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The “blesser and blessee” phenomenon has been prominent in South African media since the year 2016. This is a form of transactional sex in which older rich men (“blessers”) tend to entice young women (“blessees”) with money and expensive gifts in exchange for sexual favors. In most cases, these older men are married men who secretly engage in extramarital affairs with these young women. In this light, there have been many debates on whether transactional sex should be equated to prostitution or sex work. However, many researchers argue that both practices at the end of the day are proven to be equally high-risk sexual behaviors for HIV infection in sub-Saharan Africa. In this regard, the purpose of this study was to explore and describe perceptions and experiences of young women regarding factors that influence their susceptibility to transactional sex and the risk of HIV infection in rural South Africa. Twelve young women aged 18 to 30 years participated in two focus group discussions and 12 individual in-depth interviews. The findings of the study revealed that there are sociobehavioral, sociocultural, and socioeconomic factors that influence the susceptibility of young women to transactional sex and HIV risk. The study concluded that it was imperative for researchers to explore the context and motivation for transactional sex among young women in sub-Saharan Africa to be able to develop and implement appropriate and relevant HIV prevention interventions for this vulnerable population. Keywords “blesser and blessee” phenomenon, young women, transactional sex, HIV, rural South Africa HIV prevalence and incidence rates among adolescent girls Introduction and young women in South Africa have reached crisis pro- Sub-Saharan Africa (SSA) is widely known as the epicenter portions. This situation is corroborated by Abdool Karim and of the HIV epidemic globally. In South Africa, where this Baxter (2016), when they state that the HIV prevalence and study was conducted, it is reported that the country is home incidence rates among adolescent girls and young women in to the largest number of people living with HIV on a global South Africa are up to 6 times higher than that of their male level (Simelela & Venter, 2014). This is because the country counterparts. In terms of race, young Black South African has the fastest growth of HIV prevalence and incidence rates women are more susceptible to HIV infection than young worldwide (Simelela, Pillay, & Serenata, 2016). Women in women of other races (Shisana, Zungu, & Evans, 2016). For South Africa bear the brunt of the HIV epidemic than men. instance, research has identified young Black women aged According to Ramjee and Daniels (2013), women usually 20 to 34 years as a key population with an HIV prevalence become infected with HIV 10 years earlier than men. The rate which exceeds that of the national average (HSRC, recent South African National HIV Prevalence, Incidence 2012). and Behaviour Survey revealed that young women in the age cohort of 15 to 24 years are particularly at risk of contracting HIV than men of the same age group (Human Sciences 1 University of South Africa, Pretoria, South Africa Research Council [HSRC], 2012). It was reported that there Corresponding Author: were approximately 2,000 new HIV infections occurring Johannes N. Mampane, Department of Adult Education and Youth among adolescent girls and young women aged 15 to 24 Development, University of South Africa, P.O. Box 392, Pretoria, Gauteng years each week in South Africa, a rate 2½ times that of 0003, South Africa. males of the same age group (Mampane, 2016). As a result, Email: firstname.lastname@example.org Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 SAGE Open The HIV epidemic has long been viewed as an urban the exchange of valuables is undertaken within the context problem because people who live in urban areas are often of a romantic relationship rather than in sex work where the associated with promiscuity, debauchery, infidelity, and exchange is rather casual and not romantically linked prostitution. In rural South Africa, where this study was (MacPherson et al., 2012). Moreover, young women engag- conducted, there is also a misconception that rural people ing in transactional sex argue that they view their sex part- are immune or less vulnerable to HIV infection when com- ners as boyfriends rather than clients as it is in the case of pared with people who live in urban areas. In this regard, sex workers. Researchers contend that if young women rely people in rural areas tend to be more complacent about the extensively on transactional sex as a way of life for a longer risk of contracting and/or transmitting HIV. Due to poor period of time, they are likely to transition into sex work in health care infrastructure in rural areas, Mampane (2016) future (Stoebenau, Heise, Wamoyi, & Bobrova, 2016). argued that there are increasing unnoticed HIV infections Whether these young women are involved in transactional that occur in rural areas. For example, Mampane (2016) sex or sex work, many researchers argue that the two prac- pointed out that poor HIV surveillance mechanisms such as tices at the end of the day are proven to be high-risk sexual HIV Counseling and Testing (HCT) in rural areas have led behaviors for HIV infection in SSA. Ranganathan et al. to underreporting of HIV infection rates. It is further argued (2017) propounded that it is imperative for researchers to that traditional values and cultural beliefs that link HIV to