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Women engaging in transactional sex, defined as \u2018non\u2010commercial sexual relationships motivated by the implicit assumption that sex is exchanged for material support\u2019, are thought to share similar economic incentives as women engaging in commercial sex. Using a panel of up to six sex acts from longitudinal datasets stratified by FSWs and women engaging in transactional sex in Cameroon, we provide evidence consistent with literature of a 30% condomless risk\u00a0premium for FSWs. We then provide the first empirical evidence of a discount for condomless sex of 14% for women engaging in transactional sex. Qualitative analysis offers two explanations for this surprising finding, first a lack of HIV awareness among women engaging in transactional sex, and second, that risky sex acts are a demonstration of investment of trust in relationships and represent unobservable exchange of value. Given the larger number of women engaging in transactional relationships compared to FSWs in sub\u2010Saharan Africa, and their lower awareness of HIV risks, this finding offers a significant explanation for the disproportionate burden of HIV incidence among adolescents and young women in sub\u2010Saharan Africa.<\/jats:p>","DOI":"10.1002\/hec.4964","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T07:13:36Z","timestamp":1749798816000},"page":"1474-1486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Does the Risk Premium Differ Between Women Engaging in Commercial and Transactional Sex? Evidence From Urban Cameroon"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2378-3215","authenticated-orcid":false,"given":"Rebecca G.","family":"Njuguna","sequence":"first","affiliation":[{"name":"Health Economics Research Centre Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Cust","sequence":"additional","affiliation":[{"name":"Centre for Global Health Economics Institute for Global Health University College London  London UK"},{"name":"Sanford School of Public Policy Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The POWER Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9237-2914","authenticated-orcid":false,"given":"Aur\u00e9lia","family":"L\u00e9pine","sequence":"additional","affiliation":[{"name":"Centre for Global Health Economics Institute for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467\u20109566.2011.01400.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3368\/JHR.48.2.345"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0212315"},{"key":"e_1_2_11_5_1","volume-title":"Ministry of Health (MOH), Division of Health Operations Research (DROS). 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