Patron-client ties and a moral obligation to support the needy are central to African social life, and are usually understood as operating in a very different realm than the exchange of sex for material support that Western observers have labeled "transactional sex." Claimed by some to be a major driver of the AIDS epidemic in sub-Saharan Africa, transactional sex is described as akin to prostitution, a degraded form of sexual expression forced on vulnerable women by economic desperation. Based on evidence from rural Malawi, we argue that the exchange of sex for money is better understood as one of the many ties of unequal exchange in which Malawians and other Africans engage, an exchange in which the patrons are as important as the clients.