Transactional sex among university women in Kampala, Uganda, is a significant risk factor for HIV acquisition. Pre-exposure prophylaxis (PrEP) is a key prevention tool, yet adherence remains suboptimal. Structural interventions combining economic support with social empowerment are hypothesised to address these intertwined issues, but evidence from the local context requires synthesis. This systematic review aimed to synthesise evidence on the effect of a six-month cash-plus-social-empowerment intervention on reducing transactional sex and improving PrEP adherence among university-attending young women in Kampala, Uganda. A systematic search of peer-reviewed literature was conducted across major electronic databases. Studies were included if they evaluated a combined cash and empowerment intervention, focused on the specified population and outcomes, and were published in English. Data extraction and quality assessment were performed independently by two reviewers. No primary empirical studies meeting the full inclusion criteria were identified. The search revealed a critical evidence gap regarding the specific six-month, cash-plus-empowerment model for this population in Kampala. Available related literature highlighted the complex interplay between financial precarity, gender norms, and healthcare engagement, suggesting the potential relevance of such integrated approaches. There is a notable absence of direct evidence evaluating the specified intervention. This gap underscores the need for targeted primary research to inform programming aimed at reducing HIV risk through structural approaches for university women in this setting. Future research should prioritise robust, mixed-methods studies to develop and evaluate contextually tailored cash-plus-empowerment interventions. Programme planners should consider piloting such integrated models while embedding rigorous implementation science frameworks to generate evidence. HIV prevention, pre-exposure prophylaxis, structural intervention, economic empowerment, young women, sub-Saharan Africa, higher education This review consolidates the current knowledge state, definitively identifies a critical research gap, and provides clear directions for future primary research and programme development targeting this high-risk population.
Akello et al. (Sun,) studied this question.