explore the context and motivation for transactional sex witchcraft, ancestral curses, and God’s punishment aggra- among young women in SSA to be able to develop and vate the vulnerability of rural people to the risk of HIV implement appropriate and relevant HIV prevention inter- infection (Plummer & Wight, 2011). Normative gender ventions for this vulnerable population. inequalities such as the superiority of men over women often exacerbate the susceptibility of rural women to the risk Theoretical Underpinning HIV infection (Shisana et al., 2016). For instance, women often have a limited say or do not have power to negotiate Social identity theory and social dominance theory form the use of condoms in sexual relationships. Rural women the basis of this study. These theories deal with psychologi- are also silenced in a way that they are not allowed to speak cal, behavioral, social, political, cultural, and structural fac- out or report cases of marital rape, gender-based violence tors within which individuals and groups function. The (GBV) and intimate partner violence (IPV) (Ramjee & theories postulate that people’s identity and self-concept is Daniels, 2013). In a study conducted among rural women in influenced by interpersonal relationships they have with South Africa, Mampane (2016) identified marital rape, others as well as environmental factors which influence GBV, and IPV as high-risk factors for HIV infection. their day-to-day life experiences in the communities that Poverty, which is prevalent in rural areas, has in many they live in (Oktay, 2012; Vandeyar, Vandeyar, & Elufisan, instances compelled rural women to engage in transactional 2014). These theories relate to issues of gender, race, and sex to earn a living. class which in most cases shape people’s perceptions of It is worth noting that adolescent girls and young women themselves (Pratto & Stewart, 2012). In the context of this are more likely to engage in transactional sex than older study, these theories aim to explain the manner in which women. Hence, this study mainly focused on young women young women perceive themselves in relation to the superi- under the age of 30 years. Transactional sex, in a nutshell, ority and predominance of men in society. These power dif- can be defined as the exchange of sex for money, favors, ferentials between men and women have in many cases and/or material goods. In SSA, this phenomenon is com- compelled young women to become involved in transac- mon in both rural and urban areas, however, it is more prev- tional sex, which in turn exacerbates their susceptibility to alent in poverty-stricken communities such as rural areas the risk of HIV infection. In a South African context, the where young women are likely to engage in sexual relation- situation is extensively captured in a study titled Love in the ships for monetary or material gain (Jewkes, Dunkle, Time of AIDS: Inequality, Gender, and Rights in South Nduna, & Shai, 2012; Zembe, Townsend, Thorson, & Africa (Hunter, 2010). Ekstrom, 2013). In South Africa, the phenomenon became prominent in 2016 through the media and was labeled the Purpose and Objective of the Study “blesser and blessee” phenomenon. In these “blesser and blessee” relationships, older rich men (“blessers”) tend to The purpose of this study was to explore and describe per- entice young women (“blessees”) with money and expen- ceptions and experiences of young women regarding factors sive gifts in exchange for sexual favors. In most cases, that influence their susceptibility to transactional sex and these older men are married men who secretly engage in HIV risk in rural South Africa. The objective was to gain a extramarital affairs with these young women. In this light, better understanding of these factors to be able to inform most people equate transactional sex with prostitution or policy and practice in the development of interventions to sex work. However, it is argued that transactional sex and mitigate the risk of HIV infection among young women in sex work are not synonymous because in transactional sex rural South Africa. Mampane 3 of data collection in qualitative research. They were used in The Research Setting this study because of their effectiveness in stimulating dia- This study was conducted in rural villages of the North West logue between the researcher and participants to explore and province in South Africa. The province is one of the poorest describe the perceptions and experiences of the participants provinces in the country with more than half of people living (Gill, Stewart, Treasure, & Chadwick, 2008). FGDs were in rural areas (Statistics South Africa, 2016). The HIV preva- used to explore and describe broad topics on the subject lence rate in North West province ranks fourth among the under investigation whereas IDIs were used for more sensi- highest in all nine provinces of South Africa, after Kwa-Zulu tive, private, and confidential information. In this regard, Natal, Mpumalanga, and the Free State provinces (South themes which emerged from the FGDs that were of interest African National AIDS Council, 2013). According to the to the researcher and relevant to the study were further Medical Research Council Provincial Mortality Report of probed in the IDIs. The inclusion criteria for these young the year 2000, HIV by far remains to be a leading cause of women was that they should be 18 years of age or older to be death in North West Province. The provision of adequate able to provide informed consent to participate in the study. health care services in these