Improving the Measurement of Transactional Sex in Sub-Saharan Africa: A Critical Review

Wamoyi, Joyce; Ranganathan, N.; Kyegombe, Nambusi; Stoebenau, Kirsten

doi:10.1097/qai.0000000000001928

Cited by 45 publications

(34 citation statements)

References 25 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Within SSA, and the world at large, HIV transmission is often facilitated by men who pay for sex, as such men serve as a ‘bridge’ for HIV transmission through having unprotected sex with their female clients, spouses, girlfriends, men, and others [ 8 ]. Paying for sex involves the exchange of sex for money, gift, services, or other favours such as promotion at the work place and grades in school [ 9 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Consistent condom use among men who pay for sex in sub-Saharan Africa: Empirical evidence from Demographic and Health Surveys

et al. 2020

View full text Add to dashboard Cite

Background Paying for sex has often been associated with risky sexual behavior among heterosexual men, and men who pay for sex are considered as a bridging population for sexually transmitted infections. Consistent condom use during paid sex is essential for reducing sexually transmitted infections, including HIV/AIDS. In this study, we assessed the prevalence and predictors of consistent condom use among men who pay for sex in sub-Saharan Africa. Materials and methods We pooled data from 29 sub-Saharan African countries' Demographic and Health Surveys. A total of 3,353 men in sub-Saharan Africa who had paid for sex in the last 12 months preceding the surveys and had complete information on all the variables of interest were used in this study. The outcome variable for the study was consistent condom use for every paid sex in the last 12 months. Both bivariate and multivariable logistic regression analyses were carried out. Results were presented as adjusted odds ratios with their corresponding 95% confidence intervals. Statistical significance was declared at p< 0.05.

show abstract

Section: Introductionmentioning

confidence: 99%

Consistent condom use among men who pay for sex in sub-Saharan Africa: Empirical evidence from Demographic and Health Surveys

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Paid sex is an element of transactional sex, which has been considered to involve the exchange of sex for money, gift, services or other favours such as promotion at the work place and grades in school ( Amo-Adjei, Kumi-Kyereme, & Anamaale Tuoyire, 2014 ; Choudhry, Ambresin, Nyakato, & Agardh, 2015 ; Wamoyi, Ranganathan, Kyegombe, & Stoebenau, 2019 ). This can include both men paying women for sex and men paying men for sex ( Berg, Schmidt, Weatherburn, & The EMIS Network, 2015 ; Groom & Nandwani, 2006 ; Smith et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Paid sex among men in sub-Saharan Africa: Analysis of the demographic and health survey

Seidu

Darteh

Kumi-Kyereme

et al. 2020

SSM - Population Health

View full text Add to dashboard Cite

Background Paying for sex is regarded as a risky sexual behavior (RSB) among heterosexual men. Men paying for sex are considered to be a bridging population for sexually transmitted infections (STIs). Despite the link between paid sex and sexual and reproductive health outcomes such as STIs, little is known about the prevalence and factors associated with paid sex among men in sub-Saharan Africa. This study examined the prevalence of paid sex and the socio-demographic factors associated with it among men in sub-Saharan Africa. Methods The study made use of pooled data from the Demographic and Health Surveys (DHS) conducted from January 1, 2010 to December 3, 2016 in 27 countries in sub-Saharan Africa. Binary and multivariable logistic regression models were used to investigate the relationship between the explanatory and the outcome variables. Results The results of the study showed that of the 139,427 men who participated in the study, 4.3% reported they had paid for sex in the 12 months preceding the survey. Men in Mozambique had the highest proportion (13.6%) of paying for sex in the 12 months preceding the survey. The results of the multivariable analysis indicated that men from DR Congo [AOR = 9.74; 95% CI = 7.45–12.73], men who had completed only primary level of education [AOR = 1.31; 95% CI = 1.18–1.45], men aged 25–34 years [AOR = 2.84; 95% CI = 2.26–3.56], men belonging to “other” religious groups [AOR = 1.20; 95% CI = 1.09–1.32] and men who were employed [AOR = 1.73; 95% CI = 1.58–1.90] had higher odds of paying for sex. Men who were divorced [AOR = 4.52; 95% = 3.89–5.25], men who read newspaper/magazine almost every day [AOR = 1.34; 95% CI = 1.12–1.63], men who listened to radio almost every day [AOR = 1.19; 95% CI = 1.05–1.36] and men who watched television at least once a week [AOR = 1.10; 95% CI = 1.01–1.19] also had higher odds of paying for sex. On the other hand, men in rural areas [AOR = 0.88; 95%CI = 0.82–0.95], men in the richest wealth quintile [AOR = 0.83; 95%CI = 0.74–0.93] and those with tertiary level of education [AOR = 0.77; 95% CI = 0.65–0.90] had lower odds of paying for sex. Conclusion The odds of paid sex were high among men with only primary level of education, men aged 25–34, men who professed ‘other’ religious affiliation, men who are employed and men who are divorced. However, paid sex was low among men in the richest wealth quintile, men with tertiary level of education and men living in rural areas. This means that the decision to pay for sex is influenced by several social and demographic factors. Hence, these factors should be taken into consideration for sexual and reproductive health interventions and services. Policy and interventional measures should aim at reducing high-risk behavior of men who pay for sex.

