Transactional sex is
associated with increased risk of HIV and gender based violence in southern
Africa and around the world. However the typical quantitative
operationalization, "the exchange of gifts or money for sex," can be
at odds with a wide array of relationship types and motivations described in
qualitative explorations.
To build on the strengths of both qualitative and
quantitative research streams, we used cultural consensus models to identify
distinct models of transactional sex in Swaziland. The process allowed us to
build and validate emic scales of transactional sex, while identifying key
informants for qualitative interviews within each model to contextualize
women's experiences and risk perceptions.
We used logistic and multinomial
logistic regression models to measure associations with condom use and social
status outcomes. Fieldwork was conducted between November 2013 and December
2014 in the Hhohho and Manzini regions. We identified three distinct models of
transactional sex in Swaziland based on 124 Swazi women's emic valuation of
what they hoped to receive in exchange for sex with their partners. In a
clinic-based survey (n = 406), consensus model scales were more
sensitive to condom use than the etic definition. Model consonance had distinct
effects on social status for the three different models.
Transactional sex is
better measured as an emic spectrum of expectations within a relationship,
rather than an etic binary relationship type. Cultural consensus models allowed
us to blend qualitative and quantitative approaches to create an emicly valid
quantitative scale grounded in qualitative context.
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By: Fielding-Miller R1, Dunkle KL2, Cooper HL3, Windle M3, Hadley C3.
- 1University of California, San Diego, 9500 Gillman Drive #0507, San Diego, CA, 92093, United States. Electronic address: rfieldingmiller@ucsd.edu.
- 2South African Medical Research Council, 1 Soutpansberg Road, Pretoria, 0001, South Africa.
- 3Emory University, 201 Dowman Drive, Atlanta, GA, 30322, United States.
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