"Needs" versus "wants": examining the manifestations and motivations of transactional sex among young women in relation to HIV risk in Mbarara district, southwestern Uganda

Young women constitute a persistently disproportionate share of new HIV infections in the hardest hit countries of Africa - three times higher than among male peers. Transactional sex is a key driver of HIV infections among women in Africa, and the "women-poverty-transactional sex" perspective dominates the conceptualisation of this link. Yet, the manifest nature of poverty and its intersectionality with HIV risk among young women, is more complex and inadequately understood. We examine the evolving nature, motivations and meanings of transactional sex among young women aged 15-35 years through 32 focus group discussions with young women, young men and community members in Mbarara district, south-western Uganda. The findings affirm and transcend conventional poverty-based notions, which typically depict desperate victims struggling to meet basic "needs." Instead, they reveal the agency of relatively educated and sometimes well-off young women who engage in risky sexual behaviour to fulfil their desires - "wants." The findings advance knowledge on the intersection of poverty, agency and power inequities in shifting manifestation of transactional sex across lifecycle transitions among young women and can inform the micro targeting of relevant local HIV-prevention initiatives, including economic empowerment efforts to overcome the high rates of new HIV infections among young women.