show abstract

“…Some people have sex with other people for a living; would you consider yourself to be such a person? (24) Data were collected electronically using RedCap software (25) and self-completed by the participant on a tablet computer to improve privacy.…”

Section: Population Data Collection and Measuresmentioning

confidence: 99%

Antiretroviral Therapy Based Hiv Prevention Targeting Young Female-Sex Workers: A Mixed Method Approach to Understand the Implementation of Prep in a Rural Area of Kwazulu-Natal, South Africa

Chimbindi

Mthiyane

Zuma

et al. 2020

Preprint

View full text Add to dashboard Cite

Introduction: Pre-exposure prophylaxis (PrEP) has the potential to alter the HIV epidemic in South Africa. Between 2016 and 2018 PrEP was rolled-out for 18-24 year-old female-sex workers (FSW) in a rural KwaZulu-Natal subdistrict with very high HIV incidence among adolescent girls and young women (AGYW). Using a ‘framework of access’ model, we describe PrEP access, awareness and uptake for AGYW, including community members’ attitudes towards PrEP for young people.Methods: We enrolled a cohort of 2184 AGYW aged 13-22 living within the subdistrict and quantitatively measured their eligibility, awareness and uptake of PrEP and other HIV prevention interventions in 2017 and 2018. We supplemented this insight with in depth exploration by conducting 19 group discussions with young people and community members, nine stakeholder key informant interviews, 58 in-depth interviews with 15-24 year-olds and 33 with implementing partners, and participatory observations. All interviews were recorded, transcribed and analysed using thematic analysis.Results: PrEP awareness increased from 2% to 9% from 2017 to 2018. Among 965 AGYW sexually-active by 2018, 13.4% (95%CI: 11.4-15.7%) reported transactional sex and 10.6% (95%CI: 8.8-12.7%) sex for money. Of these latter 194 PrEP-eligible AGYW, 21 were aware of PrEP, but none had ever used it. Wider community members were generally unaware of PrEP but imagined it would benefit young people, HIV-serodiscordant couples and those in long-distance relationships. Youth saw PrEP as a positive alternative to condoms since it “will be in their system” and not get in the way of sex. Teachers and healthcare providers were more apprehensive: worrying that PrEP would lower personal responsibility for sexual health.Conclusions: Although PrEP awareness increased and it was generally acceptable, uptake was low even among eligible AGYW, i.e., who reported FSW activity. Condom use remained undesirable suggesting a need to include PrEP in offers of alternative HIV prevention technologies to comdoms. The targeted nature of public-sector PrEP for FSW may have limited the reach, and the future broader roll-out, of PrEP in this setting. Inclusive approaches to PrEP provision integrated with wider sexual healthmay help improve demand and access to PrEP.

show abstract

Improving the Measurement of Transactional Sex in Sub-Saharan Africa: A Critical Review

Cited by 45 publications

References 25 publications

Consistent condom use among men who pay for sex in sub-Saharan Africa: Empirical evidence from Demographic and Health Surveys

Consistent condom use among men who pay for sex in sub-Saharan Africa: Empirical evidence from Demographic and Health Surveys

Paid sex among men in sub-Saharan Africa: Analysis of the demographic and health survey

Antiretroviral Therapy Based Hiv Prevention Targeting Young Female-Sex Workers: A Mixed Method Approach to Understand the Implementation of Prep in a Rural Area of Kwazulu-Natal, South Africa

Contact Info

Product

Resources

About