Konlan Patience, Ganle John Kumuuori
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, P. O. Box LG 13, Ghana.
BMC Womens Health. 2025 Jul 3;25(1):298. doi: 10.1186/s12905-025-03845-6.
Transactional sex has gained public health attention in recent times because of its contributions to sexually transmitted infections and unwanted pregnancy among young women in sub-Saharan Africa. However, empirical data on the extent of this practice are lacking in Ghana. This study provides baseline information on the prevalence of transactional sex practice and associated factors among young women in a tertiary institution in Northern Ghana.
A quantitative cross-sectional survey was conducted among 340 sexually active young female students. Stratified and simple random sampling techniques were used to sample respondents. Data were collected online using a pretested questionnaire. The prevalence of transactional sex and other socio-demographic characteristics were analysed descriptively using frequencies and percentages. A logistic regression model was used to determine predictors of transactional sex and assess the links between transaction sex and other risky sexual behaviours.
Respondents were aged 18–31 years, and mean age was 24.94 (SD = ± 4.87). The prevalence of ever engaging in transactional sex was 23.8%, and 16.8% reported engaging in transactional sex in the past 12 months prior to the study. Nearly 65% of those who reported engaging in transactional sex in the last 12 months have done so at least four times. The odds of engaging in transactional sex were lower among older respondents (AOR: 0.140, 95%, CI: 0.032–0.605, = 0.008); but higher for early sexual debut (AOR: 2.745, 95%, CI: 1.068–7.060, = 0.036), area of residence (i.e. being peri-urban) (AOR: 8.300, 95%, CI: 1.655–41.617, = 0.010), insufficient family support (AOR: 5.903, 95%, CI: 1.515–23.006, = 0.011), and frequently using at least two social media applications (AOR: 3.893, 95%, CI: 1.276–11.877, = 0.017). Respondents who engaged in transactional sex reported higher odds of contracting STIs (AOR: 3.580, CI:1.059–12.099, p 0.040), and having an abortion (AOR: 2.616, CI: 1.037–6.598, p 0.042) in the last 12 months.
Targeted comprehensive sexual and reproductive health and rights education interventions are needed on the campuses of institutions of higher learning to enable young women negotiate safe sex and sexual relationships. In addition, there is need to promote contraceptive use (especially those that offer dual protection) among young women on the campuses of tertiary institutions to minimise STIs infection and unwanted pregnancy. Economic empowerment programmes such cash transfers to identifiable impoverished female students, scholarships and grant opportunities and discounted fees would also be critical to preventing and/ or minimising the occurrence of transactional sex among young women.
The online version contains supplementary material available at 10.1186/s12905-025-03845-6.
近年来，性交易因其在撒哈拉以南非洲地区年轻女性中导致性传播感染和意外怀孕问题而受到公共卫生领域的关注。然而，加纳缺乏关于这种行为程度的实证数据。本研究提供了加纳北部一所高等院校年轻女性中性交易行为的患病率及相关因素的基线信息。
对340名有性行为的年轻女学生进行了定量横断面调查。采用分层和简单随机抽样技术选取受访者。通过一份经过预测试的问卷在线收集数据。使用频率和百分比对性交易的患病率及其他社会人口学特征进行描述性分析。采用逻辑回归模型确定性交易的预测因素，并评估性交易与其他危险性行为之间的关联。
受访者年龄在18至31岁之间，平均年龄为24.94岁（标准差=±4.87）。曾经有过性交易行为的患病率为23.8%，16.8%的受访者报告在研究前的过去12个月内有过性交易行为。在过去12个月内报告有过性交易行为的人中，近65%至少进行过4次。年龄较大的受访者进行性交易的几率较低（调整后比值比：0.140，95%置信区间：0.032 - 0.605，P = 0.008）；但初次性行为较早（调整后比值比：2.745，95%置信区间：1.068 - 7.060，P = 0.036）、居住地区（即城郊）（调整后比值比：8.300，95%置信区间：1.655 - 41.617，P = 0.010）、家庭支持不足（调整后比值比：5.903，95%置信区间：1.515 - 23.006，P = 0.011）以及经常使用至少两种社交媒体应用程序（调整后比值比：3.893，95%置信区间：1.276 - 11.877，P = 0.017）的受访者进行性交易的几率较高。报告有过性交易行为的受访者在过去12个月内感染性传播感染的几率较高（调整后比值比：3.580，置信区间：1.059 - 12.099，P = 0.040），以及堕胎的几率较高（调整后比值比：2.616，置信区间：1.037 - 6.598，P = 0.042）。
高等院校校园需要有针对性地开展全面的性健康和生殖健康及权利教育干预措施，以使年轻女性能够协商安全性行为和性关系。此外，有必要在高等院校校园中推广年轻女性使用避孕药具（尤其是提供双重保护的避孕药具），以减少性传播感染和意外怀孕。经济赋权计划，如向可识别的贫困女学生提供现金转移、奖学金和助学金机会以及减免费用，对于预防和/或减少年轻女性中的性交易行为也至关重要。
在线版本包含可在10.1186/s12905 - 025 - 03845 - 6获取的补充材料。
