According to a recent study, school-age girls in South Africa are 3 times as likely to be HIV positive as boys the same age.
What is the cause of this disparity? From anecdotal accounts, interviews and our study of the context, we learned about three societal constructs that may offer clues to the answer:
These beliefs cause dangerous behaviors. If one has to reciprocate gifts with sex, then older men with higher incomes and jobs are more able to afford sexual partners. If having multiple partners proves your manhood, then these older men feel pressured to have multiple casual girlfriends. And if younger girls are perceived to be less likely to have HIV (and perhaps even able to cure HIV), then these older men seeking multiple partners are looking for young girls. All this results in the widespread prevalence of what are known as “intergenerational relationships”.
Such intergenerational relationships are thus at least partly responsible for the high prevalence of HIV among young women. When you sleep with an older man, you in effect sleep with all the people he has slept with and their partners. When you multiply by how many sexual partners a “sugar daddy” has had in his younger days, how many his wife has had, how many people he’s currently sleeping with, and how many people his partners are sleeping with, you quickly see that the chances of him having HIV – and transmitting it to his partners – grows exponentially.
But when we conducted focus groups in the field, we found that many young girls don’t think about it this way. They perceive boys their age as promiscuous, and older men as more serious. They see the gifts, the money, the car rides, and the restaurants, which they interpret as signs of commitment and love. And if young girls are told that they’re the only one, how can they see the other casual partners, who are just as hidden as they are?
Because these relationships are often concealed from the public eye, it is difficult to know how to effectively target these girls to help them make healthier choices. And the campaigns that try to do so can backfire. Anti-sugar-daddy billboards used in international settings have portrayed girls receiving gifts, attention, cars, and fancy clothes from their sugar daddies, inadvertently sending girls the message that sugar daddies are desirable. (For a detailed review of previous campaigns, see our advisory packet).
We are currently working with the Western Cape Government on a campaign to raise risk awareness and reduce the incidence of intergenerational relationships. Following our process, we’ve learned from previous campaigns, delved into the specific context of South Africa and applied our methodology to try to come up with an appropriate response.
First, we thought hard about the problem definition (read about how we define a problem). Many of the previous campaigns assumed that providing more information was the solution, which led to an unproductive problem definition: “How do we inform girls that sugar daddies are dangerous?” However, this type of information is unlikely to change behavior, since asking present-biased human beings to focus on potential long-term costs rather than the short-term benefits is like asking them to roll up a hill.
Taking the lessons from these campaigns, we approached our problem definition differently. First, we did not want to assume a solution a priori. Second, we did not want to limit the target audience to just girls, because we do not believe they should be held solely responsible. Third, we know that while changing human nature is impossible, we could change the context in which decisions are made. Previous studies found that changing people’s perception of what others around them believe (or injunctive norms) is highly effective in changing their behavior. As such, we redefined the problem to: “How can we change the perceived social desirability of intergenerational relationships?”
From this problem definition we generated some potential hypotheses for why young women choose to be in intergenerational relationships, and refined them in the course of several conversations with young girls. We found that it is hard for young women, particularly those who are socio-economically disadvantaged, to say no to the immediate benefits sugar daddies provide. In addition, many people are confused about the relationship between age and HIV risk. But we also found that young women want to resist the advances of sugar daddies, and are looking for tools to help them.
Empowered by this diagnosis, we designed two interventions to try to empower girls to make healthier choices and bring the community up to speed on how to help. We conducted initial testing of one of our interventions with Western Cape schoolgirls and are in the process of conducting follow-up. We look forward to updating you on our progress, and to seeing our potential impact on the beliefs, attitudes, choices and opportunities of schoolgirls in South Africa.