Impact case study: Question on transactional sex in the DHS

STRIVE Impact case study - TS and DHS.pdf

As of 2015, the Demographic and Health Surveys (DHS) include improved questions to capture the practice of transactional sex for women and men. Similar questions are now included in the Violence against Children surveys (VACS), evaluations of the Transfer project and other cash transfer studies in South Africa and Tanzania and numerous individual studies including at least one surveillance site. As a result, survey data can be expected to shed light on:

  • the prevalence and determinants of the practice of transactional sex
  • the contribution of the practice to the HIV risk facing adolescent girls and young women
  • thinking to inform the design of steps to address such risk within broader programmes for this population.

What is the issue?

Adolescent girls and young women in sub-Saharan Africa face a higher risk of HIV infection than any other population worldwide. HIV prevalence here is more than twice as high among young women as it is among young men. In parts of South Africa, it is up to eight times higher. Despite increased efforts, there is limited progress in reducing the burden of new infections in this population. This suggests that important factors, including transactional sex, are still being overlooked or inadequately understood and addressed.

What did STRIVE research find?

From our analysis of in-depth research in sub-Saharan African contexts, systematic reviews and conceptual thinking, STRIVE researchers have produced:

  • a clear definition of the practice
  • a nuanced understanding of three key motivations underlying the practice
  • a crucial distinction between transactional sex and sex work, demonstrated by mathematical modelling
  • clear evidence that demonstrates the association between transactional sex and HIV
  • improved survey questions
  • a technical brief for and with UNAIDS
  • a measurement brief
  • recommendations to researchers, HIV prevention programme develop

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