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Open Access Highly Accessed Research article

Transactional relationships and sex with a woman in prostitution: prevalence and patterns in a representative sample of South African men

Rachel Jewkes16*, Robert Morrell2, Yandisa Sikweyiya3, Kristin Dunkle4 and Loveday Penn-Kekana5

Author affiliations

1 Gender & Health Research Unit, Medical Research Council, Pretoria and School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

2 Research Office, University of Cape Town, Cape Town, South Africa

3 Gender & Health Research Unit, Medical Research Council, Pretoria, South Africa

4 Rollins School of Public Health, Emory University, Atlanta, USA

5 Centre for Health Policy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

6 Gender & Health Research Unit, Medical Research Council, Private Bag X385, Pretoria, 0001, South Africa

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Citation and License

BMC Public Health 2012, 12:325  doi:10.1186/1471-2458-12-325

Published: 2 May 2012

Abstract

Background

Sex motivated by economic exchange is a public health concern as a driver of the Sub-Saharan African HIV epidemic. We describe patterns of engagement in transactional sexual relationships and sex with women in prostitution of South African men, and suggest interpretations that advance our understanding of the phenomenon.

Methods

Cross-sectional study with a randomly-selected sample of 1645 sexually active men aged 18–49 years who completed interviews in a household study and were asked whether they had had sex with a woman in prostitution, or had had a relationship or sex they took to be motivated by the expectation of material gain (transactional sex).

Results

18% of men had ever had sex with a woman in prostitution, 66% at least one type of transactional sexual relationship, only 30% of men had done neither. Most men had had a transactional relationship/sex with a main partner (58% of all men), 42% with a concurrent partner (or makhwapheni) and 44% with a once off partner, and there was almost no difference in reports of what was provided to women of different partner types. The majority of men distinguished the two types of sexual relationships and even among men who had once-off transactional sex and gave cash (n = 314), few (34%) reported that they had had sex with a ‘prostitute’. Transactional sex was more common among men aged 25–34 years, less educated men and low income earners rather than those with none or higher income. Having had sex with a woman in prostitution varied little between social and demographic categories, but was less common among the unwaged or very low earners.

Conclusions

The notion of ‘transactional sex’ developed through research with women does not translate easily to men. Many perceive expectations that they fulfil a provider role, with quid pro quo entitlement to sex. Men distinguished these circumstances of sex from having sex with a woman in prostitution. Whilst there may be similarities, when viewed relationally, these are quite distinct practices. Conflating them is sociologically inappropriate. Efforts to work with men to reduce transactional sex should focus on addressing sexual entitlement and promoting gender inequity.

Keywords:
Transactional sex; Prostitution; Commodified sex; South African men; Epidemiology; Sexual entitlement