From Survival to Glamour: Motivations for Engaging in Transactional Sex and Relationships Among Adolescent Girls and Young Women in South Africa

The association of transactional sex and HIV risk in adolescent girls and young women (AGYW) in sub–Saharan Africa has been clearly demonstrated, with evidence showing increased susceptibility to HIV infection among AGYW who engage in transactional sex [1‐3]. AGYW who engage in transactional sex are more likely to experience poor sexual and reproductive health outcomes, including unintended pregnancies, unsafe abortions, sexually transmitted infections (including HIV), and sexual coercion [4]. Among the reasons that transactional sex is associated with greater risk of contracting HIV are compromised gendered power relations and the likelihood of having multiple partners [5].

Transactional sex is usually defined as a specific set of behaviours, labels and identities, distinct from commercial sex work, and characterised by the exchange of financial or material support, which occurs outside of the context of marriages, or ‘formal’ sex work [3, 6]. The key feature used to distinguish transactional sex and transactional relationships (TSR) from other non–marital romantic/ sexual relationships, is that they are not only characterised by material exchange, but motivated by it [7]. An additional feature is that TSR are differentiated from, and judged by those who participate in the exchange to be more morally acceptable than formal sex work, primarily based on the fact that the exchange occurs within the context of a relationship (no matter how temporary or ambiguous its nature) [1, 8]. However the distinction between transactional sex, sex work, and romantic/sexual relationships is challenging, as the boundaries are very blurred [9].

Evidence suggests a positive association between age–disparate, or age-asymmetrical, partnerships and HIV–infection risk among young women in South Africa [10, 11]. Although AGYW may exercise some agency in choosing to engage in age-disparate partnerships that are transactional in nature, unequal gendered power dynamics are heightened with age-disparity, exacerbating AGYW HIV risk by negatively impacting their ability to negotiate condom use [12, 13].

Motivations for engaging in TSR are situated within complex sexual economies, and go beyond basic survival or subsistence needs in circumstances of poverty [8, 14]. Qualitative research has described entrenched social norms dictating that material or financial goods received from a partner must be reciprocated with sex, framing the narrative around transactional sex to include both survival and acquisition of basic needs, as well as for gain in social status [15, 16]. The very expectation of reciprocity, and the act of receiving material benefits, enhances the vulnerability of the receiver, thereby limiting their agency [16]. Motivations for TSR include seeking peer approval and a sense of belonging, the desire for a ‘modern’ lifestyle as dictated by society, the media, and to attain financial independence, prestige and social standing [3, 8]. While it is evident that in certain cases, TSR is driven by structural factors, including poverty, gender inequality, and lack of education, it is also driven by a number of psychosocial factors, including societal/familial/peer pressure, aspirations for social mobility, and material consumer goods, as well as romantic notions of love and security [1].

Given the slipperiness of definitions and identities relating to transactional sex, transactional relationships, sex work and romantic/sexual relationships, it is important to understand how young South Africans define and conceptualise sexual transactions and relationship dynamics that are informed by gendered power and sexual norms [9]. Most of the studies exploring attitudes related to TSR in South Africa have not included male perspectives, and there has been a call for research which examines men and boys’ perspectives and opinions on transactional sexual encounters [14]. Additionally, many of the studies that have examined TSR in South Africa have focused on one geographic area. Our study includes data from a range of urban, semi–urban, and rural sites across six provinces of South Africa. Combining quantitative data on AGYW reporting of having engaged in TSR, alongside qualitive narratives and perspectives on TSR from AGYW and their male peers, we are able to deepen understanding of these complex risk behaviours, and the factors that influence AGYW decision making around TSR, helping to inform interventions that seek to address sexual and reproductive health challenges among AGYW in South Africa.

The data presented in this paper comprise quantitative and qualitative data from a larger evaluation study of a combination HIV prevention intervention for AGYW in South Africa (https://​www.​samrc.​ac.​za/​intramural–research–units/​HealthSystems–HERStory), which was funded by the Global Fund. The examination of TSR was not initially a key focus of the larger study, but emerged as important in understanding the broader context of HIV risk behaviours. For the purposes of this study we use the term Adolescent Girls and Young Women (AGYW) to refer to females between the ages of 15 and 24 years. In line with the World Health Organization’s definitions of “early adolescence” (10–14), “late adolescence” (15–19) and “post-adolescence” (20–24) (www.​who.​int/​health-topics/​adolescent-health), The Global Fund policy literature refers to AGYW aged 15–24 comprising of “adolescent girls” (ages 15–19), and “young women” (ages 20–24) (www.​theglobalfund.​org).

