Transactional sex is associated with the HIV epidemic among
young people in Uganda. Few quantitative studies based on nationally
representative survey data explored the relationship between sexual behaviors,
HIV infection, and transactional sex.
This study aimed to determine the associations between risky
sexual behaviors, participation in transactional sex, and HIV sero-status among
men and women aged 15-24 in Uganda.
The study uses data from the Uganda AIDS Indicator Survey, a
cross-sectional national HIV serological study conducted in 2011. We analyzed
data on 1,516 men and 2,824 women aged 15-24 who had been sexually active in
the 12 months preceding the survey. Private, face-to-face interviews were also
conducted to record the sociodemographics, sexual history, and experiences of
sexual coercion. Logistic regression analysis was performed to measure
associations between sexual behaviors and transactional sex, and associations
between HIV sero-status and transactional sex.
- Among young people who had been sexually active in the 12 months prior to the survey, 5.2% of young men reported paying for sex while 3.7% of young women reported receiving gifts, favors, or money for sex.
- Lower educational attainment and experience of sexual coercion were significantly associated with paying for sex among men.
- Multiple concurrent sexual relationships were significantly associated with paying for sex among young men and receiving something for sex among young women.
- Paying for sex among young men and having three to five lifetime sexual partners among young women were associated with increased odds of testing positive for HIV.
Transactional sex is associated with sexual coercion and HIV
risk behaviors such as multiple concurrent sexual partnerships among young
people in Uganda. In addition, transactional sex appears to place young men at
increased risk for HIV in Uganda. Both sexes appear equally vulnerable to risks
associated with transactional sex, and therefore should be targeted in
intervention programs. In addition, strengthening universal education policy
and improving school retention programs may be beneficial in reducing risky
sexual behaviors and transactional sex.
Table 2
Sexual behaviors and HIV status of sexually active young people in Uganda 12 months prior to the survey
| Men 15–24 (N=1,516) | Women 15–24 (N=2,824) | |||
|---|---|---|---|---|
| Characteristics | Did not pay for sex (N=1,437) n (%) | Paid for sex (N=79) n (%) | Received no gifts, favors, or money for sex (N=2,719) n (%) | Received gifts, favors or money for sex (N=105) n (%) |
| Life time number of sexual partners | ||||
| ≤2 partners | 595 (41.4) | 8 (10.1) | 2,047 (75.3) | 52 (49.5) |
| 3–5 partners | 549 (38.2) | 19 (24.1) | 624 (22.9) | 40 (38.1) |
| >5 partners | 294 (20.4) | 52 (65.8) | 48 (1.8) | 13 (12.4) |
| Multiple and concurrent sexual partnerships in the past 12 months | ||||
| <2 partners | 1,143 (79.6) | 28 (35.9) | 2,605 (95.8) | 76 (72.4) |
| ≥2 partners but not concurrent | 110 (7.7) | 15 (19.2) | 35 (1.3) | 13 (12.4) |
| ≥2 partners and concurrent | 183 (12.7) | 35 (44.9) | 79 (2.9) | 16 (15.2) |
| Age at sexual debut | ||||
| ≥15 | 1,194 (83.1) | 51 (64.6) | 2,231 (82.1) | 68 (64.8) |
| <15 | 243 (16.9) | 28 (35.4) | 488 (17.9) | 37 (35.2) |
| Condom use at the last sexual activity with the recent partner | ||||
| Yes | 966 (67.2) | 51 (65.4) | 2,306 (84.8) | 82 (78.1) |
| No | 471 (32.8) | 27 (34.6) | 413 (15.2) | 23 (21.9) |
| Sexual coerciona | ||||
| No | 442 (89.7) | 20 (71.4) | 751 (77.6) | 21 (63.6) |
| Yes | 51 (10.3) | 8 (28.6) | 217 (22.4) | 12 (36.4) |
| HIV status | ||||
| Negative | 1,375 (98.0) | 66 (83.5) | 2,490 (94.0) | 92 (88.5) |
| Positive | 28 (2.0) | 12 (15.2) | 160 (6.0) | 12 (11.5) |
| Condom use at the last sexual activity with transactional partner | ||||
| Yes | – | 41 (68.0) | – | 53 (51.0) |
| No | – | 20 (32.0) | – | 52 (49.0) |
All percentages are weighted.
aData include respondents questioned about sexual coercion (n=522 men and n=1,010 women).
Full article at:
By:
- 1Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
- 2Multidisciplinary Unit for Adolescent Health, Lausanne University Hospital, Lausanne, Switzerland.
- 3Institute of Interdisciplinary Training and Research (IITR), Mbarara University of Science and Technology, Mbarara, Uganda.
- 4Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
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