reproductive health needs and utilisation of health services in the Bono East Region, Ghana.Reproductive health · 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
- Economic vulnerabilities, mental health, and coping strategies among Tanzanian youth during COVID-19.BMC public health · 2024Article
- Article
- Trading HIV for sheep: Risky sexual behavior and the response of female sex workers to Tabaski in Senegal.Health economics · 2024Article
- Batswana Adolescents' Attitudes Toward Sex With Older Adults: Psychometric Properties of the Attitudes Toward Transactional Sex Scale.Assessment · 2023Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransactional sex, or informal sexual exchange, is considered to be an important contributing factor to the disproportionately high HIV infection rates experienced by adolescent girls and young women in sub-Saharan Africa. Nonetheless, confusion remains over how best to define and measure this practice, hindering efforts to mitigate the role of transactional sex in the epidemic. We critically review current measures and offer evidence-based recommendations for improvement.
settingAlthough transactional sex is practiced around the world, we focus attention on the definition and measurement of this practice in sub-Saharan Africa, given the role it plays in young women's risk of HIV in this region.
methodsWe relied on both secondary and primary data sources. We draw on a systematic review of literature on transactional sex from sub-Saharan Africa and interview data from both key informants and cognitive interviews (n = 160) with young women (ages 14-24) and men (ages 18-35) in Uganda and Tanzania.
resultsWe find current measures are inconsistent, conflate transactional sex with sex work, and fail to capture the gendered nature of the practice. We provide an evidence-based definition of transactional sex that guides our measurement recommendations. We then detail the development of improved measures through cognitive interviews. Finally, we offer recommended approaches to improved measurement of transactional sex for women and men in large-scale surveys.
conclusionsImproved measures are critical for accurate estimation of the prevalence of transactional sex and assessment of the extent to which transactional sex determines HIV risk.
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