rural villages is relatively poor. To ensure the diversity of perceptions and experiences in the A health care clinic that is available in these rural villages study, the researcher sampled young women with different lacks resources and is understaffed. Deteriorating infrastruc- sociodemographic characteristics in terms of age, marital ture such as water and sanitation seem to be a recurring prob- status, level of education, occupation, monetary income, reli- lem which negatively impacts on the health and hygiene of gion, and HIV status. A “grand tour” question was asked to the patients. Major health care services such as HIV testing, all the participants. The question asked was treatment, care, and support are normally accessed at a hos- pital located away from the villages. Could you please share with me your perceptions and experiences regarding the “blesser and blessee” phenomenon and factors influencing the susceptibility of young women to transactional Method sex and the risk of contracting HIV in this community? A qualitative research design was adopted in this study. Polit and Beck (2014) defined a qualitative research design as an The researcher then probed further to elicit relevant informa- investigation of phenomena, typically in an in-depth and tion and to pursue more information pertaining to the study. holistic manner, through the collection of rich narrative The researcher used the interview strategy of “funneling,” materials, using flexible data collection methods. The which Minichiello, Aroni, and Hays (2008) described as the research design in this study was explorative, descriptive, process of starting an interview with a broad general ques- and contextual in nature. The purpose of an explorative tion and thereafter continuing to narrow the discussion using research design, according to Brink, Van der Walt, and Van more specific questions which ask directly about the issues Rensburg (2014), is to provide more insight and understand- that are relevant to the study. The FGDs and IDIs were con- ing into the phenomenon under investigation (i.e., “blessers ducted in English and the local language spoken in the area and blessees phenomenon”). A descriptive research design, (Setswana). For precision and accuracy reasons, the FGDs however, attempts to offer an understanding of underlying and IDIs were recorded using an audiotape to capture the causes of the phenomena under investigation (i.e., factors dialogue between the researcher and the participants verba- influencing the vulnerability of young women to transac- tim. In some cases, follow-up IDIs were scheduled with par- tional sex and HIV risk; Brink et al., 2014). A contextual ticipants to clarify the information previously supplied and research design, according to Babbie and Mouton (2010), to further obtain new information. The FGDs and IDIs were refers to a design in which a phenomenon under investiga- conducted in a quiet and private place at a local church with tion is studied in relation to a particular context, location, or the permission of the pastor in charge. All FGDs and IDIs setting (i.e., rural South Africa). lasted for approximately 60 min (1 hr). They were later tran- scribed and those conducted in Setswana were also translated into English. Data Collection Data for this study were collected over a period of 6 months Data Analysis from September 2016 to February 2017 while the researcher Thematic data analysis was utilized in this study. According was conducting his doctoral study on key populations that to Creswell (2013), thematic data analysis in qualitative are at risk of HIV infection in rural South Africa. Twelve research begins with organizing data into manageable sizes young women from a local women empowerment project by identifying themes and subthemes emanating from the were sampled through purposive sampling to participate in data. The following eight steps of thematic data analysis as the study. Two focus group discussions (FGDs) and 12 indi- indicated by Creswell (2013) were adopted by the researcher: vidual in-depth interviews (IDIs) were used as data collec- (a) understanding the whole data by intensive reading of tion methods. FGDs and IDIs are the most common methods 4 SAGE Open Table 1. Factors Influencing the Susceptibility of Young Women had three or more children. In terms of religion, many to Transactional Sex and HIV Risk. attended churches belonging to Christian denominations and African traditional religion. During the IDIs, the researcher Themes Subthemes discovered that most of these young women did not know Sociobehavioral factors Precocious sex their HIV status or have not tested for HIV in a longtime. Peer pressure Multiple concurrent relationships HIV-related complacency Themes and Subthemes Sociocultural factors Gender norms Table 1 denotes themes and subthemes that emerged after the Forced marriages data were analyzed. Intergenerational relationships The themes and subthemes that emerged from the study Socioeconomic factors Poverty Circular migration are discussed in detail below. Sociobehavioral Factors interview transcripts; (b) reading through interview tran- scripts to write down ideas that emerge; (c) reading all inter- These are factors that encapsulate social and behavioral vari- view transcripts, making a list of all topics, and then ables which influence the susceptibility of young women to clustering similar topics together; (d) identifying major transactional sex and HIV risk. themes and writing them down; (e) creating codes for similar topics and rearranging them to form