Improving the Measurement of Transactional Sex in Sub-Saharan Africa
Themes:
Joyce Wamoyi, Meghna Ranganathan, Nambusi Kyegombe, Kirsten Stoebenau
Journal of Acquired Immune Deficiency Syndromes, 2019;
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Transactional 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.
This paper critically reviews current measures and offers evidence-based recommendations for improvement. It finds that current measures are inconsistent, conflate transactional sex with sex work, and fail to capture the gendered nature of the practice.
The paper provides an evidence-based definition of transactional sex that guides measurement recommendations. It then details the development of improved measures through cognitive interviews. Finally, it recommends approaches to improved measurement of transactional sex for women and men in large-scale surveys.
