{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T12:59:04Z","timestamp":1780837144726,"version":"3.54.1"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Transactional and intergenerational sexual relationships, often termed \u201csugar daddy-marandza\u201d dynamics, are a key driver of HIV among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA). This narrative review synthesizes evidence from 29 studies across the region, using the term \u201cmarandza\"\u2014originating in Mozambique\u2014as an illustrative lens to examine a region-wide phenomenon. The review confirms these relationships consistently increase HIV vulnerability due to power imbalances, economic dependency, and patriarchal norms. Poverty, consumerism, and peer pressure propel AGYW into these partnerships, which are characterized by low condom use and limited negotiation power. The findings demonstrate that the issue is rooted in structural inequalities rather than cultural specificity. Digital platforms are increasingly facilitating these transactional encounters. Effective response requires multisectoral, gender-transformative interventions focusing on economic empowerment, social norm change with men and boys, and youth-friendly health services. Future research should evaluate integrated program models and the evolving role of digital technology in reshaping these relationships.<\/jats:p>","DOI":"10.1177\/23259582261457825","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T12:53:56Z","timestamp":1780664036000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cSugar Daddy-Marandza\u201d Dynamics and HIV Vulnerability: A Literature Review of Transactional and Intergenerational Sexual Relationships Among Adolescent Girls and Young Women in Sub-Saharan Africa, With a Focus on Mozambique"],"prefix":"10.1177","volume":"25","author":[{"given":"Miguel","family":"Osorio","sequence":"first","affiliation":[{"name":"Monitoring & Evaluation Unit, CERD (Centro de Estudos de Risco e Desenvolvimento)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9091-3844","authenticated-orcid":false,"given":"Dulce","family":"Osorio","sequence":"additional","affiliation":[{"name":"Research Unit, Tinpswalo Research Association to Fight AIDS and TB, Ch\u00f3kw\u00e8, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7190-6016","authenticated-orcid":false,"given":"Isabelle","family":"Munyangaju","sequence":"additional","affiliation":[{"name":"Research Unit, Tinpswalo Research Association to Fight AIDS and TB, Ch\u00f3kw\u00e8, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teles","family":"Nhanombe","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Unit, Pediatric Adolescent Treatment Africa, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizete Andissene","family":"Matos","sequence":"additional","affiliation":[{"name":"Monitoring &amp; Evaluation Unit, SDSMAS \u2013 Matola: Centro de Sa\u00fade S\u00e3o Damasso, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Chissone","sequence":"additional","affiliation":[{"name":"Sexual and Reproductive Health (SRH) Unit, Secretariado Executivo do Combate ao SIDA, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0617-9609","authenticated-orcid":false,"given":"Edy","family":"Nacarapa","sequence":"additional","affiliation":[{"name":"Research Unit, Tinpswalo Research Association to Fight AIDS and TB, Ch\u00f3kw\u00e8, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2307\/3583175"},{"issue":"9","key":"e_1_3_3_3_2","first-page":"1","article-title":"Sugar dating, perceptions of power, and condom use: Comparing the sexual health risk behaviours of sugar dating to non-sugar dating women","volume":"58","author":"Kirkeby KM","year":"2021","unstructured":"Kirkeby KM, Lehmiller JJ, Marks MJ. 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