Analysis uncovered complex motivations for engaging in transactional sex and transactional relationships, ranging from economic deprivation, hunger and poverty, to desires for social approval, prestige, glamour, and luxury. Narratives revealed prevalent socio-cultural norms informing the way in which TSR are perceived in these communities, including the normalisation of TSR amongst AGYW, and the practices of using sex as a currency for exchange. With survey data revealing that money was the commodity most commonly exchanged for sex, and the most frequently endorsed response option for reason for starting or staying in relationships, the boundaries between ‘commercial sex work’ and ‘transactional sex/relationships’ were shown to be unclear, subjective and context dependent.

In the qualitative data, poverty and food insecurity were listed as key drivers for AGYW engaging in TSR. Those AGYW from poor families, who have to provide support to siblings and family members, and with few opportunities for income generation, regarded TSR as a valid means of attaining material and/or financial support. Respondents suggested that the need to pay for basic costs related to food, education, and clothing led more economically vulnerable AGYW to engage in TSR. Survey reporting of TSR was higher among AGYW who reported experiencing higher food insecurity compared with those who did not.

However, AGYW motivations to engage in TSR cannot be reduced to poverty related factors. In our study, both AGYW and male respondents described the way in which TSR are closely associated with materialism, and a desire for glamour and luxury, among AGYW in South Africa today. It is possible that for AGYW who come from poor families and resource constrained settings, the desire for visible material wealth, and the prioritisation of ‘bling’ and material prestige, influence AGYW’s relationship choices and act as contributory factors in the decision to engage in TSR. The desire that our respondents expressed to wear labelled clothing and eat at restaurants, is framed within a broader social prioritisation of visible material wealth and social approval. Finding a male partner who is able to provide status–inferred expensive commodities may be part of AGYW’s desire for what has been termed 'symbol capital', in this case symbols of a modern and successful life [11, 21].

In the survey, clothes and cosmetics/make–up were among the most commonly listed items that AGYW reported entering into a transactional relationship for, after money and airtime. We divided our qualitative findings into items that AGYW “want” versus those that they “need” for basic survival. For example, where our respondents spoke of poor households and families, and the need to buy food and pay education costs, we categorised this as “need”. Where AGYW spoke of the desire for glamour, hairstyles, branded clothing and restaurant meals, we categorised this as “want”. Prior research has all used framing of items for ‘survival’ (need) versus ‘consumption’ (want) [22]. These categorisations have also been problematised for the reason that researchers, not AGYW themselves, have constructed these hierarchical/binary classifications,constructs of luxury and necessity are subjective and context dependent [22]. In addition, while these categories might be useful to frame ‘wants’ as those items non–essential for survival, it may be true that they are “needed” as key ingredients which confer peer approval, social status. For example, fashionable, branded clothing may be deemed ‘essential’ for preventing social exclusion, which for adolescents and young people, who tend to be highly sensitive to how their physical appearance is perceived by peers, and therefore essential for mental health and self–esteem [22, 23]. Additionally, clothing and outward appearances are mechanisms through which young people express their identities, and their ability to portray themselves in a ‘socially–acceptable’ manner may be intricately tied up with self–esteem, which itself is linked with vulnerability to sexual risk [22]. Lastly, when researchers engage in the hierarchical categorisation of items for which AGYW exchange sex, there is a danger of misclassifying items that AGYW consider important needs as frivolous luxuries [22]. A consequence of this misinterpretation could be that interventions are inappropriately designed according to a misconstrual of the true underlying motivations of AGYW sexual risk behaviour [22].

Some AGYW respondents commented that transactional relationships with blessers can be exciting and engender a feeling of adult maturity and independence. The sense of self–worth and power that AGYW gain from exploiting their sexuality in exchange to gain material assets may explain why many AGYW engage in TSR even when their basic material needs are provided for by family members [24]. Attaining financial independence has been identified as an important driver of young women entering into transactional relationships [3]. Given that so few of the AGYW respondents who were out of school were employed, it is possible that transactional relationships were considered a valid source of income. Research has suggested that in settings with high unemployment where there is a lack of alternative sources of income, examples set for AGYW by older sister or friends, demonstrate that one means of acquiring material goods, and paying for “non–necessary” items that family spending budgets do not allow, is through transactional relationships [3, 14].

