“Sugar Daddy-Marandza” 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

Transactional and intergenerational sexual relationships, often termed "sugar daddy-marandza" 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 "marandza"-originating in Mozambique-as 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.