Transactional Sex as a Response to Risk in Western Kenya

44 Pages Posted: 20 Apr 2016

See all articles by Jonathan Robinson

Jonathan Robinson

University of California, Santa Cruz

Ethan Yeh

World Bank

Multiple version iconThere are 2 versions of this paper

Date Written: March 1, 2009


Formal and informal commercial sex work is a way of life for many poor women in developing countries. Though sex workers have long been identified as crucial in affecting the spread of HIV/AIDS, particularly in Sub-Saharan Africa, the nature of sex-for-money transactions remains poorly understood. Using a unique panel dataset constructed from 192 self-reported sex worker diaries which include detailed information on sexual behavior, labor supply, and health shocks, the authors find that sex workers adjust their supply of risky, better compensated sex to cope with unexpected health shocks, exposing themselves to increased risk of HIV infection. In particular, women are 3.1 percent more likely to see a client, 21.2 percent more likely to have anal sex, and 19.1 percent more likely to have unprotected sex on days in which a household member falls ill. Women also increase their supply of risky sex on days after missing work due to symptoms from a sexually transmitted infection. Given that HIV prevalence has been estimated at 9.8 percent in this part of Kenya, these behavioral responses entail significant health risks for sex workers and their partners, and suggest that sex workers are unable to cope with risk through other formal or informal consumption smoothing mechanisms.

Keywords: Population Policies, Adolescent Health, Gender and Health, Disease Control & Prevention, Health Monitoring & Evaluation

Suggested Citation

Robinson, Jonathan and Yeh, Ethan, Transactional Sex as a Response to Risk in Western Kenya (March 1, 2009). World Bank Policy Research Working Paper No. 4857, Available at SSRN:

Jonathan Robinson (Contact Author)

University of California, Santa Cruz ( email )

1156 High St
Santa Cruz, CA 95064
United States

Ethan Yeh

World Bank ( email )

1818 H Street, NW
Washington, DC 20433
United States

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