title: Transactional sex as a form of child sexual exploitation and abuse in Rwanda: implications for child security and protection.
abstract: OBJECTIVE
  To illuminate the different manifestations of transactional sexual exploitation and abuse among Rwanda's children in order to inform effective responses by policies, programs, and communities.
  
  
  METHODS
  Qualitative data was collected during April and May 2010. One-hundred and thirty-nine adults (56% female) and 52 children (60% female) participated in focus groups across three geographic locations in Rwanda. Eleven interviews were held with child protection stakeholders.
  
  
  RESULTS
  Interview and focus group participants reported how children, primarily girls, engaged in transactional sex as a survival strategy in response to situations of adversity including economic deprivation, difficulty accessing school, and social pressure.
  
  
  CONCLUSIONS
  Policy and programs should work to address the underlying social and economic determinants of transactional sexual exploitation through structural interventions that reduce gender inequalities to accessing school and securing basic needs. Further quantitative and qualitative research to better understand the complexities of this issue is warranted.
authors.affiliation: Department of Social and Policy Sciences, University of Bath, UK.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Williams
authors.forename: Agnes
authors.initials: A
authors.lastname: Binagwaho
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
mesh_terms: D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D002669:Child Welfare / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D011203:Poverty; D012432:Rwanda / Q000453:epidemiology; D011477:Sex Work / Q000706:statistics & numerical data; D017406:Sexual Harassment / Q000706:statistics & numerical data; D035862:Vulnerable Populations