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In sub-Saharan Africa, young women who engage in transactional sex the exchange of sex for money or gifts with a male partner show an elevated risk of prevalent HIV infection. We analyse longitudinal data to estimate the association between transactional sex and HIV incidence. We used longitudinal data from a cohort of HIV-negative young women aged 13—20 years enrolled in a randomized controlled trial in rural, South Africa who were followed for up to four visits over 6 years. The effect of transactional sex on incident HIV was analysed using stratified Cox proportional hazards models and cumulative incidence curves. Risk ratios were estimated using log-binomial models to compare the effects across visits. HIV incidence was higher for young women that reported transactional sex hazard ratio 1. We also find that effects were much stronger during the main trial and dissipate at the postintervention visit, despite an increase in both transactional sex and HIV.