Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa.
Division of Social and Behavioural Sciences in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
AIDS Behav. 2021 Oct;25(10):3238-3254. doi: 10.1007/s10461-021-03291-z. Epub 2021 May 5.
We explored transactional sex and relationships (TSR) among South African adolescent girls and young women (AGYW) using (1) survey data from 4,399 AGYW aged 15-24 years, and (2) qualitative data from 237 AGYW and 38 male peers. Ten percent of sexually active AGYW reported having ever had transactional sex; 14% reported having stayed in a relationship for money or material items. Factors associated with higher reporting of TSR included HIV positivity, higher food insecurity, and alcohol use. Those AGYW who were between the ages of 20-24 years (OR: 1.0; 95% CI: 0.81-1.24), had a sexual partner older than her by 5 years or more (OR: 1.89; 95% CI: 1.58-2.26), and had a transactional relationship in the past (OR: 61.1; 95% CI: 47.37-78.76) were more likely to report having transactional sex. AGYW qualitative narratives included both assertions of agency in choosing to engage in TSR, and power inequities resulting in condomless sex. Our findings can inform interventions to addressing transactional sex and relationships, critical to South Africa's HIV response.
我们使用（1）来自 4399 名年龄在 15-24 岁的 AGYW 的调查数据，以及（2）来自 237 名 AGYW 和 38 名男性同伴的定性数据，探讨了南非青少年女孩和年轻妇女（AGYW）的性交易和关系（TSR）。10%的有性行为的 AGYW 报告曾经有过性交易；14%的人报告为了金钱或物质物品而维持一段关系。与 TSR 报告率较高相关的因素包括 HIV 阳性、更高的粮食不安全和酒精使用。那些年龄在 20-24 岁之间的 AGYW（OR：1.0；95%CI：0.81-1.24）、性伴侣比她大 5 岁或以上的（OR：1.89；95%CI：1.58-2.26）、过去有过性交易关系的（OR：61.1；95%CI：47.37-78.76）更有可能报告有性交易。AGYW 的定性叙述包括在选择参与 TSR 时的自主权主张，以及导致无保护性行为的权力不平等。我们的研究结果可以为解决性交易和关系的干预措施提供信息，这对南非的艾滋病毒应对至关重要。
