Exchange and condom use in informal sexual relationships in urban Kenya

The continuing spread of HIV/AIDS, particularly in sub-Saharan Africa, has prompted increasing attention toward the "informal" exchange of money or gifts for sex that takes place outside of formalized prostitution. Informal exchange relationships are widespread in many African contexts and are believed to contribute to rising levels of HIV infection, particularly among adolescent girls. In this article, I use the term "informal exchange relationships" to designate nonmarital sexual partnerships where material items are given by a male to his female partner. I use the umbrella term "transfers" to describe the items that are given, whether monetary or nonmonetary. The major aim of this article is to determine if a market for unsafe sexual activity among informal relationships exists in a high HIV/AIDS environment, with money and gifts traded for sex without a condom. The article is divided into five sections. The second section lays out a conceptual framework that characterizes the properties of a market for unsafe sexual behavior, which leads to the testable prediction that condom use and transfers should be negatively correlated within partnerships. This section also describes the alternative view, which predicts the absence of such a relationship. The third section describes the empirical specification, data, and variables. The fourth section presents the estimates of the correlation between transfers and condom use in three parts: (1) the overall relationship between the level of transfers and the probability of condom use, (2) the relationship with monetary and nonmonetary transfers separately, and (3) the relationship between transfers and condom use across partnerships with females of different ages (adolescents vs. adults). The last section concludes.