Ranganathan, M., MacPhail, C., Pettifor, A., et al. BMC Public Health (2017), 17:666, doi: 10.1186/12889-017-4636-6.
This qualitative study examined how young women enrolled in the Conditional Cash Transfer Trial perceived their role in relationships, and their understanding of HIV risks associated with transactional sex. Following five focus group discussions and 19 individual interviews with young women aged 13–31 years, four themes emerged.
- Hopes for education and financial independence: Most participants desired financial independence, which required performing well academically to find a good job. Participants believed that financial independence reduced the need for transactional sex.
- Character of sexual relationships: Reasons for initiating a relationship included love, and financial and material support. Two-thirds of focus group discussion participants reported the latter reason, and most reported receiving gifts from their partner.
- Thoughts about sexual transactions: Participants described relationships as purely transactional. They reported seeing love as more important than material transactions; they wanted financial independence but were materially dependent upon the boyfriend.
- Control over sexual encounters and HIV risk perceptions: Participants said they had control over choosing and ending relationships; however, once in a relationship, they reported challenges negotiating condom use.
The authors concluded that educational programs for HIV prevention should include income generation components to boost young women's opportunities for financial independence and increase their negotiating power in their romantic relationships.