Self-Esteem as an Indicator of Transactional Sex Among Young Women in Rural South Africa (HPTN 068)

AIDS Behav. 2020 Mar;24(3):823-826. doi: 10.1007/s10461-019-02698-z.


Transactional sex (TS) has been shown to contribute to the HIV epidemic in sub-Saharan Africa. Previous research has yet to identify psychosocial factors that make young women vulnerable to engaging in TS. This analysis examined the association between self-esteem and TS among young women in rural South Africa. A post hoc analysis of post-intervention survey data from HPTN 068 was conducted. Log-binomial regression was used to compute a prevalence ratio measure of association. Among 1942 young women, the prevalence of TS among those with lower self-esteem was 4.7 times the prevalence of TS among those with higher self-esteem (p < 0.001). Findings provide support for the association between lower self-esteem and TS in this context and may inform intervention development.

Keywords: HIV; Self-esteem; South Africa; Transactional sex; Young women.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Epidemics
  • Female
  • HIV Infections / epidemiology
  • Humans
  • Prevalence
  • Randomized Controlled Trials as Topic
  • Rural Population / statistics & numerical data
  • Self Concept*
  • Sex Work / psychology
  • Sex Work / statistics & numerical data*
  • South Africa / epidemiology
  • Surveys and Questionnaires
  • Young Adult