Cultural factors crucial in Aids prevention efforts

Cultural factors crucial in Aids prevention efforts
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Published: Sunday, 29 July, 2007, 02:28 AM Doha Time
By Cesar Chelala

NEW YORK: Dr Anthony Fauci, one of the world’s leading Aids scientists, has warned at an international conference on Aids in Sydney, Australia, recently that the world is losing the battle against the virus. He indicated that, to improve the situation, increased emphasis should be placed into prevention efforts, particularly into the social and cultural circumstances that affect the rate in which the pandemic is growing.

One of the cultural factors that have proven to be significant is cross-generational relationships — that is relationships where there are at least a 10-year difference between partners. Unless this problem is properly addressed, it will have significant social and demographic consequences in the regions most affected by it - in Sub-Saharan countries, the Caribbean and the Middle East, among others.

This ‘sugar daddy’ phenomenon , as it is also termed, accounts a much greater prevalence of the HIV infection among teenage girls than among boys. In several African countries, young girls have up to six times the rates of HIV-infection as do boys of similar ages.

In Uganda, according to a government report, 10.3% of women aged 15 to 24 had HIV/Aids, compared with 2.8% of men in the same age bracket.Women, particularly adolescents and young women, are more vulnerable than men to becoming infected with sexually transmitted diseases. One of the reasons is that their reproductive tract tissues are not yet fully developed and therefore are more susceptible to tearing and becoming infected.

What explains the high prevalence of this kind of uneven age relationships between older men and younger women? For one, older men believe that younger women can better satisfy their sexual needs than can older women; and, too, it is a sign of status among their friends to have one or more young girlfriends. In addition, older men believe that younger women are virgins and therefore less likely to be infected.

For young women, taking older men as sexual partners is also a sign of prestige among their peers and a way of paying for luxuries that otherwise they wouldn’t be able to afford, such as mobile phones, clothes and fancy jewelry. In other cases, these relationships provide young women with funds to finance their education.

Many poor families encourage young girls to enter into this kind of relationships in the belief that they will improve their and their family’s economic situations.

This phenomenon clearly illustrates the powerful link between women’s health and women’ empowerment, since young women are frequently unable to negotiate safe sexual relationship with older, more powerful men.

For example, in traditional African societies, because of the respect due to their elders, it is difficult for young women to reject advances by older men. This also places young women at a disadvantage in terms of demanding that their partners use condoms.

The reluctance by men, both young and old, to use condoms is one of the main reasons that fuel the HIV/Aids epidemic. It has been demonstrated that the older the man is with regard to his female companion and the more money it gives her, the less likely he is to use condom. Studies have also shown that the greater the age difference between partners, the more frequent is the practice of unsafe sexual behaviours.

There are many activities now being conducted across Africa to deal with this phenomenon, some of them with the collaboration of the clergy — a critical ally in the fight against HIV/Aids. There are mass communication campaigns to help create a stigma against this kind of relationship. There are also a wide range of education activities aimed at empowering young women by providing them with life skills, micro-credit loans and vocational training.These initiatives should be reinforced through outreach activities with NGOs working in the field to train local health workers to recognise this issue and help address it within their communities. At the same time, there should be increased co-operation between the ministries of health and education to improve the health curricula in schools and to sensitise members of parliament to pass legislation in those countries that have no laws addressing the seduction of minors.

Although many countries have such legislation, it is seldom enforced. Prevention of cross generational sex should be an important part of Aids prevention efforts. Because of its devastating effects on young women, sugar daddy relationships have proven to be anything but sweet.

* Cesar Chelala, an international public health consultant, is the author of Aids: A Modern Epidemic, a publication of the Pan American Health Organisation.