Background Evidence suggests a range of HIV-associated vulnerabilities associated with the exchange of sex for money or other material goods, but most research and programs in Ukraine focus on formal sex work. We sought to describe the prevalence of HIV and HIV-associated vulnerabilities among adolescent girls and young women engaged in transactional sex outside of formal sex work.

Methods We conducted a cross-sectional bio-behavioral study in Dnipro, Ukraine in 2016 of young women (14–24 years). 469 participants were recruited who reported transactional sex but not sex work, from places where female sex workers solicit clients. Transaction sex was defined as a sexual engagement with the expectation of receiving, gifts or other resources in return, when the price of sex is often not negotiated upfront and is implicitly understood.

Results Mean age of participants was 21.2 years. The mean age among participants at first sex was 16.0 years (range 12–21). At first sex 34% (160) received gifts or money, and 7% (34) reported forced first sex. During the past week, 81% (378) had sex with a regular transactional partner, with whom 35% (132) had condomless sex. In the past month, 29% (137) had sex while inebriated with regular transactional partners, and 64% (299) did not use/remember whether a condom was used during last sex act with them. 49% (231) reported also having non-transactional intimate partners, with whom 46% (107) reported condomless sex in the last week. 56% (262) never had an HIV test and 87% (408) were unaware of HIV prevention programs in Dnipro. HIV prevalence was 1.7% (8).

Conclusion The high prevalence of HIV-associated vulnerabilities, low testing rates, and high HIV prevalence highlight the importance of designing HIV prevention programs to reach young women engaging in transactional sex.

Disclosure No significant relationships.