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Men (and Women) as “Sellers” of Sex in Alcohol-Serving Venues in Cape Town, South Africa

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Abstract

The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine associations between transactional sex and HIV risk among women and men in alcohol-serving venues in Cape Town, South Africa. We surveyed 1,989 women and 2,468 men attending alcohol-serving venues in Cape Town, South Africa to assess transactional sex behavior (i.e., receiving money or goods in exchange for sex), alcohol and drug use, history of childhood abuse, current relationship violence, and sexual risk behaviors. Among both women and men, trading sex was related to higher alcohol use, greater likelihood of drug use, substance use in sexual contexts, and a greater likelihood of experiencing physical and sexual violence. Compared to other women, women who traded sex reported a greater proportion of condom-unprotected sex; this relationship was not found for men. Analyses showed that men were almost twice as more likely to report trading sex for items, including money or alcohol, than women (9.7 vs. 5.8 %). Overall, men who traded sex were similar to their female counterparts. Similar associations between trading sex and different risk behaviors were found among women and men with limited economic means and substance use problems. Future research should more closely study transactional sex in high-risk venues as it relates to violence and should examine men who trade sex as a potential bridge population between heterosexual women and men who have sex with men.

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References

  • Blankenship, K. M., & Koester, S. (2002). Criminal law, policing policy, and HIV risk in female street sex workers and injection drug users. The Journal of Law, Medicine & Ethics, 30, 548–559.

    Article  Google Scholar 

  • Bobashev, G. V., Zule, W. A., Osilla, K. C., Kline, T. L., & Wechsberg, W. M. (2009). Transactional sex among men and women in the south at high risk for HIV and other STIs. Journal of Urban Health, 86, 32–47. doi:10.1007/s11524-009-9368-1.

    Article  PubMed Central  PubMed  Google Scholar 

  • Braitstein, P., Asselin, J. J., Schilder, A., et al. (2006). Sexual violence among two populations of men at high risk of HIV infection. AIDS Care, 18, 681–689. doi:10.1080/13548500500294385.

    Article  PubMed  Google Scholar 

  • Carlson, C. E., Chen, J., Chang, M., et al. (2012). Reducing intimate and paying partner violence against women who exchange sex in Mongolia: Results from a randomized clinical trial. Journal of Interpersonal Violence, 27, 1911–1931. doi:10.1177/0886260511431439.

    Article  PubMed Central  PubMed  Google Scholar 

  • Catania, J. A., Gibson, D. R., Chitwood, D. D., & Coates, T. J. (1990). Methodological problems in AIDS behavioral research: Influences on measurement error and participation bias in studies of sexual behavior. Psychological Bulletin, 108, 339–362.

    Google Scholar 

  • Dunkle, K. L., Jewkes, R. K., Brown, H. C., Gray, G. E., McIntryre, J. A., & Harlow, S. D. (2004a). Transactional sex among women in Soweto, South Africa: Prevalence, risk factors and association with HIV infection. Social Science and Medicine, 59, 1581–1592. doi:10.1016/j.socscimed.2004.02.003.

    Article  PubMed  Google Scholar 

  • Dunkle, K. L., Jewkes, R. K., Brown, H. C., Gray, G. E., McIntryre, J. A., & Harlow, S. D. (2004b). Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. The Lancet, 363, 1415–1421. doi:10.1016/S0140-6736(04)16098-4.

    Article  Google Scholar 

  • Ewing, J. A. (1984). Detecting alcoholism: The CAGE questionnaire. Journal of the American Medical Association, 252, 1905–1907.

    Article  CAS  PubMed  Google Scholar 

  • Goldman, M. S., & Darkes, J. (2004). Alcohol expectancy multiaxial assessment: A memory network-based approach. Psychological Assessment, 16, 4–15. doi:10.1037/1040-3590.16.1.4.

    Article  PubMed  Google Scholar 

  • Hedden, S. L., Hulbert, A., Cavanaugh, C. E., Parry, C. D., Moleko, A. G., & Latimer, W. W. (2011). Alcohol, drug and sexual risk behavior correlates of recent transactional sex among female black South African drug users. Journal of Substance Use, 16, 57–67. doi:10.3109/14659891003721141.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jewkes, R. K., Dunkle, K., Nduna, M., & Shai, N. (2010). Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: A cohort study. The Lancet, 376, 41–48. doi:10.1016/S0140-6736(10)60548-X.

    Article  Google Scholar 

  • Kalichman, S. C., Williams, E. A., Cherry, C., Belcher, L., & Nachimson, D. (1998). Sexual coercion, domestic violence, and negotiating condom use among low-income African American women. Journal of Women's Health, 7, 371–378.

    Article  CAS  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Kaufman, M., Cain, D., & Jooste, S. (2007). Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prevention Science, 8, 141–151. doi:10.1007/s11121-006-0061-2.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Vermaak, R., Jooste, S., & Cain, D. (2008). HIV/AIDS risks among men and women who drink at informal alcohol serving establishments (shebeens) in Cape Town, South Africa. Prevention Science, 9, 55–62. doi:10.1007/s11121-008-0085-x.

