Pilot Award Recipient: Kirsten Stoebenau, PhD

Studies have shown that girls and young women in sub-Saharan Africa who report having had relationships with men based on an expectation that the man will support them financially and they will provide sex in return (transactional sex) are more likely to have HIV. In this study, the researchers will develop two new measures to improve the currently limited understanding of whether expectations about how men and women should act in transactional sex relationships might explain girls and young women’s increased risk. The researchers are especially interested in measuring whether 1) girls and young women’s own attitudes about these relationships; and 2) social norms, or social rules, about how women and men should behave in these relationships, might increase women’s risk of HIV. To measure attitudes, the researchers will develop a scale, or ask people how much they agree with a series of statements that together capture their attitude. To measure social norms, the researchers will develop small stories, or ‘vignettes’ and test how much people agree with different versions of the story. To develop these measures, the researchers will conduct a study in two sites in Uganda, including an urban and a rural area. The researchers will use what they know from other studies and from past research they have done to begin to develop these measures. Then the researchers will hold 10 small group discussions with unmarried girls and women ages 15-24 to ask them to react to the statements they have developed for the scale, and the vignettes they have developed to measure social norms. Next they will refine the statements and vignettes and then conduct 32 one on one interviews to make sure girls and young women understand them as the researchers intend them to be understood. Finally, the researchers will conduct a small pilot survey with 100 15-24 year old women to test the new measures. They will analyze the results to see if the statements in the scale they have developed fit well together and if gender unequal attitudes are associated with transactional sex. The researchers will also test to see if there is evidence that social norms are influencing how people behave in these relationships. The findings from this study will be important for the growing number of interventions trying to prevent girls and young women from contracting HIV. The attitude measures can help providers identify which girls and women are at higher risk of HIV through transactional sex and make sure they get preventative care; and social norm measures can identify the settings and groups where more unequal norms need to be changed.