Skip to main content
SpringerLink
Log in

Predictors and Patterns of Transactional Sex with Casual Partners Among Adult Men Living in an Informal Urban Area, South Africa

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Few studies have explored the relationship between transactional sex and HIV in adult men, with even fewer exploring the predictors of providing money or goods in exchange for sex. This study aimed to characterise the predictors and patterns of transactional sex in adult men in an urban informal area in South Africa. We used baseline, cross-sectional data from a study of 2406 men aged 18–40 years from an urban informal area. Past year transactional sex was assessed through questions adapted from those used previously. Controlling behaviour was measured using an adapted Sexual Relationship Power Scale. Multivariable logistic regression was used to determine associations between transactional sex and other potential explanatory variables. Nearly half (47%) of respondents who had ever had sex reported at least one type of transactional sex with a casual partner in the past year. A third of men provided support or money for a sex partner’s family, 30% provided cash and 28% provided somewhere to stay. Controlling for other factors, men with higher levels of controlling behaviour had nearly double the odds of engaging in transactional sex. Men reporting three or more sexual partners had significantly higher odds of engaging in transactional sex. Hazardous drinkers had 33% higher odds of engaging in transactional sex. Men’s provision of money or goods in exchange for sex with women is related to other high-risk behaviours, such as multiple sexual partners, hazardous drinking and controlling behaviour. To address transactional sex-related HIV risks, programming should address harmful masculinities, including relationship control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD. Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection. Soc Sci Med. 2004;59(8):1581–92.

    Article  PubMed  Google Scholar 

  2. Kilburn K, Ranganathan M, Stoner MCD, Hughes JP, MacPhail C, Agyei Y, et al. Transactional sex and incident HIV infection in a cohort of young women from rural South Africa. AIDS (London, England). 2018;32(12):1669–777.

    Article  Google Scholar 

  3. Ranganathan M, Heise L, Pettifor A, Silverwood RJ, Selin A, MacPhail C, et al. Transactional sex among young women in rural South Africa: prevalence, mediators and association with HIV infection. J Int AIDS Soc. 2016;19(1):20749.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wamoyi J, Stobeanau K, Bobrova N, Abramsky T, Watts C. Transactional sex and risk for HIV infection in sub-Saharan Africa: a systematic review and meta-analysis. J Int AIDS Soc. 2016;19(1):20992.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Choudhry V, Ambresin AE, Nyakato VN, Agardh A. Transactional sex and HIV risks—evidence from a cross-sectional national survey among young people in Uganda. Global Health Action. 2015;8:27249.

    Article  PubMed  Google Scholar 

  6. Stoebenau K, Heise L, Wamoyi J, Bobrova N. Revisiting the understanding of "transactional sex" in sub-Saharan Africa: a review and synthesis of the literature. Soc Sci Med. 1982;2016(168):186–97.

    Google Scholar 

  7. Connell R. Gender and power. Stanford, CA: Stanford University Press; 1987.

    Google Scholar 

  8. Stoebenau K, Kyegombe N, Bingenheimer JB, Ddumba-Nyanzi I, Mulindwa J. Developing experimental vignettes to identify gender norms associated with transactional sex for adolescent girls and young women in Central Uganda. J Adolesc Health. 2019;64(4):S60–S6666.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jewkes R, Morrell R, Sikweyiya Y, Dunkle K, Penn-Kekana L. Transactional relationships and sex with a woman in prostitution: prevalence and patterns in a representative sample of South African men. BMC Public Health. 2012;12:325.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Dunkle KL, Jewkes R, Nduna M, Jama N, Levin J, Sikweyiya Y, et al. Transactional sex with casual and main partners among young South African men in the rural Eastern Cape: prevalence, predictors, and associations with gender-based violence. Soc Sci Med. 2007;65(6):1235–48.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Council P. Male partners of adolescent girls and young women: relationship characteristics and HIV risk—findings from DREAMS implementation science research. Washington, DC: DREAMS Results Brief; 2018.

    Google Scholar 

  12. Statistics South Africa. Census 2001: investigation into appropriate definitions of urban and rural areas for South Africa: Discussion document/Statistics South Africa. Pretoria, South Africa.

