Transactional Sex as a Response to Risk in Western Kenya

Formal and informal commercial sex work is a way of life for many poor women in developing countries. Though sex workers have long been identi\u85ed as crucial in a¤ecting 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 income shocks, we \u85nd that sex workers adjust their supply of risky, better compensated sex to cope with unexpected income shocks, exposing themselves to increased risk of HIV infection. In particular, women are 3.2 % more likely to see a client, 21.7 % more likely to have anal sex, and 20.6 % 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 STI symptoms. Given that HIV prevalance has been estimated at 9.8 % in this part of Kenya, these behavioral responses entail signi\u85cant health risks for sex workers and their partners, and suggests that sex workers are unable to cope with incom