Transactional Sex and the Health Repercussions in Forced Migration

Why, when and how do refugees engage in transactional sex across genders and what are the sexual and reproductive health and mental health consequences of refugees involved in transactional sex?

Project Summary

In forced displacement, refugees can face extreme hardship due to food, housing and income insecurity, family separation, social exclusion and other factors.

Due to the lack of decent job opportunities, many refugees may resort to transactional sex for survival, to meet their basic needs. The elements of this exchange include obtaining security and protection from sexual violence or protection while crossing borders. Engaging in transactional sex can bear health risks – particularly sexual and reproductive health and mental health implications. Therefore, these refugees have greater health needs while facing greater barriers to access services, including due to stigma and discrimination

Although transactional sex is widespread among refugees, there is silence and stigma around it, which leads to a significant evidence gap. There is very limited information about factors that facilitate transactional sex in forced displacement or about its health repercussions. The leading research questions of our study are:

  • Why do refugees engage in transactional sex?
  • How do refugees engage in transactional sex?
  • What is the impact of transactional sex on refugees’ sexual. reproductive, and mental health?
  • What is the connection between gender and transactional sex?

Data will be collected in Greece, France and Switzerland through ethnographic observation, interviews and focus group discussions. A law and policy analysis will identify structural factors that facilitate transactional sex and impact refugees’ health. We also intend to engage refugees themselves in ethical digital storytelling to share their lived experiences in their own way. The project fosters the exchange of expertise and mutual learning through a collaborative and participatory approach with NGOs, researchers and refugees themselves.

This study is the first of its kind and with it we hope to generate evidence to inform local and international gender-responsive policies, to train health personnel to better identify cases of transactional sex and to offer appropriate care and improve programmes to address barriers to access appropriate health services.


Research Team

Shirin Heidari
Graduate Institute Geneva

Vinh-Kim Nguyen
Graduate Institute Geneva

Thanasis Tyrovolas
Principal Member
Social Action and innovation Centre (KMOP) Athens


Sophie Durieux-Paillard
Associated Member
Geneva University Hospitals (HUG)

Monica Adhiambo Onyango
Associated Member
Boston University School of Public Health





Policy domains


Host Institution