title: Transactional sexual relationships, sexually transmitted infection risk, and condom use among young Black Women in peri-urban areas of the Western Cape Province of South Africa.
abstract: BACKGROUND
  Transactional sexual behavior has been demonstrated as an important factor underlying the HIV epidemic in sub-Saharan Africa. The aim of this study was to evaluate the relationship between having a history of transactional sexual relationships with condom use and STI risk.
  
  
  METHODS
  Participants completed a behavioral questionnaire in isiXhosa and provided self-collected vaginal swabs which were tested for Chlamydia trachomatis, Neisseria gonorrhea, and Trichomonas vaginalis. Multinomial logistic regression was used to compare condom use rates and sexually transmitted infection (STI) risk among women with a history of transactional sexual relationships to women with a history of casual sexual relationships and those with no history of casual sexual relationships.
  
  
  RESULTS
  Of the 446 respondents, 223 (50%) reported no history of casual sexual relationships, 94 (23.32%) indicated a history of casual sexual relationships, and among these 119 (26.68%) reported a history of transactional sexual relationships with casual partners. Participants with a history of transactional sexual relationships had a higher rate of condom use with a main partner and a lower prevalence of Chlamydia infection than participants with a history of casual relationships. Participants with a history of transactional sexual relationships were also less likely to have had a STI in the past compared with those who indicated no history of casual relationships.
  
  
  CONCLUSIONS
  These results highlight attempts by women who report participation in transactional sex to use condoms. The results also point to possibly concealed risk to STI and HIV among women who indicate no history of transactional sex.
authors.affiliation: Human Sciences Research Council, HIV/AIDS, STI and TB Program, Cape Town, South Africa. donoya@hsrc.ac.za
authors.forename: Dorina
authors.initials: D
authors.lastname: Onoya
authors.forename: Priscilla
authors.initials: P
authors.lastname: Reddy
authors.forename: Sibusiso
authors.initials: S
authors.lastname: Sifunda
authors.forename: Delia
authors.initials: D
authors.lastname: Lang
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Bart
authors.initials: B
authors.lastname: van den Borne
authors.forename: Robert A C
authors.initials: RA
authors.lastname: Ruiter
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult