Why being with an older ‘blesser’ is particularly risky for adolescent girls and young women

Research from South Africa suggests that adolescent girls and young women who are in relationships with ‘blessers’ who are more than five years older than them are more at risk of HIV than their peers.

What is this research about?

HIV risk for adolescent girls and young women in South Africa.

The study involved around 18,900 adolescent girls and young women (ages 12 to 24) from four South African districts. Some were in relationships with ‘blessers’ and/or men who were more than five years older than them.

Blessers are men who give gifts or money in return for a sexual relationship. Adolescent girls and young women use these relationships to enhance their lifestyle, rather than for basic survival.

Participants answered questionnaires and provided blood samples.

Why is this research important?

Adolescent girls and young women are at high risk of HIV in sub-Saharan Africa. One of the things that makes them vulnerable is their relationships with male partners. Understanding whether certain types of relationships put them more at risk of HIV than others is essential for designing effective HIV prevention services that take these different levels of risk into account.

What did they find out?

Most participants (68%) weren’t in a relationship with a blesser or an older partner.

Around one-third (29%) were in a relationship with a partner more than 5 years older. 1% were in a relationship with a blesser only.

1.5% were in a relationship with a partner who was both a blesser and older, or they were with multiple partners who were either blessers or older.

Most participants (79%) used condoms inconsistently.

Around 6% of participants had HIV and 9% had a sexually transmitted infection (STI). The highest HIV and STI prevalence rates were among participants in age-gap and/or blesser relationships.

Participants in relationships with an older blesser, or in multiple relationships with a blesser(s) and an older partner(s), were more likely to have HIV or an STI than participants who had relationships with just a blesser, just an older partner or neither.

They were also more likely to have had 2 or more sexual partners in the previous 12 months, to have had sex at age 15 or younger, and to have been pregnant. They were the least likely to be attending school.

What does this mean for HIV services?

If you are working to prevent HIV among adolescent girls and young women it is important to be aware of the kind of sexual relationships they are in.

To do this, it is essential to build trusting, non-judgemental relationships. Without this, adolescent girls and young women may not feel comfortable enough to open up about their relationships with men and their reasons for having them. Trained peer educators are often effective at building these sort of relationships because they experience similar things.

Helping adolescent girls and young women understand the different risks different relationships carry is important. This will help them weigh up these risks against what they see as their benefits.

The study shows adolescent girls and young women who are not in school are more likely to have relationships with both blessers and older men. This is further evidence that supporting adolescent girls and young women to stay in education is one of the most effective ways to reduce their HIV risk.