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Nishimura HM, Nakyanjo N, Ddaaki W, Kiyingi AC, Mukwana E, Nalugoda F, Ssekyewa C, Denison J, Grabowski MK, Kagaayi J, Kennedy CE. Dissolution of transactional sex relationships during COVID-19: a qualitative study of Ugandan men's experiences during COVID-19 lockdowns. CULTURE, HEALTH & SEXUALITY 2024; 26:687-700. [PMID: 37647132 DOI: 10.1080/13691058.2023.2238796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023]
Abstract
The COVID-19 pandemic and subsequent mitigation measures led to social disruption and negative economic shocks for a large proportion of Uganda's population. The social and economic consequences of COVID-19 on Ugandan men's sexual behaviours, including transactional sex relationships, are unclear. We conducted in-depth interviews between November 2021-February 2022 with 26 men in a high HIV prevalence region of Uganda. Data were analysed thematically to understand how sexual relationships, including transactional sex, were impacted by COVID-19. We found that COVID-19 mitigation measures had far-reaching social and economic impacts on most respondents, particularly those employed in the informal economy. Men described experiencing job loss, food insecurity and restricted mobility, which limited opportunities to provide for and meet with transactional sex partners. Inability to provide financial resources meant that men could not form new transactional sex relationships and men who could no longer provide for their existing transactional sex partners consistently reported relationship dissolution. Men who reported stable employment during the pandemic described few changes in transactional sex relationships. Similarly, men in non-transactional relationships did not report relationship dissolution despite decreased financial provision. Further research should assess the potential short- and long-term impacts of COVID-19 mitigation measures on transactional sex relationships.
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Affiliation(s)
- Holly M Nishimura
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | | | - Julie Denison
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M Kate Grabowski
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Rogers K, Kajula L, Kilonzo MN, Palermo T, Ranganathan M, Collins RL, Livingston JA, Yamanis T. 'You are looked upon as a luxury tool': Young Tanzanian women's perception of community norms supporting partner violence during transactional sex ( kudanga). CULTURE, HEALTH & SEXUALITY 2024:1-16. [PMID: 38669268 DOI: 10.1080/13691058.2024.2339280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
This paper explores the definition of, and perceived community attitudes, toward kudanga, a Swahili street term for a type of transactional sex practised in Dar es Salaam, Tanzania. Rooted in economic and gender disparity, transactional sex increases adolescent girls' and young women's vulnerability to HIV and gender-based violence. We sought to understand perceived community attitudes about kudanga, and how the internalisation of norms surrounding gender-based violence relate to the experiences of young women who practise kudanga. Using qualitative data from focus group discussions with 37 young women, we found that community perceptions of kudanga were largely negative, and those who engaged in it were looked down upon and despised. Violence and lack of sexual agency were normalised when doing kudanga. However, young women understood kudanga to often be their best option to obtain economic stability and felt strongly that those who practised kudanga should not be stigmatised. Our research provides further evidence that transactional sex exists on a continuum and highlights the importance of reducing community stigma surrounding transactional sex as a means of decreasing risk of HIV and gender-based violence for young women. To our knowledge, this article is the first to explore kudanga.
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Affiliation(s)
- Kate Rogers
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
| | - Lusajo Kajula
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Gillings School of Global Public Health, UNC-Chapel Hill, NC, USA
| | - Mrema Noel Kilonzo
- UNICEF Office of Research, Innocenti, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Tia Palermo
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | | | - R Lorraine Collins
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
| | | | - Thespina Yamanis
- School of International Service, American University, WA, DC, USA
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Tumwesige E, Asiimwe A, Kawuma R, Bernays S, Seeley J. Young migrant men managing risk and seeking protection in a small town in Southern Uganda. J Migr Health 2023; 8:100191. [PMID: 37440919 PMCID: PMC10333604 DOI: 10.1016/j.jmh.2023.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/04/2023] [Accepted: 06/07/2023] [Indexed: 07/15/2023] Open
Abstract
Young migrants in resource-constrained settings face multiple challenges when they move away from home for work and try to make their way in a new place. In Uganda, with a growing youthful population increasing numbers of young people are leaving home to look for opportunities in urban areas, often facing a precarious existence as they try to make money. Using data from in-depth interviews we investigate the lived experience of precarity of 20 young men who had recently migrated to a small town in south-west Uganda. We adopt a case study approach to look in-depth at the experience of three of the young men, showing how they engage in a continual evaluation of risk in their day to day lives, as they face multiple challenges related to their insecure employment and poor access to health services. We found that the risks that the young men are willing to take to maximise their limited opportunities changed over time. Our findings provide valuable insights into the gendered risks faced by young male migrants and illustrate the ways in which young migrants, many of whom may only have travelled a relatively short distance from home, face risks and challenges to their health and wellbeing, and need to be recognised as a population in need of attention and support.
