Transactional sex is an important factor in the spread of HIV, particularly in Sub-Saharan Africa. In this chapter, we review empirical evidence on the economic incentives which influence the decision to supply transactional sex, and discuss several policies which may affect supply decisions. While the primary motivation for entering the transactional sex market is the large income premium relative to other jobs, unexpected income shocks also affect sexual behavior. Based largely on a set of studies in Western Kenya, we show that women are more likely to supply unprotected sex when they experience unexpected income shocks. We also show that sex workers receive informal insurance transfers from regular clients when shocks occur. Such support may induce some women into supplying sex. We conclude with a discussion of possible policy options, including providing conditional cash transfers, giving information on health risks, and introducing risk coping mechanisms such as insurance or bank accounts.
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