The extent and risk factors for transactional sex among young people, in urban informal settlements in Blantyre, Malawi
Date
2015-09-08
Authors
Longwe, Monica Brenda
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction: Studies across Sub-Sahara have established transactional sex as one of the of the keys factors contributing to young people’s risk of HIV infection. However, there are few studies that have explored the dynamics of transactional sex among young people in Malawi. The aim of this study was to investigate the extent of, and risk factors associated with transactional sex among (in and out of school) young men and women of ages 18 – 23 years in urban informal settlements in Blantyre, Malawi.
Methods: This was a secondary analysis of data from a cross-sectional study conducted in 2013 on sexual risk-taking among young people aged 18 – 23 years in urban informal settlements in the city of Blantyre, Malawi. The analysis was restricted to sexually active young men and women (those respondents who reported ever having sexual intercourse in the primary study). Bivariate and multivariate analyses were conducted to detect associations between socio-demographic factors (i.e. age, socio-economic status, relationship status and education, as well as behavioral factors (i.e. sexual debut, number of partners, age disparity with sexual partner, coercive sex and alcohol consumption), and transactional sex.
Results: The majority (60.06%) of the study population reported involvement in transactional sex. Stratified by sex, 67.10% of young men had ever given cash or material goods in order to get sex, and 53.45% of young women had ever received cash or material goods in exchange for sex. Half (50.75%) of the transactional sex reported was in exchange for cash and consumption/lifestyle goods and from this, over half of the young women (58.67%) reported receiving consumption and lifestyle goods in exchange for sex, and slightly over a quarter (26.32%) of the young men reported giving survival needs in exchange for sex. Among men, household structure (AOR 2.07, 95% CI 1.37 – 3.13) and severe food insecurity (AOR 1.67, 95% CI 1.05 – 2.67) emerged as important socio-demographic predictors of transactional sex, and number of sexual partners (AOR 2.67, 95% CI 1.78 – 4.08) and age disparity (AOR 0.34, 95% CI 0.21 – 0.57) were shown to be the behavioral factors that influence giving cash/material goods for sex. Among young women, only age at sexual debut (AOR 2.07, 95% CI 1.37 – 3.13) and number of sexual partners (AOR 3.02, 95% CI 1.65 – 5.52), were significantly associated with receiving cash or goods in exchange for sex.
Conclusions: Overall, the study findings show that transactional sex is a common practice among young men and women, and that both young and women exchange luxury or aspirational items more than survival items for sex. Among young men, household structure, food security, age at sexual debut, number of sexual partners and age differentials with sexual partner were associated with giving material goods or money for sex. Among women on the other hand, age at sexual debut and number of sexual partners were associated with receiving material goods or money in exchange with sex. These findings suggest that young people in poor urban settings engage in risky sexual behavior such as Transactional sex, and highlight the need for HIV prevention interventions to deliberately target this group. Programmers should consider designing interventions that suit the needs of the different gender groups. The study findings also highlight the importance of targeting young women with behavioral change interventions before sexual debut, and integrating transactional sex interventions with those focused on reduction of multiple sexual partnerships may have beneficial implications for transactional sex among young people in poor urban settings. Further research should explore the influence of materialist and consumeristic cultures on transactional sex among young people.
Description
A Research Report submitted to the School of Public Health, University of the Witwatersrand in partial fulfillment of the requirements for the degree of Master of Public Health.
May 27, 2015