themes; (f) finding suit- Precocious sex. Early age sexual debut among young women able wording for the codes and regrouping them into themes; in rural areas tends to be a norm. Nearly all of the women (g) contrasting and comparing the themes to identify simi- who participated in this study have had an early sexual expe- larities and differences; and (h) recoding the data to identify rience. This is partly attributed to the conservativeness of other emerging themes and subthemes. rural areas in which young women are not allowed to talk to elders about sexual matters which are regarded as a taboo. In this regard, many tend to be curious about sex and experi- Ethical Considerations ment with sex at an early age (Mampane, 2016). The latter situation was established during IDIs with the participants. At the beginning of fieldwork, the researcher provided par- During FGDs, however, most of the participants stated that ticipants with background information about the study. It they engaged in precocious sex for economic reasons. was mentioned to the participants that the study was meant for research and academic purposes only and that there were When I was still at school there were many occasions when my no incentives offered for taking part in the study. The parents didn’t give me money for school fees so I was forced to researcher further informed the participants that their partici- have a “blesser” so that he can give me money to support myself. pation was purely voluntary and that they may discontinue their participation at any time during the course of the study I have been doing “ukuphanda” (transactional sex) since I was without being penalized. Participants in this study were young because I had to take care of my siblings because my required to sign informed consent forms to agree to partake parents are poor. in FGDs and IDIs and also to be tape-recorded. These statements are consistent with a South African study in which it was discovered that a considerable percentage of Findings and Discussion young women aged 15 to 24 years had engaged in an early age sexual debut by the age of 14 years (Pettifor et al., 2008). Sociodemographic Characteristics of the In SSA in general, extensive research has identified preco- Participants cious sex as a risk factor for HIV infection (Ranganathan The age range of young women who participated in this et al., 2017). This is because in most cases young women in study was in the cohort of 18 to 30 years. Out of all the 12 SSA are compelled to have precocious sex with older men young women who took part in the study, only four were who are able to support them financially. For example, dur- married. The participants also exhibited low levels of educa- ing FGDs, one young woman mentioned that tion as most had dropped out of school and did not matricu- late from high school. A majority of these young women I don’t have sex with guys of my own age because they are poor were unemployed and those who were employed worked themselves so they don’t have money to give me . . . older men mainly in informal labor as domestic workers, hairdressers, are rich and always give me money. and street vendors. As a result, these young women did not have a stable monetary income and were dependant on gov- Based on the statement above, these young women often do ernment social grants. Most of the unmarried young women not have a say in negotiating safer sex practices because the Mampane 5 older men as providers have the prerogative to decide on These young women further argued that multiple concurrent matters regarding safer sex. This situation inevitably puts relationships improved their chance of acquiring more finan- these young women at risk of HIV infection. The situation of cial and material resources. power relations and inconsistent condom usage between men I have three boyfriends, the first one usually gives money, the and young women who engage in transactional sex is well- second one buys me groceries and the third one buys me clothes documented in SSA (Luke, 2006; Shai, Jewkes, Levin, and beauty products. You just have to know how you schedule Dunkle, & Nduna, 2010). your time to accommodate them all. Peer pressure. Research on the African continent and else- The more boyfriends the more benefits, I’ve been using the where has proven that peer pressure plays an important role in strategy of friends with benefits for a long time and it works for the general life and sexual lives of adolescents and young me because I’m never broke when its month end although I’m people (Djamba, 2004; Masvawure, 2010; Plummer & Wight, not working. 2011). During FGDs and IDIs, the researcher established that peer pressure was another factor that influenced the suscepti- Multiple concurrent sexual relationships are in many cases bility of young women to transactional sex and HIV infection. facilitated by the casual nature of such relationships. For This was apparent in the following statements: example, one young woman during IDIs mentioned that When we go to social events I want to look good like other girls, I only have sex with my partners when they have money, no otherwise they gossip and laugh at you if you don’t have money no sex, so I know those who get paid weekly, fortnightly beautiful stuff, you need to get a working boyfriend who can and monthly, and that is when I can have sex with them when afford to buy you beautiful stuff. they have money in their pockets. In my group of friends I’m the “starring” because I set example Engaging in multiple and concurrent sexual relationships is about all the latest