Sexual and reproductive health and transactional sex in forced displacement: a comparative multi-country study

There is a significant gap in data concerning the patterns and drivers of transactional sex, sexual exploitation, and abuse in transactional sex and their implications on the sexual and reproductive health and rights of refugees.

Though shrouded in secrecy, transactional sex is widespread among forcibly displaced populations. Women, men (heterosexual and homosexual) and transgender refugees resort to transactional sex for various reasons, including to meet their basic needs, raise sufficient money to continue their journey, or in exchange for security. In most cases, refugees who engage in transactional sex are at greater risk of physical and sexual violence, mental health problems, unwanted pregnancies and unsafe abortions, and HIV/sexually transmitted infections. The silence and stigma around transactional sex — especially among young women — and the poor understanding of the role of gender relations as a driver hinder access to health services and rights to health, privacy, and freedom from violence and discrimination.

This comparative, multi-disciplinary, and multi-country research study will examine the gendered nature of transactional sex and the sexual and reproductive health and rights trajectories among refugee women, girls, and sexual minority persons, with the aim of developing appropriate interventions to improve policy and programmatic responses. The methodological approach will use ethnographic and qualitative methods in Lebanon, Jordan, and Turkey and will include preparing and piloting comparative quantitative surveys. The main analysis will describe the impact of transactional sex on sexual and reproductive health with a focus on needs and barriers to these services. This proposed research is part of a larger multi-country research program in Lebanon, Jordan, Turkey, Greece, and Sweden to examine the pattern and experiences of transactional sex and its sexual and reproductive health and rights implications across refugees’ migration journeys originating in the Middle East, and in transit en route to desired safe destinations.

The study will generate unique evidence to inform public health policies and interventions addressing transactional sex in refugee populations. The research will influence change by fostering a community of practice with local researchers, community members, program managers, policymakers, and other practitioners. A key outcome will be policy recommendations to address the sexual and reproductive health consequences of transactional sex among vulnerable population groups.