As our respondents described, peer pressure to conform to these standards was a motivating factor in AGYW engaging in TSR. Using transactional sex as a means of acquiring the material possessions needed to belong and attain peer respect and approval has been found in previous research among young people [3, 7]. In a social and economic context where AGYW’s feelings of self–worth and self–esteem are closely associated with their appearance and material possessions, having a means of attaining these items is a pathway for developing their own identity within their peer networks [14].

Links between TSR and alcohol use emerged in our findings. In the survey, reporting of TSR was higher among AGYW who had high alcohol use and alcohol use was strongly associated with transactional sex in the regression analysis. In the qualitative data, male respondents described their perceptions that it is a common practice for AGYW to have sex with men who purchase alcoholic drinks for them. Male respondents in our study suggested that AGYW should be more sensible, and take care of themselves, as men’s behaviour of buying alcohol in expectation of receiving sex in exchange, is unlikely to change. Findings from previous ethnographic research conducted in Cape Town corroborate our respondents’ assertions around the commonality of alcohol being exchanged for sex, suggesting young women who frequent shebeens (township bars) do so with the expressed intention of finding men to pay for their drinks and that sexual encounters usually follow [25‐27]. Links between transactional sex and alcohol consumption have previously been described, suggesting that accepted social norms determine that if a woman accepts drinks bought by a man, she should expect to have sex with him in exchange [26‐28]. Men use alcohol as a currency with which to trade for sex with women,in these transactions the paying man holds the power in negotiating the conditions of sex, including condom use [26]. Evidence also suggests higher HIV risk among AGYW who frequent shebeens [25].

Evident in the narratives of male respondents in our study was the recognition of the perceived normalcy of TSR, and the notion of men as material/financial providers, in exchange for sex. Some of our male respondents explained their preference for relationships that are transactional in nature as it puts them in a position of power and indispensability as the provider. Transactions related to sex have been described as an embedded expectation in heterosexual romantic relationships in South Africa [12, 29]. Our findings support the notion that men’s role as providers is linked to masculine identities, and young men’s sense of self–esteem [2]. Socioculturally scripted gender roles in sub–Saharan Africa frame men as providers and women as receivers, who expect to be materially supported by male partners [4, 23]. The notion of women as financially dependent on male partners appears to be socially normative in sub–Saharan Africa, and one of the key structural drivers of gendered socio–economic power disparities in the region [6]. The belief held by South African men that sex does not come for free but must be exchanged for something demonstrates the commodification of female sexuality [24]. These social norms framing gendered power discourse serve to reproduce certain unequal gendered power structures and gender role expectations [23, 30]. Material/financial provision by males can be viewed as the mechanism through which they attract and control female partners, and hold the reins in sexual decision making [30].

Survey data revealed an association between HIV positive status and reporting of transactional sex among AGYW in our sample, with HIV positive AGYW more likely to report transactional sex experiences than HIV negative AGYW. In the qualitative data, AGYW respondents described the way in which the exchange of material/financial compensation for sex informs the power dynamics in transactional relationships. AGYW suggested that because of power disparities between partners, transactional sex is more likely to be condomless, and thus lead to HIV infection and unintended pregnancies. While AGYW may feel a sense of power and actively seek multiple partners to meet their needs or desires for material support, at the same time, the unequal power dynamics inherent in these economically asymmetric relationships enhances their risk [31]. Men, as the financial providers, are entitled to dictate sexual interactions [23]. Evidence corroborates the findings that gendered socio–economic power disparities are a key driver for AGYW’s vulnerability to HIV infection, and that participation in transactional sex is associated with condomless sex and HIV seropositivity among AGYW in South Africa [2, 31].

With regards to the links between TSR and HIV risk, comments made by AGYW in our study suggest that those AGYW who engage in TSR are likely to have multiple partners, depending on the current financial status and availability of partners. This finding concurs with the conceptualisation of multiple sexual partners as being on the pathway between TSR and HIV [12]. Additionally, young men in our study shared perceptions that AGYW who engage in transactional relationships with older men are ‘damaged goods’, likely to have had sex with multiple partners. Links can be made between this narrative and evidence suggesting a positive association between age–disparate partnerships and HIV–infection risk among young women [10, 12]. AGYW with older male partners have been found to be more likely to practice other behaviours that exacerbate their HIV risk, including having a greater number of partners, engaging in transactional sex, and having condomless sex [36]. Due to the heightened power imbalances in age-disparate partnerships, AGYW are less likely to be successful in negotiating condom use with older partners [12, 13]. An important distinction to make however is that whilst TSR are often characterized by age-disparate partnerships, age-disparate partnerships are not always transactional in nature [16].

