Technical brief: Measuring transactional sex and HIV risk

STRIVE Transactional sex measurement brief.pdf

In sub-Saharan Africa, adolescent girls and young women (AGYW) face a disproportionate burden of HIV risk. Globally, 2.1 million young women are living with HIV. Four-fifths live in sub-Saharan Africa and over 25% of all new HIV infections occur in young women aged 15-24.

Transactional sex (TS) has received increasing attention in the public health literature, as it is considered to be an important contributing factor to the high HIV infection rates observed among this age group in sub-Saharan Africa. This practice, driven by economic and gender inequality, increases women’s risk of HIV.

A recent systematic review found that having ever practised TS increased women’s risk of HIV by almost 50%. Yet, as the attention to the role of transactional sex in HIV risk for AGYW has grown, so too has misunderstanding over its meaning and how best to measure it. 

This brief provides:

  • a definition of TS
  • a case for improving measures of TS
  • approaches to improving measures of TS
  • recommended measure of TS for the sub-Saharan context

There is an urgent need to improve the measurement of transactional sex in order to effectively capture the contribution of transactional sex to the HIV epidemic in sub-Saharan Africa."

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