Introduction: Studies across Sub-Sahara have established transactional sex as one of the of the
keys factors contributing to young people’s risk of HIV infection. However, there are few studies
that have explored the dynamics of transactional sex among young people in Malawi. The aim of
this study was to investigate the extent of, and risk factors associated with transactional sex
among (in and out of school) young men and women of ages 18 – 23 years in urban informal
settlements in Blantyre, Malawi.
Methods: This was a secondary analysis of data from a cross-sectional study conducted in 2013
on sexual risk-taking among young people aged 18 – 23 years in urban informal settlements in
the city of Blantyre, Malawi. The analysis was restricted to sexually active young men and
women (those respondents who reported ever having sexual intercourse in the primary study).
Bivariate and multivariate analyses were conducted to detect associations between sociodemographic
factors (i.e. age, socio-economic status, relationship status and education, as well as
behavioral factors (i.e. sexual debut, number of partners, age disparity with sexual partner,
coercive sex and alcohol consumption), and transactional sex.
Results: The majority (60.06%) of the study population reported involvement in transactional
sex. Stratified by sex, 67.10% of young men had ever given cash or material goods in order to
get sex, and 53.45% of young women had ever received cash or material goods in exchange for
sex. Half (50.75%) of the transactional sex reported was in exchange for cash and
consumption/lifestyle goods and from this, over half of the young women (58.67%) reported
receiving consumption and lifestyle goods in exchange for sex, and slightly over a quarter
(26.32%) of the young men reported giving survival needs in exchange for sex. Among men,
household structure (AOR 2.07, 95% CI 1.37 – 3.13) and severe food insecurity (AOR 1.67,
95% CI 1.05 – 2.67) emerged as important socio-demographic predictors of transactional sex,
and number of sexual partners (AOR 2.67, 95% CI 1.78 – 4.08) and age disparity (AOR 0.34,
95% CI 0.21 – 0.57) were shown to be the behavioral factors that influence giving cash/material
goods for sex. Among young women, only age at sexual debut (AOR 2.07, 95% CI 1.37 – 3.13)
and number of sexual partners (AOR 3.02, 95% CI 1.65 – 5.52), were significantly associated
with receiving cash or goods in exchange for sex.