Transactional Sex, Alcohol Use and Intimate Partner Violence Against Women in the Rakai Region of Uganda

Amanda P. Miller, Eileen V. Pitpitan, Dorean Nabukalu, Fred Nalugoda, Gertrude Nakigozi, Godfrey Kigozi, Mary Kate Grabowski, Caitlin E. Kennedy, Jennifer A. Wagman

Research output: Contribution to journalArticlepeer-review


Transactional sex (TS) is prevalent in sub-Saharan Africa. Women’s engagement in TS is linked with HIV infection; little is known about the relationship between TS, intimate partner violence (IPV) and alcohol use—established HIV risk behaviors. Using modified Poisson regression, we assessed associations between TS and physical, verbal and sexual IPV among 8248 women (15–49 years) who participated in the Rakai Community Cohort Study across forty communities in Uganda. An interaction term assessed moderation between alcohol use and TS and no significant interaction effects were found. In adjusted analysis, alcohol use and TS were significantly associated with all forms of IPV. In stratified analysis, TS was only associated with IPV in agrarian communities; alcohol use was not associated with physical IPV in trade communities or sexual IPV in trade and fishing communities. Identifying differences in IPV risk factors by community type is critical for the development of tailored interventions.

Original languageEnglish (US)
Pages (from-to)1144-1158
Number of pages15
JournalAIDS and behavior
Issue number4
StatePublished - Apr 2021


  • Alcohol use
  • HIV
  • Intimate partner violence
  • Sub-Saharan Africa
  • Transactional sex
  • Uganda

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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