Sugar daddies 'not riskier'
"Sugar daddies destroy lives", warn posters across KwaZulu-Natal, where the prevalence of HIV is the among the highest in the world.
But new research, which focused on women in Mtubatuba, might dispel the notion that sex with an older man increases a woman's chances of contracting the virus.
The study was presented at the Conference on Retroviruses and Opportunistic Viruses held in Boston, US.
The Africa Centre in Hlabisa followed 4000 women between 2005 and 2012, testing them regularly for HIV and interviewing them about their sexual behaviour.
Guy Harling, a researcher at the Harvard School of Public Health, analysed the data and found that women aged 15 to 29 who were in sexual relationships with men as much as 10 years older did not have a higher risk of contracting HIV than those who had partners their own age.
This finding contradicts the popular belief that one of the drivers of the Aids epidemic in KwaZulu-Natal is older men with more money and power and capable of coercing younger partners into riskier sex.
Money earmarked for prevention of HIV is spent trying to discourage relationships between teenage girls and older men, with Health Minister Aaron Motsoaledi regularly slamming "sugar daddies".
But Harling found there has been a lack of scientific evidence to show that "age-disparate" relationships drive up rates of HIV.
He warned that the men in Mtubatuba - where more than a quarter of adults are HIV-positive - could not necessarily be labelled sugar daddies because poverty was prevalent and many did not have money to offer their young lovers.
Surprisingly, it was found that women aged 30 and older were less likely to contract HIV when they chose partners 10 years older. Harling said it was possible that men over the age of 40 engaged in less risky sexual behaviour.
He warned that the campaigns against sugar daddies could discourage women in their 30s from having older, safer partners.
Researchers do not know why people in KwaZulu-Natal are four times more likely to contract HIV than those in the Western Cape, despite the fact that, according to Harling, "most sexual behaviours don't look different in KZN compared with other provinces".
"Our findings were that HIV infection was not associated with the age disparity in reported relationships in this period, in this setting. We do not claim it doesn't matter anywhere, just that we are not seeing it here," said Harling.
The deputy director of the Wits Reproductive Health and HIV Institute, Francois Venter, who is at the Boston conference, warned that HIV-prevention efforts needed to focus on what was scientifically shown to increase the risk of getting HIV, rather than stopping behaviour that people found morally uncomfortable.