Hurricane impact associated with transactional sex and moderated, but not mediated, by economic factors in Okay, Haiti

Abstract

Natural disasters, such as hurricanes, often negatively affect the economic wellbeing of affected individuals. Under such conditions, women may engage in transactional sexual behaviors in order to compensate for lost income and provide for their households. In this study, we evaluated the relationship between hurricane impact and transactional sex and if this relationship was moderated, or mediated, through economic factors. Between December 2017 and February 2018, approximately one year after the area was hit by a category 4 hurricane (Hurricane Matthew), we interviewed a random sample of female microfinance members (n = 304) in Okay, Haiti. We estimated the association between hurricane impact and transactional sex using log-binomial regression. Next, we tested for economic moderation of this relationship by incorporating interaction terms between hurricane impact and food insecurity, poverty, and loss of income generating materials in three separate log-binomial models. Finally, we assessed possible mediation of this relationship by loss of income generating resources and a latent variable, economic stress, using a structural equation model. We found participants who had experienced hurricane impact were 58% more likely to have engaged in transactional sex [prevalence ratio (95% confidence interval): 1.58 (1.19-2.09)]. This relationship was significant and strongly positive among women who were food insecure and had high poverty but not so among women who were food secure and had low poverty, respectively. The final structural equation model (with fit: χ² = 19.700, degrees of freedom = 15; CFI = 0.958; TLI = 0.941; RMSEA = 0.040) revealed that the relationship was not mediated through economic factors. However, the association between hurricane impact and transactional sex remained significant while controlling for these economic factors. Notably, the findings that the relationship between hurricane impact and transactional sex was moderated, but not mediated, by economic factors implies populations at-risk of experiencing natural disasters should be preemptively targeted with economic interventions to build capacity and resilience before such a disaster hits.

Keywords: Economics; Haiti; Hurricanes; Natural disasters; Transactional sex.

Figure 1.

The association between hurricane impact and transactional sex, testing mediation through economic factors such as loss of income generating resources and the latent variable, economic stress, among female microfinance members in Okay, Haiti (N=304) *Bolded estimates indicate significance at an a priori α=0.05.