    Article  PubMed  Google Scholar 

  • Kim, S., Johnson, T. P., Goswami, S., & Puisis, M. (2011). Risk factors for homelessness and sex trade among incarcerated women: A structural equation model. Journal of International Women’s Studies, 12, 128–148.

    PubMed Central  PubMed  Google Scholar 

  • Leclerc-Madlala, S. (2003). Transactional sex and the pursuit of modernity. Social Dynamics, 29, 213–233.

    Article  Google Scholar 

  • Maman, S., Campbell, J., Sweat, M. D., & Gielen, A. C. (2000). The intersections of HIV and violence: Directions for future research and interventions. Social Science & Medicine, 50, 459–478.

    Article  CAS  Google Scholar 

  • Mataure, P., McFarland, W., Fritz, K., et al. (2002). Alcohol use and high-risk sexual behavior among adolescents and young adults in Harare, Zimbabwe. AIDS and Behavior, 6, 211–219.

    Article  Google Scholar 

  • Meade, C. S., Watt, M. H., Sikkema, K. J., et al. (2012). Methamphetamine use is associated with childhood sexual abuse and HIV sexual risk behaviors among patrons of alcohol-serving venues in Cape Town, South Africa. Drug and Alcohol Dependence, 126, 232–239. doi:10.1016/j.drugalcdep.2012.05.024.

    Article  PubMed Central  PubMed  Google Scholar 

  • Meneses-Gaya, C., Zuardi, A. W., Loureiro, S. R., et al. (2010). Is the full version of the AUDIT really necessary? Study of the validity and internal construct of its abbreviated versions. Alcoholism, Clinical and Experimental Research, 34, 1417–1424. doi:10.1111/j.1530-0277.2010.01225.x.

    PubMed  Google Scholar 

  • Minichiello, V., Mariño, R., Browne, J., et al. (1999). A profile of the clients of male sex workers in three Australian cities. Australian and New Zealand Journal of Public Health, 23, 511–518.

    Article  CAS  PubMed  Google Scholar 

  • Mittal, M., Senn, T. E., & Carey, M. P. (2011). Mediators of the relation between partner violence and sexual risk behavior among women attending a sexually transmitted disease clinic. Sexually Transmitted Diseases, 38, 510–515. doi:10.1097/OLQ.0b013e318207f59b.

    PubMed Central  PubMed  Google Scholar 

  • Morisky, D. E., Malow, R. M., Tiglao, T. V., Lyu, S.-Y., Vissman, A. T., & Rhodes, S. D. (2010). Reducing sexual risk among Filipina female bar workers: Effects of a CBPR-developed structural and network intervention. AIDS Education and Prevention, 22, 371–385. doi:10.1521/aeap.2010.22.4.371.

    Article  PubMed Central  PubMed  Google Scholar 

  • Morojele, N. K., Kachieng’a, M. A., Mokoko, E., et al. (2006). Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science & Medicine, 62, 217–227. doi:10.1016/j.socscimed.2005.05.031.

    Article  Google Scholar 

  • Napper, L. E., Fisher, D. G., Reynolds, G. L., & Johnson, M. E. (2010). HIV risk behavior self-report reliability at different recall periods. AIDS and Behavior, 14, 152–161. doi:10.1007/s10461-009-9575-5.

    Article  PubMed Central  PubMed  Google Scholar 

  • Norris, A. H., Kitali, A. J., & Worby, E. (2009). Alcohol and transactional sex: How risky is the mix? Social Science and Medicine, 69, 1167–1176. doi:10.1016/j.socscimed.2009.07.015.

    Article  PubMed  Google Scholar 

  • Parry, C. D. H. (2005). South Africa: Alcohol today. Addiction, 100, 426–429. doi:10.1111/j.1360-0443.2005.01015.x.

    Article  PubMed  Google Scholar 

  • Pitpitan, E. V., Kalichman, S. C., Eaton, L. A., Sikkema, K. J., Watt, M. H., & Skinner, D. (2012). Gender-based violence and HIV sexual risk behavior: Alcohol use and mental health problems as mediators among women in drinking venues, Cape Town. Social Science and Medicine, 75, 1417–1425. doi:10.1016/j.socscimed.2012.06.020.

    Article  PubMed Central  PubMed  Google Scholar 

  • Reisner, S. L., Mimiaga, M. J., Mayer, K. H., Tinsley, J. P., & Safren, S. A. (2008). Tricks of the trade: Sexual health behaviors, the context of HIV risk, and potential prevention intervention strategies for male sex workers. Journal of LGBT Health Research, 4, 195–209.

    Article  PubMed  Google Scholar 

  • Rekart, M. L. (2005). Sex-work harm reduction. The Lancet, 366, 2123–2134. doi:10.1016/S0140-6736(05)67732-X.

    Article  Google Scholar 

  • Saunders, J. B., Aasland, O. G., Babor, T. F., De la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction, 88, 791–804.

