Transactional Sexual Relationships in Ugandan Universities: A Systematic Review of Structural Drivers, Protective Factors, Consequences, and Interventions for Policy and Practice

Abstract

This article presents a systematic literature review of existing research on transactional sexual relationships among students in Ugandan universities. Unlike empirical studies that collect primary data, this review synthesizes findings from previously published studies to identify structural drivers, protective factors, consequences, and interventions. Following PRISMA guidelines, the authors searched Google Scholar, PubMed, and African Journals Online for peer-reviewed studies published between January 2010 and December 2024. The CASP tool was used to assess the quality of 42 high-quality studies selected from an initial pool of 847 records. As a literature review, this article does not present new empirical data; rather, it aggregates and analyzes patterns across existing scholarship. Key findings from the reviewed literature indicate that transactional sex is associated with systemic failures including poverty, housing shortages, abuse of power, and institutional silence, while protective factors such as family support, religious attendance, and peer refusal skills offer intervention pathways. Consequences documented in the literature include psychological distress, sexually transmitted infections, academic failure, and social stigma. The review also notes that most existing studies are cross-sectional, meaning causation cannot be proven, and calls for longitudinal research. Based on synthesized evidence, the authors propose practical interventions for policy and practice. This review concludes that transactional sex in Ugandan universities is consistently associated with structural drivers rather than individual moral failure alone.