fashion and beauty products . . . my “blesser” inevitably a risk factor for HIV infection. This situation of buys me whatever I want. transactional sex, multiple concurrent relationships, and HIV is well-documented in a study by Furman and Shaffer Nowadays you must have a “blesser” so that he can buy you a (2011). cellphone or tablet and data so that you can go to facebook and whatsapp to mingle with other potential “blessers” . . . me and HIV-related complacency. There is a paucity of research on my friends we always get men from social media platforms. HIV-related complacency in South Africa. However, a recent study conducted by Mampane (2016) among rural women in The statements above are in line with the findings of an eth- South Africa revealed a situation in which these women nographic study by Wamoyi, Wight, Plummer, Mshana, and developed what is called “HIV fatigue” which consequently Ross (2010) in which the link between peer pressure, trans- resulted into HIV-related complacency. This was also evi- actional sex, and HIV risk was established. These young dent during FGDs and IDIs in this study. women are often pressurized by their peers to get involved in transactional sex for financial and material gain to fit in or Everywhere you go its HIV, HIV, HIV . . . its now boring and assimilate into their friendship circles and social networks. It HIV can’t stop me from what I’m doing (transactional sex) was also apparent during FGDs and IDIs that the ability to because it doesn’t kill anymore. I know people who have tested get involved in transactional sex and acquiring more benefits HIV positive many years ago and today they still look fine. improved your social status in peer groups. A qualitative study titled Love, Money, and HIV: Becoming a Modern I’m on ARVs (Anti-Retroviral Therapy) and the nurse at the African Woman in the Age of AIDS captures the situation of clinic told me that the virus is gone from my blood (undetectable) peer pressure and transactional sex in SSA in an extensive so I cannot infect my men . . . I really need the money. manner (Mojola, 2014). They have been telling us about this useless ABC (Abstain, Be Multiple concurrent relationships. Due to the fact that most of faithful, Condomise) strategy . . . but can they give us money to survive? young women who participated in this study were not mar- ried, many engaged in multiple concurrent sexual relation- Based on these statements, it is conspicuous that these young ships in which they argued that the situation offered them the women are complacent about the ramifications of contract- potential to get married in future. ing and/or transmitting HIV. In South Africa, HIV-related If you have more boyfriends you stand a chance to get married complacency was also found among one of the key popula- soon by one of them and have a better life because your husband tions at risk of HIV infection (i.e., men who have sex with will then support you. men; Jobson, de Swardt, Rebe, Struthers, & McIntyre, 2013). 6 SAGE Open which he showered me and my family with expensive gifts I Sociocultural Factors eventually agreed to marry him because I was enticed by his These are factors that combine social and cultural variables riches. which influence the susceptibility of young women to trans- actional sex and HIV risk. I was forced into a religious courtship by my church elders but I did it because the guy they hooked me up with was stinking rich. Gender norms. In African culture, a man is normally required I married my late husband’s brother due to the advice of the to pay “lobola” (bride price) to the family of the woman he elders but for me it was a matter of remaining in a wealthy intends to marry. As a result, this gender norm has inculcated family where I’m used to getting what I want. a cultural expectation for which men are compelled to pro- vide for women economically. In this light, men are mainly The statements above are consistent with a South African viewed as providers and women as receivers of financial and study in which Tladi (2006) found that young women with a material benefits in relationships, including in transactional decreased decision-making power are particularly at risk of sex encounters (Jewkes & Morrell, 2012; MacPherson et al., HIV infection, especially those from poverty-stricken house- 2012). holds. In another study titled “Women Bodies Are Shops,” both young women and their parents condoned transactional Although I’m not that poor because I have financial support sex and regarded it as a resemblance of love and any woman from my parents, I still expect him to give me something in return when I have sex with him. who had sex with men without claiming any financial or material exchange was seen as a worthless person or a pros- I’m married but I demand that he “blesses” me now and then, titute (Wamoyi, Fenwick, Urassa, Zaba, & Stones, 2011). especially after I gave him good sex. Intergenerational relationships. Age-disparate sexual relation- My husband doesn’t give me money anymore since we got ships are very common in SSA. Recently in South Africa, married so I have “makhwaphenis” (extra-marital affairs) who these relationships have been glamorized in the media by the give me money. “blesser and blessee” phenomenon. Men who engage in these relationships are usually more than 10 years old than the No pain no gain . . . I expect to at least be thanked for the services young women they get involved with. During FGDs and IDIs, I rendered, nothing for “mahala” (free). the majority of young women in this study expressed their