TY - JOUR
T1 - Revisiting the understanding of “transactional sex” in sub-Saharan Africa
T2 - A review and synthesis of the literature
AU - Stoebenau, Kirsten
AU - Heise, Lori
AU - Wamoyi, Joyce
AU - Bobrova, Natalia
N1 - Funding Information:
The study was made possible by support from the STRIVE research consortium program , funded by UKAid from the Department of International Development (DFID). However, the views expressed do not necessarily reflect the department's official policies. The authors would like to thank Kirsty Sievwright for her skillful research assistance in coding textual data; and Sanyu Mojola as well as fellow colleagues within the STRIVE Working Group on Transactional Sex and HIV for their insights and fruitful discussions on earlier drafts of this work. We would also like to thank the members of the STRIVE research consortium, the UNAIDS Prevention Division, and the Center on Health, Risk and Society at American University for constructive feedback on earlier presentations of this material. We thank Jane Shepherd and Annie Holmes for their expertise in the rendering of Fig. 1 . Finally, we must extend an extremely heartfelt thanks to the incredibly thoughtful anonymous reviewers of this manuscript whose constructive criticism strengthened this paper in numerous ways.
Publisher Copyright:
© 2016 The Authors
PY - 2016/11/1
Y1 - 2016/11/1
N2 - In sub-Saharan Africa, young women ages 15–24 have more than twice the risk of acquiring HIV as their male counterparts. A growing body of epidemiological evidence suggests that the practice of “transactional sex” may contribute to this disparity. Over the last 15 years, the social sciences have contributed significantly to understanding the meaning of and motivations for this practice. The findings from these studies are rich, but varied, rendering lessons difficult to navigate for intervention and further research. We therefore contribute a historically-grounded, comprehensive literature review on the nature and motivations for women's participation in transactional sex in sub-Saharan Africa. Drawing from over 300 studies (through 2014), we distill three prominent paradigms observed in the literature that we review toward presenting a unified conceptualization of the practice. “Sex for basic needs,” the first paradigm, positions women as victims in transactional sexual relationships, with implications for interventions that protect girls from exploitation. In contrast, the “sex for improved social status” paradigm positions women as sexual agents who engage in transactional sex toward attaining a middle-class status and lifestyle. Finally, a third paradigm, “sex and material expressions of love,” draws attention to the connections between love and money, and the central role of men as providers in relationships. We find important commonalities in the structural factors that shape the three paradigms of transactional sex including gender inequality and processes of economic change. We suggest that there are three continua stretching across these paradigms: deprivation, agency, and instrumentality. This review proposes a definition of transactional sex and discusses implications for research and interventions aiming to reduce young women's risk of HIV through such relationships. We consider the consequences of drawing from too narrow an understanding of the practice, and highlight the benefits of a broader conceptualization.
AB - In sub-Saharan Africa, young women ages 15–24 have more than twice the risk of acquiring HIV as their male counterparts. A growing body of epidemiological evidence suggests that the practice of “transactional sex” may contribute to this disparity. Over the last 15 years, the social sciences have contributed significantly to understanding the meaning of and motivations for this practice. The findings from these studies are rich, but varied, rendering lessons difficult to navigate for intervention and further research. We therefore contribute a historically-grounded, comprehensive literature review on the nature and motivations for women's participation in transactional sex in sub-Saharan Africa. Drawing from over 300 studies (through 2014), we distill three prominent paradigms observed in the literature that we review toward presenting a unified conceptualization of the practice. “Sex for basic needs,” the first paradigm, positions women as victims in transactional sexual relationships, with implications for interventions that protect girls from exploitation. In contrast, the “sex for improved social status” paradigm positions women as sexual agents who engage in transactional sex toward attaining a middle-class status and lifestyle. Finally, a third paradigm, “sex and material expressions of love,” draws attention to the connections between love and money, and the central role of men as providers in relationships. We find important commonalities in the structural factors that shape the three paradigms of transactional sex including gender inequality and processes of economic change. We suggest that there are three continua stretching across these paradigms: deprivation, agency, and instrumentality. This review proposes a definition of transactional sex and discusses implications for research and interventions aiming to reduce young women's risk of HIV through such relationships. We consider the consequences of drawing from too narrow an understanding of the practice, and highlight the benefits of a broader conceptualization.
KW - HIV/AIDS
KW - Prevention
KW - Structural drivers
KW - Transactional sex
KW - Young women
KW - sub-Saharan Africa
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U2 - 10.1016/j.socscimed.2016.09.023
DO - 10.1016/j.socscimed.2016.09.023
M3 - Review article
C2 - 27665064
AN - SCOPUS:84988515866
SN - 0277-9536
VL - 168
SP - 186
EP - 197
JO - Social Science and Medicine
JF - Social Science and Medicine
ER -