School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Genesis Analytics, Johannesburg, South Africa.
AIDS Behav. 2020 Sep;24(9):2616-2623. doi: 10.1007/s10461-020-02818-0.
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.
很少有研究探讨过男性性行为交易与 HIV 之间的关系，更少有研究探讨过提供金钱或物品换取性的预测因素。本研究旨在描述南非一个城市非正式地区成年男性性行为交易的预测因素和模式。我们使用了一项研究的基线、横断面数据，该研究涉及 2406 名年龄在 18-40 岁之间的城市非正式地区男性。过去一年的性行为交易是通过从以前使用过的问题改编的问题来评估的。控制行为是通过改编的性关系权力量表来衡量的。多变量逻辑回归用于确定性行为交易与其他潜在解释变量之间的关联。近一半（47%）有过性行为的受访者报告说，在过去一年中，他们至少与一个偶然伴侣进行过一次性交易。三分之一的男性为性伴侣的家庭提供支持或金钱，30%的男性提供现金，28%的男性提供住宿。在控制其他因素的情况下，控制行为水平较高的男性进行性行为交易的可能性几乎是前者的两倍。报告有三个或更多性伴侣的男性进行性行为交易的可能性显著更高。危险饮酒者进行性行为交易的可能性高 33%。男性提供金钱或物品换取与女性的性行为与其他高风险行为有关，如多个性伴侣、危险饮酒和控制行为。为了解决与性行为交易相关的 HIV 风险，规划应解决有害的男性气质，包括关系控制。
