Women who engage in transactional sex are not only at increased risk of HIV and intimate partner violence, but also face social risks including gossip and ostracism. These social and physical risks may be dependent on both what a woman expects and needs from her partner and how her community perceives the relationship. Gender theory suggests that some of these social risks may hinge on whether or not a woman's relationship threatens dominant masculinity. We conducted a qualitative study in Swaziland from September 2013 to October 2014 to explore transactional sex and respectable femininity through the lens of hegemonic gender theory. Using cultural consensus modeling, we identified cultural models of transactional sex and conducted 16 in-depth interviews with model key informants and 3 focus group discussions, for a total of 41 participants. We identified 4 main models of transactional relationships: One typified by marriage and high social respectability, a second in which women aspire towards marriage, a third particular to University students, and a fourth "sugar daddy" model. Women in all models expected and received significant financial support from their male partners. However, women in less respectable relationships risked social censure and stigma if they were discovered, in part because aspects of their relationship threatened hegemonic masculinity. Conversely, women who received male support in respectable relationships had to carefully select HIV risk reduction strategies that did not threaten their relationship and associated social status. Research and programming efforts typically focus only on the less socially respectable forms of transactional sex. This risks reinforcing stigma for women in relationships that are already considered socially unacceptable while ignoring the unique HIV risks faced by women in more respectable relationships.
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http://dx.doi.org/10.1016/j.socscimed.2016.04.005 | DOI Listing |
AIDS
January 2025
Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya.
Background: Transactional sexual relations in the absence of condom use is a well-established behaviour that strongly contributes to HIV transmission if the infected person is not virally suppressed. In this study, we determined the trends and factors associated with VLNS among treatment-experienced FSWs in Kenya.
Methods: This retrospective cohort study used data collected from 7-sex workers outreach clinics between 2015 and 2022.
AIDS Behav
December 2024
Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, USA.
This brief report presents findings on informal, non-prescribed PrEP use among an online sample of gay, bisexual and other men who have sex with men (n = 196). Mean age was 33.4.
View Article and Find Full Text PDFReprod Health
December 2024
Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Plot 51-59, Nakiwogo Road, Entebbe, Uganda.
Background: HIV prevention trials usually require that women of childbearing potential use an effective method of contraception. This is because the effect of most investigational products on unborn babies is unknown. We assessed contraceptive use, prevalence and incidence of pregnancy and associated factors among women in a HIV vaccine preparedness study in Masaka, Uganda.
View Article and Find Full Text PDFTher Adv Infect Dis
December 2024
Section of Infectious Diseases & Global Health, University of Chicago Medicine, 5841 S. Maryland Avenue, MC5065, Chicago, IL 60637, USA.
Introduction: Despite escalating rates of sexually transmitted infections (STIs) in the United States (US), there has been progressive divestment of sexual health services leading to the reliance on emergency departments (EDs) for sexual healthcare, particularly among vulnerable populations. The Sexual Wellness Clinic (SWC), a novel care delivery model operating in collaboration with the ED, offers comprehensive sexual health services.
Objectives: This study aims to analyze the demographics, STI positivity, and HIV Pre-Exposure Prophylaxis (PrEP) uptake among patients accessing the SWC.
Curr Opin Infect Dis
February 2025
Factor-Inwentash Faculty of Social Work, University of Toronto.
Purpose Of Review: Discuss the recent evidence on climate change and related extreme weather events (EWE) and linkages with HIV prevention and care outcomes.
Recent Findings: We identified 22 studies exploring HIV prevention and care in the context of EWE. HIV prevention studies examined sexual practices that increase HIV exposure (e.
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