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Affiliation(s)
| | - Allen Asiimwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Rachel Kawuma
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Sarah Bernays
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, University of Sydney, Sydney, Australia
| | - Janet Seeley
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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Meinhart M, Seff I, Villaveces A, Roa AH, Stark L. Violence Exposure Among Adolescent Boys and Young Men in Colombia With a Lifetime History of Transactional Sex. J Adolesc Health 2022; 71:696-704. [PMID: 36088231 PMCID: PMC9891716 DOI: 10.1016/j.jadohealth.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE There is a paucity of research examining the contextual factors that shape the violence experienced by those engaged in transactional sex, particularly among adolescent boys and young men. Recognizing the acute vulnerability among youth engaged in transactional sex, this analysis examined the associations between lifetime transactional sex and experience of violence among 13- to 24-year-old males. METHODS Using data from two strata of the 2018 Violence Against Children and Youth Survey from Colombia, logistic regressions were used to estimate the association between engagement in transactional sex and violence exposure. Three groups of violence outcomes were examined: violence victimization, violence perpetration, and witnessing violence. RESULTS Violence victimization and witnessing violence were widespread. Adolescent boys and young men with a lifetime history of transactional sex were significantly more likely to experience violence victimization than those without a lifetime history of transactional sex, particularly intimate partner violence (adjusted odds ratio [aOR]: 5.23 and 5.41) and caregiver emotional violence (aOR: 7.23 and 8.74). In the national and priority samples respectively, those with a lifetime history of transactional sex were also significantly more likely to witness violence within the home (aOR: 4.42 and 4.99) and outside of the home (aOR: 7.24 and 28.32). DISCUSSION Although research is needed to determine causal pathways, our findings highlight the ubiquity of violence and the criticality of supporting this group of adolescent boys and young men. Interventions for those with a history of transactional sex should address factors that may contribute to drivers of violence and transactional sex.
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Affiliation(s)
- Melissa Meinhart
- National Coalition of Independent Scholars, Brattleboro, Vermont
| | - Ilana Seff
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - Andrés Villaveces
- Division of Violence Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Lindsay Stark
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri.
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Gottert A, Pulerwitz J, Heck CJ, Shabangu P, Lukhele B, Cawood C, Khanyile D, Apicella L, Okal J, Mathur S. Inroads for HIV prevention among men: findings from mixed methods research in the context of the DREAMS partnership in Southern Africa. AIDS 2022; 36:S85-S97. [PMID: 35766578 DOI: 10.1097/qad.0000000000003225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess trends in men's HIV risk factors and service use, and their experiences with prevention programming, during an intensive HIV response for adolescent girls and young women and their male partners. DESIGN Independent cross-sectional surveys in 2016-2017 and 2018 with men in Eswatini (20-34 years-old, n = 1391) and Durban, South Africa (20-40 years-old; n = 1665), complemented by 74 in-depth interviews (IDIs) with men exposed to HIV services/prevention programming. METHODS Survey recruitment was primarily at hot-spot venues. We assessed Round 1-2 trends in HIV risk factors and service use, overall and by HIV risk profiles. IDI respondents were identified via survey responses or program partners. RESULTS HIV risk factors were prevalent in both countries at each survey round, although there were reductions over time among the highest risk profiles in South Africa. Most men were engaged in HIV services (e.g. nearly two-thirds tested for HIV in the last year at round 2, with large increases in Eswatini). Qualitative data suggest HIV service uptake was facilitated by increased convenience and supportive information/messaging about HIV treatment efficacy. Men described eagerly receiving the information and support offered in HIV prevention programming, and effects on HIV risk reduction and newly engaging in HIV services. However, less than 15% of survey respondents reported being reached by such programming. CONCLUSION Important inroads have been made to engage men in HIV services and prevention programming in the two countries, including among the high-risk profiles. Still, improving coverage of comprehensive HIV prevention programming is critical, particularly for men most at risk.
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Affiliation(s)
| | | | - Craig J Heck
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | - Cherie Cawood
- Epicentre Health Research, Pietermaretzburg, South Africa
| | - David Khanyile
- Epicentre Health Research, Pietermaretzburg, South Africa
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