A quarterly international newsletter on sexuality, sexual health, and sexuality education.
Volume 3, Issue 2 - Summer 2004
Younger Women, Older Men, and the Spread of HIV in Africa
Cherreka Montgomery, Policy Advocate, International Center for Research on Women
Vanessa Brocato, International Policy Assistant, SIECUS
HIV infection rates for girls, between the ages of 15 and 19, in sub-Saharan Africa are up to six times higher than those of their male peers. In addition to biological factors that render young women more vulnerable to HIV infection, trends in "cross-generational" sex are increasing their risk.
Cross-generational sex generally refers to a sexual relationship in which one person is significantly older than the other.
Overwhelmingly, cross-generational sex is characterized by adult men having sexual relationships with female partners ages 15 to 19. Cross-generational sex can take place outside of marriage or within a marital relationship.
Cross-Generational Sex Increases the Risk of HIV Infection Among Young Women and Girls
The on-going HIV/AIDS pandemic contributes to an environment in which young people, especially girls, have few options. For example, when parents die of AIDS, the eldest girl child often drops out of school in order to support herself and her siblings. These girls, with the responsibility of an entire household and few economic options, become vulnerable to sexual relationships with much older men who can provide them with money, food, or other necessities.
These sorts of relationships have become commonplace in much of Africa, to the point of being described as a "cultural norm."1 A recent study in Kenya found that 25 percent of men over the age of 30 who reported non-marital partners had a partner at least 10 years younger.2 According to the United Nations Population Fund, "in sub-Saharan Africa in particular, girls' early sexual relationships are very likely to occur with men who are considerably older, often in exchange for money or gifts."3
Cross-generational sex leaves young women vulnerable to HIV infection for a number of reasons. First, older men are more likely to have or have had other partners, including spouses, and therefore are more likely to have been exposed to HIV. In fact, many of the men who engage in cross-generational sex do so because they perceive younger girls to be "HIV-free."4
In addition, the power imbalance in these sexual relationships leaves young women unable to negotiate condom use. Research indicates that men tend to control the conditions of sexual intercourse, including condom and contraceptive use.5 For example, girls participating in small discussion groups in South Africa have explained that they would rather give in to their older partners' insistence on not wearing condoms than lose the benefits of the relationship.6 Studies have shown that among young women ages 15-19 in Uganda, the risk of HIV doubles for those with male partners 10 or more years older,7 and in Zimbabwe the risk increases for each year of age difference.8
Abstinence-Until-Marriage Fails to Address the Problem of Cross-Generational Sex
The President's Emergency Plan for AIDS Relief: U.S. Five-Year Global HIV/AIDS Strategy (the U.S. Strategy, also known as PEPFAR) mentions that cross-generational sex is a risk factor for HIV infection for girls in Africa, but the U.S. Strategy fails to insist that country-specific strategies include a substantive focus on this issue.9 In fact, PEPFAR presents abstinence-until-marriage programs as the only acceptable method for unmarried people, and specifically states that condoms are only "appropriate" for narrowly defined "high risk groups," i.e. "prostitutes" and "sero-discordant couples," couples in which one partner is HIV-positive and the other is HIV-negative.10 The assumption seems to be that marriage is risk-free, obscuring the fact that many marriages in Africa are between an adolescent girl and a significantly older man. According to the United Nations Population Fund, the younger the girl is when she marries, the larger this age gap tends to be. In 16 sub-Saharan African countries, husbands of girls 15-19 are on average at least 10 years older.11 The factors that render crossgenerational sex high-risk, such as a greater number of previous partners and an inability on the part of the girl to negotiate safer sex, do not disappear simply because the behavior is happening under the auspices of marriage.
Rather than simply promoting abstinence outside of marriage, the U.S. Strategy should address the broad, underlying societal factors contributing to cross-generational sex.Young women need more life options, including education and job training, and access to a full range of resources to ensure their health and safety. In addition, young women need access to comprehensive sexuality education, and free youth-friendly healthcare. At the same time, older men need to be educated about the dangers of cross-generational sex and HIV-risk avoidance measures. To be effective and reduce the spread of HIV/AIDS in Africa, HIV-prevention programs need to respond to the complexities of the phenomena of cross-generational sex.
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