Transactional sex and incident HIV infection in a cohort of young women from rural South Africa enrolled in HPTN 068

Kelly Kilburn, Meghna Ranganathan, Marie C.D. Stoner, James P. Hughes, Catherine Macphail, Yaw Agyei, F. Xavier Gomez-Olive, Kathleen Kahn and Audrey Pettifor AIDS, 2018; Read the full paper online

In 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. This paper analyses longitudinal data to estimate the association between transactional sex and HIV incidence. The researchers used data from a cohort of 2,362 HIV negative young women (aged 13–20) enrolled in a randomized controlled trial in rural, South Africa who were followed for up to 4 visits over 6 years.

The results revealed that HIV incidence was higher for young women that reported transactional sex, particularly when money and/or gifts were received frequently (at least weekly).  Effects were also much stronger during the main trial and dissipated at the post-intervention visit, despite an increase in both transactional sex and HIV.

The paper concludes that transactional 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.

Filter by