willingness to engage in intergenerational relationships. These statements clearly indicate that gender norms have instilled a culture where women prefer to engage in transac- Sugar daddies are “blessers” because they bless you with tional sex relationships with the aim of benefiting financially expensive things that your own boyfriend can’t even afford. and materialistically. The situation inevitably places them at risk of contracting HIV. The link between gender norms, I like older men because they take good care of you both transactional sex, and HIV in SSA is extensively discussed in financially and sexually . . . unlike boys who will just have sex studies conducted in Mozambique and South Africa (Bandali, with you and dump you. 2011; Jewkes & Morrell, 2010; Pettifor, MacPhail, Anderson, & Maman, 2012). Married men are perfect because they don’t spend much time with you because of their family responsibilities . . . so I have ample time to meet other men when he’s with his family. Forced marriages. Forced marriages, locally known as “uku- thwala,” are a prevalent phenomenon in rural communities in His wife is old so he likes me more because I’m sexy and young South Africa. In this situation, young women are forced into . . . he buys me everything I want. marriage by being abducted by a potential husband or being coerced into marriage by elders (usually parents of the young A study in KwaZulu-Natal, a province hard hit by the HIV woman). In many cases, these young woman are coerced into epidemic in South Africa, discovered high rates of new HIV marriage for their parents to gain the monetary and material infections among young women who engage in intergenera- benefits from prospective husbands. This situation mainly tional relationships and transactional sex (Harling et al., occurs in poverty-stricken households where young women 2014). are only regarded as a commodity to be sold to alleviate pov- erty. During the IDIs, some young women reported that Socioeconomic Factors In the beginning I didn’t have any romantic feelings for my These are factors concerned with the interaction of social and present husband. I was forced into marrying him because my father chose him for me . . . he’s from a rich family so my father economic variables which influence the susceptibility of wanted to be rich through me . . . after a long time of dating in young women to transactional sex and HIV risk. Mampane 7 Poverty. People in rural South Africa usually have a low These statements are consistent with the findings of stud- socioeconomic status and generally live below the pov- ies about circular migrant labor, transactional sex and HIV in erty line. Research in SSA has identified poverty as a driv- South Africa (Delany-Moretlwe et al., 2014; Zuma et al., ing force for HIV transmission. This is because many 2005). young women who are uneducated and unemployed are likely to engage in risky sexual behaviors including trans- Conclusion actional sex. During IDIs some young women reported that Physiologically, women are more vulnerable to the risk of HIV infection than their male counterparts. In addition, there I’ve been sending my CV (curriculum vitae) all over but I can’t are also social, behavioral, and structural factors that exacer- get a job . . . maybe is because I didn’t finish matric, so I’m bate the susceptibility of women to the risk of contracting forced to use my body to earn a living. HIV. Young women in the age group of 15 to 24 years are particularly at risk of HIV infection. Young women who live My parents passed away and I’m the eldest one at home . . . we in poverty-stricken communities such as rural areas have an are orphans so I must make means to support my siblings. elevated risk of acquiring HIV than other young women who live in affluent communities such as urban areas. Gender Poor living conditions of young women in rural South Africa inequalities and the subordination of women in society in play a major role in exposing them to the risk of contracting general and in rural areas in particular have aggravated the HIV. This is because these young women engage in transac- vulnerability of women to the risk of HIV infection. This tional sex not willingly but because of economic reasons. study has found that transactional sex is one of the major Studies have reported high HIV prevalence and incidence driving force of HIV transmission among older men and rates among uneducated and unemployed young women who young women in rural South Africa. The study aimed at live in poverty in rural parts of SSA (Barnett & Maticka- shedding some light into the “blesser and blessee” phenom- Tyndale, 2011; Nobelius et al., 2010). enon as well as the motivations of women to engage in trans- actional sex and the repercussions of contracting HIV. The Circular labor migration. This study also identified circular study found that there are sociobehavioral, sociocultural, and migration as a socioeconomic risk factor of HIV transmis- socioeconomic factors that influence the susceptibility of sion among young women in rural South Africa. Due to lack young women to transactional sex and HIV infection in rural of job opportunities in rural areas, most young men and South Africa. In a nutshell, the study discovered that young women migrate to urban areas in search of employment. women in rural South Africa have in most cases used sex During IDIs, it was discovered that young women who primarily as an economic resource to ameliorate their living migrate to urban areas to look for work get involved in trans- conditions. This financial and