In addition these is an association between TSR and multiple concurrent sexual partnerships, exacerbating HIV risks. As our respondents suggested, AGYW may have concurrent relationships with ‘blessers’ (financial providers), at the same time as romantic relationships with boyfriends of their own age. It has been demonstrated that AGYW who report staying in relationships for economic reasons, or engaging in transactional sex with non–regular partners, are more likely to have multiple concurrent sex partners [31]. Maintaining multiple concurrent relationships enables AGYW to fulfil their different needs and desires, providing romantic/emotional connection, at the same time as receiving material support [4, 31].

Researchers have problematised the assumption that TSR is necessarily based on poverty, with young African women as the victims of male sexual and financial power [32]. It is evident that some AGYW are active social agents in these relationships, realising the economic potential of their sexuality and cognisant of the personal gains to be made, they exploit men’s lust to uplift themselves and attain their material aspirations [8, 21, 23]. That young women exercise their autonomy in actively and strategically engaging in such relationships challenges the idea that young women are passive, hapless victims of predatory older men [24, 32]. Indeed it has been suggested women are aware of their own agency and power in these transactions, and use explicit strategies to exploit and extract resources from male partners, as well as having control over the initiation, maintenance and termination of relationships [26, 33]. However, there is a need to recognise the reality of the South African context and gender inequity in which AGYW have reduced access to economic resources [32]. This gendered economic inequity places South African men in an economically privileged position, framing notions of masculinity as being linked to control over economic resources, referred to as ‘provider masculinity’ [32]. Within broader macro socio–economic contexts where there are high levels of unemployment, and AGYW have limited access to income generating activities, sexual attractiveness and desirability become valuable resources [34].

Previous literature has outlined three paradigms with which to organise and explain motivations for transactional sex: (1) sex for basic needs; (2) sex for upward mobility and status, and (3) sex for material expressions of love [3]. Findings from the analysis of qualitative data in our study primarily related to the first two. In recognising the complexity of motivations for engaging in TSR, and the heterogeneity of such interactions it is important to allow that motivations are not mutually exclusive and often AGYW are driven by a combination of subsistence needs and consumerist desires [14, 23]. The decisions that AGYW make about entering into such relationships may be based on various reasons that differ in relation to specific contexts [23]. It is therefore critical to take into consideration both the vulnerability and agency of AGYW in the specific context that shapes their choices [23].

Several limitations of our study should be stated. (1) Data presented comprise a subset from a larger data set from a study (secondary data analysis) in which the examination of TSR was not a key focus of inquiry; although both quantitative and qualitative data on TSR were collected, limited detail was available. (2) Although the overall sample realisation rate for the survey was comparative with sample realization rates of the 2016 South African Demographic and Health Survey (SADHS), and the South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2017 (HSRC, 2019), it was relatively low. (3) Given the cross-sectional design of the survey, it is not possible to determine whether HIV was an antecedent to or consequence of TSR, and the same applies to higher food insecurity and alcohol use. (4) The survey did not directly ask about sex in exchange for alcohol or substances, and the data lacks event-level detail on how individual episodes of drinking are associated with sex and sexual risk in TSR. (5) Both quantitative and qualitative study components relied on participants’ self–reports. Since TSR may be considered undesirable or socially stigmatised behaviours, it is possible that there was under–reporting, as AGYW who engage in transactional sex seldom disclose that they have exchanged sex for money [25]. (6) We employed the terms “transactional sex” and “transactional relationships” in this study, however we did not investigate participants’ own understandings and conceptualisations of the definitions and terminology related to transactional sex or sex work. (7) Our data on perceptions of HIV risk amongst AGYW engaging in TSR is limited,as TSR was not an initial focus of the inquiry, there was limited in-depth probing around the topic at the time of data collection. (8) Limitations in the qualitative sampling relate to this study being part of a larger intervention evaluation study, and thus the selection of respondents was not determined by reporting of TSR; this is likely to have impacted on the views represented. Additionally, older men who engage in TSR with AGYW were not included in the sample; this population are hard to engage in research, and may be unlikely to speak openly about TSR, but their perspectives would add great value to understanding the dynamics of TSR. (9) Lastly, a weakness in this study which should be noted relates to the limited measurement of household food insecurity; the complexity of which is has been previously described [35].