  13. Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, Labadarios D, Onoya D, et al. South African National HIV Prevalence, Incidence and Behaviour Survey, 2012. Cape Town: HSRC Press; 2014.

    Google Scholar 

  14. Christofides NJ, Hatcher AM, Pino A, Rebombo D, McBride RS, Anderson A, et al. A cluster randomised controlled trial to determine the effect of community mobilisation and advocacy on men's use of violence in periurban South Africa: study protocol. BMJ Open. 2018;8(3):e017579.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Wamoyi J, Ranganathan M, Kyegombe N, Stoebenau K. Improving the measurement of transactional sex in Sub-Saharan Africa: a critical review. JAIDS J Acquir Immune Defic Syndr. 2019;80(4):367–74.

    Article  PubMed  Google Scholar 

  16. Wamoyi JSK, Kyegombe N, Heise L, Ranganathan M. STRIVE Technical Brief: Measuring transactional sex and HIV risk. London; 2017.

  17. Gibbs A, Hatcher A, Jewkes R, Sikweyiya Y, Washington L, Dunkle K, et al. Associations between lifetime traumatic experiences and HIV-risk behaviors among young men living in informal settlements in South Africa: a cross-sectional analysis and structural equation model. J Acquir Immune Defic Syndr. 2019;81(2):193–201.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Deitchler M, Ballard T, Swindale A, Coates J. Validation of a measure of household hunger for cross-cultural use. Washington, DC: Food and Nutrition Technical Assistance II Project (FANTA-2), Academy for Educational Development; 2010.

    Google Scholar 

  19. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Neglect. 2003;27(2):169–90.

    Article  PubMed  Google Scholar 

  20. Jewkes R, Morrell R. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention. J Int AIDS Soc. 2010;13:6.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Pulerwitz J, Barker G. Measuring attitudes toward gender norms among young men in Brazil: development and psychometric evaluation of the GEM Scale. Men Masc. 2008;10(3):322–38.

    Article  Google Scholar 

  22. Pulerwitz J, Gortmaker SL, DeJong W. Measuring sexual relationship power in HIV/STD research. Sex Roles. 2000;42(7):637–60.

    Article  Google Scholar 

  23. Jewkes RK, Dunkle K, Nduna M, Shai N. Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study. Lancet (London, England). 2010;376(9734):41–8.

    Article  Google Scholar 

  24. Kaufman MR, Shefer T, Crawford M, Simbayi LC, Kalichman SC. Gender attitudes, sexual power, HIV risk: a model for understanding HIV risk behavior of South African men. AIDS Care. 2008;20(4):434–41.

    Article  PubMed  Google Scholar 

  25. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO Collaborative Project on early detection of persons with harmful alcohol consumption—II. Addiction (Abingdon, England). 1993;88(6):791–804.

    Article  CAS  Google Scholar 

  26. StataCorp. Stata Statistical Software: Release 14. College Station, TX; 2015.

  27. Mampane JN. Exploring the “Blesser and Blessee” phenomenon: young women, transactional sex, and HIV in rural South Africa. SAGE Open. 2018;8(4):2158244018806343.

    Article  Google Scholar 

  28. Dube Y. Social media fuels transactional sex. The Chronicle. 2016;2016:23.

    Google Scholar 

  29. Hunter M. Love in the time of AIDS: inequality, gender and right in South Africa. Pietermaritzburg: University of KwaZulu-Natal Press; 2010.

    Google Scholar 

  30. Wentzell E. ‘I help her, she helps me:’ Mexican men performing masculinity through transactional sex. Sexualities. 2014;17(7):856–71.

    Article  Google Scholar 

  31. Wamoyi J, Buller AM, Nyato D, Kyegombe N, Meiksin R, Heise L. "Eat and you will be eaten": a qualitative study exploring costs and benefits of age-disparate sexual relationships in Tanzania and Uganda: implications for girls' sexual and reproductive health interventions. Reprod Health. 2018;15(1):207.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hatcher AM, Colvin CJ, Ndlovu N, Dworkin SL. Intimate partner violence among rural South African men: alcohol use, sexual decision-making, and partner communication. Culture Health Sex. 2014;16(9):1023–39.