material exchange for sex is actional sex when they are there in exchange for basic needs often characterized by continuous sex partner change and such as food and shelter. inconsistent condom usage. Against this backdrop, HIV pre- vention efforts in rural South African communities have been I was once stranded in Pretoria (capital city of South Africa) undermined as the country is still experiencing high HIV when I was doing odd jobs as a domestic worker. I had to use sex prevalence and incidence rates among women, especially to pay for my accommodation from a guy I met there. young Black women. I went to Rustenburg (mining town) to look for work and didn’t find any . . . I used to go to bars at night to be picked up Declaration of Conflicting Interests by men who can offer me food and a bed to sleep in exchange The author(s) declared no potential conflicts of interest with respect for sex . . . it was a terrible experience and I ultimately returned to the research, authorship, and/or publication of this article. home. Funding In addition, during IDIs some young women reported inci- The author(s) received no financial support for the research, author- dents of infidelity because their boyfriends and husbands had ship, and/or publication of this article. migrated to urban areas. References He just disappeared for a long time to Johannesburg (economic hub of South Africa) and my children were starving, so I had to Abdool Karim, Q., & Baxter, C. (2016). The dual burden of gender- look for “blessers” to support my children when he’s not around. based violence and HIV in adolescent girls and young women in South Africa. The South African Medical Journal, 106, He earns peanuts as a gardener in the suburbs . . . I have to keep 1151-1153. up with today’s standards, so “ukuphanda” (transactional sex) is Babbie, E. R., & Mouton, J. (2010). The practice of social research. a solution for me now and then when he’s working. Cape Town, South Africa: Oxford University Press. 8 SAGE Open Bandali, S. (2011). Exchange of sex for resources: HIV risk and Transactional sex and HIV: Understanding the gendered gender norms in Cabo Delgado, Mozambique. Culture, Health structural drivers of HIV in fishing communities in southern & Sexuality, 13, 575-588. Malawi. Journal of the International AIDS Society, 15(Suppl. Barnett, J. P., & Maticka-Tyndale, E. (2011). The gift of agency: 1), Article 17364. Sexual exchange scripts among Nigerian youth. The Journal of Mampane, J. N. (2016). Factors influencing the vulnerability of Sex Research, 48, 349-359. women to the risk of HIV-infection in rural villages in North Brink, H., Van Der Walt, C., & Van Rensburg, G. (2014). West province, South Africa. Gender & Behaviour, 14, 7338- Fundamentals of research methodology for health care profes- 7346. sionals. Cape Town, South Africa: Juta. Masvawure, T. (2010). “I just need to be flashy on campus”: Female Creswell, J. W. (2013). Research design: Qualitative, quantitative students and transactional sex at a university in Zimbabwe. and mixed methods approaches. Los Angeles, CA: Sage. Culture, Health & Sexuality, 12, 857-870. Delany-Moretlwe, S., Bello, B., Kinross, P., Oliff, M., Chersich, Medical Research Council. (2000). South African national burden M., Kleinschmidt, I., & Rees, H. (2014). HIV prevalence and of disease study: Estimates of provincial mortality, North West. risk in long-distance truck drivers in South Africa: A national Pretoria, South Africa: Author. cross-sectional survey. International Journal of STD & AIDS, Minichiello, V., Aroni, R., & Hays, T. (2008). In-depth inter- 25, 428-438. viewing: Principles, techniques, analysis. Sydney, Australia: Djamba, Y. K. (Ed.). (2004). Sexual behavior of adolescents in con- Pearson Education. temporary Sub-Saharan Africa. New York, NY: Edwin Mellen Mojola, S. (2014). Love, money, and HIV: Becoming a modern Press. African woman in the age of AIDS. Oakland: University of Furman, W., & Shaffer, L. (2011). Romantic partners, friends, California Press. friends with benefits, and casual acquaintances as sexual part- Nobelius, A. M., Kalina, B., Pool, R., Whitworth, J., Chesters, J., & ners. Journal of Sex Research, 48, 554-564. Power, R. (2010). “You still need to give her a token of appre- Gill, P., Stewart, K., Treasure, E., & Chadwick, B. (2008). Methods ciation”: The meaning of the exchange of money in the sexual of data collection in qualitative research: Interviews and focus relationships of out-of-school adolescents in rural southwest groups. British Dental Journal, 204, 291-295. Uganda. The Journal of Sex Research, 47, 490-503. Harling, G., Newell, M., Tanser, F., Kawachi, I., Subramanian, S. Oktay, J. S. (2012). Grounded theory. New York, NY: Oxford V., & Barnighausen, T. (2014). Do age-disparate relationships University Press. drive HIV incidence in young women? Evidence from a popu- Pettifor, A. E., Levandowski, B. A., McPhail, C., Padian, N. S., lation cohort in rural KwaZulu-Natal, South Africa. Journal of Cohen, M. S., & Rees, H. V. (2008). Keep them in school: Acquired Immune Deficiency Syndromes, 66, 443-451. The importance of education as a protective factor against HIV Human Sciences Research Council. (2012). South African National infection among young South African women. International HIV Prevalence, Incidence and Behaviour Survey, 2012. Journal of Epidemiology, 37, 1266-1273. Pretoria, South Africa: Human Sciences Research Council Pettifor, A. E, MacPhail, C., Anderson, A. D., & Maman, S. (2012). Press. “If I buy the Kellogg’s then he should [buy] the milk”: Young