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Pathways to transactional sex among peri-urban South African women: the role of relationship control, food insecurity and alcohol misuse.
- Source :
-
AIDS care [AIDS Care] 2024 Jul; Vol. 36 (sup1), pp. 179-186. Date of Electronic Publication: 2024 Feb 09. - Publication Year :
- 2024
-
Abstract
- Transactional sex increases sub-Saharan African women's risk of HIV acquisition. We quantitatively explored the pathways contributing towards women's future engagement in transactional sex with casual partners and khwapheni (secret concurrent sex partners). We conducted secondary data analysis from a cluster randomised controlled trial in urban informal settlements in eThekwini Municipality., South Africa. Data were collected at enrolment (t0) and 24 months' later (t2) using self-completed questionnaires. Structural equation modelling (SEM) assessed pathways leading to transactional sex over two years. 677 women 18-35 years were enrolled and 80.5% ( n = 545) were followed up. At t2, 44.6% of respondents reported transactional sex with a casual partner or khwapheni. The SEM demonstrated a small effect (d = 0.23) between transactional sex at t0 and at t2. Controlling for past transactional sex, main partner relationship control had a large effect size on future transactional sex (d = 0.60). Hazardous drinking had a medium effect size (d = 0.45) and food insecurity a small effect (d = 0.24), (RMSEA 0.03, 90%CI 0.02-0.04; CFI 0.97; TLI 0.96). HIV prevention programming should highlight current transactional sex but also address structural issues predicting future transactional sex, including food insecurity and alcohol misuse. Gender transformative interventions to reduce controlling behaviours in main relationships are worth investigating.
- Subjects :
- Humans
Female
South Africa epidemiology
Adult
Young Adult
Adolescent
Urban Population statistics & numerical data
Sex Work statistics & numerical data
Sex Work psychology
Surveys and Questionnaires
Sexual Behavior psychology
Sexual Behavior statistics & numerical data
Alcoholism epidemiology
Food Insecurity
HIV Infections prevention & control
HIV Infections epidemiology
Sexual Partners psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1360-0451
- Volume :
- 36
- Issue :
- sup1
- Database :
- MEDLINE
- Journal :
- AIDS care
- Publication Type :
- Academic Journal
- Accession number :
- 38334776
- Full Text :
- https://doi.org/10.1080/09540121.2024.2307385