    Article  CAS  PubMed  Google Scholar 

  • Scott, J., Minichiello, V., Mariño, R., Harvey, G. P., Jamieson, M., & Browne, J. (2005). Understanding the new context of the male sex work industry. Journal of Interpersonal Violence, 20, 320–342. doi:10.1177/0886260504270334.

    Article  PubMed  Google Scholar 

  • Sherman, S. S., Plitt, S., Ul Hassan, S., Cheng, Y., & Zafar, S. T. (2005). Drug use, street survival, and risk behaviors among street children in Lahore, Pakistan. Journal of Urban Health, 82, iv113–124. doi:10.1093/jurban/jti113.

    Article  PubMed  Google Scholar 

  • Shisana, O., Rehle, T., Simbayi, L., & Mbelle, N. (2008). South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey, 2005. South Africa: HSRC Press.

    Google Scholar 

  • Stoltz, J.-A. M., Shannon, K., Kerr, T., Zhang, R., Montaner, J. S., & Wood, E. (2007). Associations between childhood maltreatment and sex work in a cohort of drug-using youth. Social Science and Medicine, 65, 1214–1221. doi:10.1016/j.socscimed.2007.05.005.

    Article  PubMed Central  PubMed  Google Scholar 

  • Townsend, L., Ragnarsson, A., Mathews, C., et al. (2011). “Taking care of business”: Alcohol as currency in transactional sexual relationships among players in Cape Town, South Africa. Qualitative Health Research, 21, 41–50. doi:10.1177/1049732310378296.

    Article  PubMed  Google Scholar 

  • UNAIDS. (2009). AIDS epidemic update 2009. Retrieved from http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2009/default.asp. Accessed 10 Aug 2012.

  • Wahab, S. (2005). Violence within the sex industry: Introduction. Journal of Interpersonal Violence, 20, 263–269. doi:10.1177/0886260504270328.

    Article  PubMed  Google Scholar 

  • Wamoyi, J., Wight, D., Plummer, M., Mshana, G. H., & Ross, D. (2010). Transactional sex amongst young people in rural northern Tanzania: An ethnography of young women’s motivations and negotiation. Reproductive Health, 7, 2. doi:10.1186/1742-4755-7-2.

    Article  PubMed Central  PubMed  Google Scholar 

  • Watt, M. H., Aunon, F. M., Skinner, D., Sikkema, K. J., Kalichman, S. C., & Pieterse, D. (2012). “Because he has bought for her, he wants to sleep with her”: Alcohol as a currency for sexual exchange in South African drinking venues. Social Science and Medicine, 74, 1005–1012. doi:10.1016/j.socscimed.2011.12.022.

    Article  PubMed Central  PubMed  Google Scholar 

  • Weir, S. S., Morroni, C., Coetzee, N., Spencer, J., & Boerma, J. T. (2002). A pilot study of a rapid assessment method to identify places for AIDS prevention in Cape Town, South Africa. Sexually Transmitted Infections, 78, i106–113.

    Article  PubMed Central  PubMed  Google Scholar 

  • Weir, S. S., Pailman, C., Mahlalela, X., Coetzee, N., Meidany, F., & Boerma, J. T. (2003). From people to places: Focusing AIDS prevention efforts where it matters most. AIDS, 17, 895–903. doi:10.1097/01.aids.0000050809.06065.e0.

    Article  PubMed  Google Scholar 

  • Welch Cline, R. J., Johnson, S. J., & Freeman, K. E. (1992). Talk among sexual partners about AIDS: Interpersonal communication for risk reduction or risk enhancement? Health Communication, 4, 39–56. doi:10.1207/s15327027hc0401_4.

    Article  Google Scholar 

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Acknowledgments

This project was supported by National Institute of Alcohol Abuse and Alcoholism grant R01AA018074.

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Authors and Affiliations

  1. University of Connecticut, Storrs, CT, USA

    Eileen V. Pitpitan, Seth C. Kalichman, Lisa A. Eaton & Demetria Cain

  2. Duke University, Durham, NC, USA

    Melissa H. Watt & Kathleen J. Sikkema

  3. Stellenbosch University, Cape Town, South Africa

    Donald Skinner & Desiree Pieterse

  4. Division of Global Public Health, University of California San Diego, School of Medicine, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA

    Eileen V. Pitpitan

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  1. Eileen V. Pitpitan
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  2. Seth C. Kalichman
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  3. Lisa A. Eaton
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  4. Melissa H. Watt
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  5. Kathleen J. Sikkema
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  6. Donald Skinner
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  7. Desiree Pieterse
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  8. Demetria Cain
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Correspondence to Eileen V. Pitpitan.

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Pitpitan, E.V., Kalichman, S.C., Eaton, L.A. et al. Men (and Women) as “Sellers” of Sex in Alcohol-Serving Venues in Cape Town, South Africa. Prev Sci 15, 296–308 (2014). https://doi.org/10.1007/s11121-013-0381-y

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