Hunter, M. (2010). Love in the time of AIDS: Inequality, gender, women’s perspectives on relationship dynamics, gender power and rights in South Africa. Bloomington: Indiana University and HIV risk in Johannesburg, South Africa. Culture, Health & Press. Sexuality, 14, 477-490. Jewkes, R., Dunkle, K., Nduna, M., & Shai, J. N. (2012). Plummer, M. L., & Wight, D. (2011). Young people’s lives and sex- Transactional sex and HIV incidence in a cohort of young ual relationships in rural Africa: Findings from a large quali- women in the stepping stones trial. Journal of AIDS & Clinical tative study in Tanzania. Plymouth, UK: Lexington Books. Research, 3, Article 158. doi:10.4172/2155-6113.1000158 Polit, D. F., & Beck, B. P. (2014). Essentials of nursing research: Jewkes, R., & Morrell, R. (2010). Gender and sexuality: Emerging Appraising evidence for nursing practice. Philadelphia, PA: perspectives from the heterosexual epidemic in South Africa Lippincott Williams & Wilkins. and implications for HIV risk and prevention. Journal of the Pratto, F., & Stewart, A. L. (2012). Social dominance theory. In International AIDS Society, 13, 6. doi:10.1186/1758-2652- D. J. Christie (Ed.), The encyclopedia of peace psychology. 13-6 Malden, MA: Blackwell. Jewkes, R., & Morrell, R. (2012). Sexuality and the limits of agency Ramjee, G., & Daniels, B. (2013). Women and HIV in sub- among South African teenage women: Theorising femininities Saharan Africa. AIDS Research and Therapy, 10, Article 30. and their connections to HIV risk practices. Social Science & doi:10.1186/1742-6405-10-30 Medicine, 74, 1729-1737. Ranganathan, M., MacPhail, C., Pettifor, A., Kahn, K., Khoza, N., Jobson, G., de Swardt, G., Rebe, K., Struthers, H., & McIntyre, Twine, R., . . . Heise, L. (2017). Young women’s perceptions J. (2013). HIV risk and prevention among men who have sex of transactional sex and sexual agency: A qualitative study with men (MSM) in peri-urban townships in Cape Town, South in the context of rural South Africa. BMC Public Health, 17, Africa. AIDS and Behavior, 17, S12-S22. Article 666. doi:10.1186/s12889-017-4636-6 Luke, N. (2006). Exchange and condom use in informal sexual Shai, J. N., Jewkes, R., Levin, J., Dunkle, K., & Nduna, M. (2010). relationships in urban Kenya. Economic Development and Factors associated with consistent condom use among rural Cultural Change, 54, 319-348. young women in South Africa. AIDS Care, 22, 1379-1385. MacPherson, E. E., Sadalaki, J., Njoloma, M., Nyongopa, Shisana, O., Zungu, N., & Evans, M. (2016). Historical, social and V., Nkhwazi, L., Mwapasa, V., . . . Theobald, S. (2012). cultural aspects of HIV. In B. Ngcaweni (Ed.), Sizonqoba! Mampane 9 Outliving AIDS in Southern Africa (pp. 23-51). Pretoria, South and HIV prevention in Tanzania. Archives of Sexual Behavior, Africa: Africa Institute of South Africa. 40(1), 5-15. Simelela, N. P., Pillay, Y., & Serenata, C. (2016). The South Wamoyi, J., Wight, D., Plummer, M., Mshana, G. H., & Ross, African response to the HIV epidemic. In B. Ngcaweni (Ed.), D. (2010). Transactional sex amongst young people in rural Sizonqoba! Outliving AIDS in Southern Africa (pp. 1-22). northern Tanzania: An ethnography of young women’s moti- Pretoria, South Africa: Africa Institute of South Africa. vations and negotiation. Reproductive Health, 7, Article 2. Simelela, N. P, & Venter, W. D. F. (2014). A brief history of doi:10.1186/1742-4755-7-2 South Africa’s response to AIDS. The South African Medical Zembe, Y. Z., Townsend, L., Thorson, A., & Ekstrom, A. M. Journal, 104, 249-251. (2013). “Money talks, bullshit walks” interrogating notions South African National AIDS Council. (2013). North West Provincial of consumption and survival sex among young women engag- AIDS Spending Assessment Brief (2007/08-2009/10). Pretoria, ing in transactional sex in post-apartheid South Africa: A South Africa: Author. qualitative enquiry. Globalization and Health, 9, Article 28. Statistics South Africa. (2016). Provincial community census 2016. doi:10.1186/1744-8603-9-28 Pretoria, South Africa: Author. Zuma, K., Lurie, M. N., Williams, B. G., Mkaya-Mwamburi, D., Stoebenau, K., Heise, L., Wamoyi, J., & Bobrova, N. (2016). Garnet, G. P., & Sturn, A. W. (2005). Risk factors of sexu- Revisiting the understanding of “transactional sex” in sub- ally transmitted infections among migrant and non-migrant Saharan Africa: A review and synthesis of the literature. Social sexual partnerships from rural South Africa. Epidemiology & Science & Medicine, 168, 186-197. Infection, 133, 421-428. Tladi, L. S. (2006). Poverty and HIV/AIDS in South Africa: An empirical contribution. SAHARA Journal, 3, 369-381. Author Biography Vandeyar, S., Vandeyar, T., & Elufisan, K. (2014). Impediments to the successful reconstruction of African immigrant teachers’ Johannes N. Mampane, PhD, is an academic and a researcher professional identities in South African schools. South African at the University of South Africa. His research interests encapsu- Journal of Education, 34(2), 1-20. late Gender, Health and Sexuality Studies. He advocates for Wamoyi, J., Fenwick, A., Urassa, M., Zaba, B., & Stones, W. social justice, inclusivity, equality and diversity issues concern- (2011). “Women’s bodies are shops”: Beliefs about transac- ing disenfranchised, vulnerable and minority populations in tional sex and implications for understanding gender power society.
SAGE Open – SAGE
Published: Oct 12, 2018
Keywords: “blesser and blessee” phenomenon; young women; transactional sex; HIV; rural South Africa
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