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Transactional sex, the casual exchange of sexual favors for money or gifts, has been associated with negative outcomes and health risks, particularly among youth. This global review of the evidence explores trends of buying and selling sex among the general population of male and female youth across 28 countries. It compares the differences and similarities in prevalence rates between genders (male versus female), sex trading activities (selling versus buying), and country income groups (high-income versus low- and middle-income countries) and examines the relationships and situations surrounding transactional sex, and its correlates. The screening of reports resulted in the inclusion of 37 manuscripts (N = 120,447 participants), involving peer review and grey literature describing longitudinal and cross-sectional research across 7 high-income and 21 low- and middle-income countries. The review …