age-mixing among young women in South Africa Socio-cultural factors in gender power imbalances and age-mixing among young women in South Africa S. Leclerc-Madlala1 & Y. Naidoo2 1USAID, Office of HIV/AIDS, Global Health, Washington D.C., United States 2Human Science Research Council, Durban, South Africa Introduction Across Southern Africa imbalances in HIV prevalence between young women and young men are marked , and age-mixing has been identified as a key factor in young women’s increased risk of infection. A recent study contrasting the sexual behavior of young people in South Africa and the United States revealed that while American youngsters reported riskier behaviors across a range of sexual practices, the exception was South African women’s reportage of greater age-differences with sexual partners. Examining actual patterns of age-mixing in rural KwaZulu-Natal, another study found substantial age gaps in spousal relationships but few cross-generational casual relationships. While these studies and others support calls for programs that alert young women to risks associated with relationships where there are wide age disparities and marked gender power imbalances, they also highlight the need for a sound and nuanced understanding of context and culture to inform relevant programming. To date broad-brush dissemination of information on the hazards of cross- generational sex has been the common programmatic response to the ‘problem’ of age- mixing in South Africa and throughout the region. Programs have been designed with little regard for how young women perceive age-gaps in relationships or the motivations beyond material considerations that prompt them to seek, accept or reject men across the age range. Even less is known of the cultural value placed on age-gaps and gender power imbalances in sexual relationships. A better understanding of these factors is urgently needed to develop maximally effective prevention strategies. Figure 3. Line graph to show ideal age difference between partners Goodlife.com (2012) Conclusions The desire for a slightly older partner with a job, money, and transportation, and a willingness to act as a social mentor by ‘opening doors’ into adult life plays a significant role in shaping HIV vulnerability amongst young women in South Africa. Age-gaps in sexual relationships are important factors in HIV acquisition and possibly the key social determinant of high rates of HIV amongst young women across Southern Africa. While programs that focus on the advantages of restricting or reducing age-gaps are recommended, effective strategies will be those informed by a sound understanding of the cultural logics that pattern power imbalances in relationships where gender and generation are factors. There remains a need for more robust incorporation of the theories, methods and concepts of the social sciences to ensure HIV prevention programs in the region do not continue to miss the mark by failing to resonate with and mobilize those most directly affected. Figure 1. Photograph of young South African woman (18 years old) with boyfriend (25 years old). Used with the permission of Sindile Dlamini. Materials and methods We conducted a focused ethnographic study of socio-cultural factors associated with sexual age-mixing practices in 3 peri-urban communities of KwaZulu-Natal (Figure 2) over a 10 month period in 2011. 65 women between ages 18 and 24 participated in a series of in-depth interviews and guided conversations to explore perspectives on different patterns and degrees of age difference in relationships, gender power dynamics and values held in relation to these. The overall objective was to understand what young women in that province consider as culturally appropriate and desirable power balances in modern day sexual relationships. Literature cited Hertog, S. 2007. Heterosexual behavior patterns and the spread of HIV/AIDS: the interacting effects of rate of partner change and sexual mixing. Sex Transm Dis. 34:820-828. [PubMed:20057320] Leclerc-Madlala, S. 2008. Age-disparate and intergenerational sex in southern Africa: the dynamics of hypervulnerability. AIDS 22:S17-S25. [PubMed: 19033753] Ott, M.Q., Barnighausen, T., Tanser, F., Lurie, M.N., and Newell, M. 2011. Age-gaps in sexual partnerships: seeing beyond ‘sugar daddies’. AIDS 25(6):861-863. Pettifor, A.E., Levandowski, B.A., Macphail, C., Miller, W.C., Tabor, J., Ford, C., Stein C.R., Rees, H., and Cohen, M. 2011. A tale of two countries: rethinking sexual risk for HIV among young people in South Africa and the United States. Adolesc Health. 49(3):237-243 Shisana, O., Simbayi, L.C., Rehle, T., Zungu, N.P., Zuma, K., Ngogo, N, et al. 2010. South African national HIV prevalence,,HIV incidence, behavior and communication survey 2008: the health of our children. Cape Town. Figure 2. KwaZulu-Natal province in South Africa. Results Relationships with men who were between 4 and 8 years older than themselves carried the highest prestige value amongst young women and were viewed as most desirable (Figure 3). These relationships reportedly represented slight but clear power imbalances that favored men. Involvement with a man of similar age or younger was negatively valued, a sign of immaturity and an inability to compete as a woman with other women for the attentions of men. The experience of having sex with an older man was akin to initiation into womanhood, while cross-generational relationships were mostly stigmatized, viewed as mutually exploitive and symbolic of poverty. In South Africa where the basic subsistence needs of young women are largely being met by parents of other adult care takers, it may be more sociologically appropriate to think in terms of sugar-’big brother’ as opposed to sugar-’daddy’ relationships as a more common sexual risk practice. Acknowledgments We thank the young women participants in this study who generously shared their views and experiences regarding age, gender, and power in relationships as well as their thoughts about social change and HIV vulnerability. We hope these findings will be used to develop more relevant and effective prevention strategies and that reflections on HIV risks prompted during the research process have somehow better equipped the participants to protect themselves against disease and exploitation. Presented at AIDS 2012 – Washington, D.C., USA