    Article  Google Scholar 

  33. Fleming PJ, DiClemente RJ, Barrington C. Masculinity and HIV: dimensions of masculine norms that contribute to men's HIV-related sexual behaviors. AIDS Behav. 2016;20(4):788–98.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bello B, Moultrie H, Somji A, Chersich MF, Watts C, Delany-Moretlwe S. Alcohol use and sexual risk behaviour among men and women in inner-city Johannesburg, South Africa. BMC Public Health. 2017;17(Suppl 3):548.

    Article  PubMed  Google Scholar 

  35. Morojele NK, Kachieng'a MA, Mokoko E, Nkoko MA, Parry CD, Nkowane AM, et al. Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Soc Sci Med. 2006;62(1):217–27.

    Article  PubMed  Google Scholar 

  36. Rich EP, Nkosi S, Morojele NK. Masculinities, alcohol consumption, and sexual risk behavior among male tavern attendees: a qualitative study in North West Province. South Africa Psychol Men Masc. 2015;16(4):382–92.

    Article  Google Scholar 

  37. Onoya D, Zuma K, Zungu N, Shisana O, Mehlomakhulu V. Determinants of multiple sexual partnerships in South Africa. J Public Health (Oxford, England). 2015;37(1):97–106.

    Article  Google Scholar 

  38. Meekers D, Calves AE. 'Main' girlfriends, girlfriends, marriage, and money: the social context of HIV risk behaviour in sub-Saharan Africa. Health Transit Rev. 1997;7(Suppl):361–75.

    PubMed  Google Scholar 

  39. MacPhail C, Campbell C. 'I think condoms are good but, aai, I hate those things': condom use among adolescents and young people in a Southern African township. Soc Sci Med. 2001;52(11):1613–27.

    Article  CAS  PubMed  Google Scholar 

  40. Gibbs A, Hatcher AM, Jewkes R, Sikweyiya Y, Washington L, Dunkle K, Magni S, Peacock D, Khumalo M, Christofides N (accepted for publication). Associations between lifetime traumatic experiences and HIV-risk behaviours amongst young men living in informal settlements in South Africa: a cross-sectional analysis and structural equation model. JAIDS.

  41. Shannon K, Leiter K, Phaladze N, Hlanze Z, Tsai AC, Heisler M, et al. Gender inequity norms are associated with increased male-perpetrated rape and sexual risks for HIV infection in Botswana and Swaziland. PLoS ONE. 2012;7(1):e28739.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Jewkes R, Morrell R. Hegemonic masculinity, violence, and gender equality: using latent class analysis to investigate the origins and correlates of differences between men. Men Masc. 2017. https://doi.org/10.1177/1097184X17696171.

    Article  Google Scholar 

  43. Gibbs A, Dunkle K, Washington L, Willan S, Shai N, Jewkes R. Childhood traumas as a risk factor for HIV-risk behaviours amongst young women and men living in urban informal settlements in South Africa: a cross-sectional study. PLoS ONE. 2018;13(4):e0195369.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, et al. Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. BMJ (Clin Res ed). 2008;337:a506.

    Article  Google Scholar 

Download references

Acknowledgements

The Sonke CHANGE Trial was funded by the What Works to Prevent Violence? A Global Programme on Violence Against Women and Girls funded by the United Kingdom Government’s Department for International Development. This study was supported by funding from the South African Medical Research Council’s Office of AIDS and TB Research.

Author information

Authors and Affiliations

  1. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

    Sarah Magni, Abigail Hatcher & Nicola Christofides

  2. Genesis Analytics, Johannesburg, South Africa

    Sarah Magni

  3. Department of Sexual and Reproductive Health, National Institute for Medical Research, Mwanza, Tanzania

    Joyce Wamoyi

Authors
  1. Sarah Magni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abigail Hatcher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joyce Wamoyi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nicola Christofides
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SM, AH, JW and NC conceived and designed the experiments. SM analysed the data. SM, AH, JW and NC wrote the paper. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Sarah Magni.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Magni, S., Hatcher, A., Wamoyi, J. et al. Predictors and Patterns of Transactional Sex with Casual Partners Among Adult Men Living in an Informal Urban Area, South Africa. AIDS Behav 24, 2616–2623 (2020). https://doi.org/10.1007/s10461-020-02818-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-020-02818-0

Keywords

Search

Navigation