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Teenage girls in Zimbabwe with much-older sexual partners call them "Sugar Daddies". Tragically, one gift they bring is anything but sweet. Intergenerational sex — consensual or forced sexual relations between vulnerable girls and older men — is driving much of the AIDS epidemic in southern Africa because many of the men are HIV-infected, according to UNAIDS executive director Peter Piot. Experts warn that it is young women who are most at risk in sub-Saharan Africa — they are up to six times more likely than young men to be HIV positive, according to some studies in the region. “It is women and girls who are overwhelmingly the casualties of this scourge, and it's getting worse,” Stephen Lewis, the UN secretary-general's special envoy on AIDS in Africa told the international AIDS conference in Barcelona in July. “It is a nightmare.” Researchers have long suspected that intergenerational sex leads to high rates of infection among African girls, who are also biologically more susceptible to the virus than young men. Now several Zimbabwe-based studies have proved it. A study sponsored jointly by the Universities of Zimbabwe and California found that many teenage girls depend on Sugar Daddies for food, school fees or to satisfy their desire for high-status consumer goods. The study of seventy-one 16 to 19-year-old adolescents of both sexes found that 30-40 per cent of girls have dangerously unequal relationships with older partners. The girls said that the men were often violent if they suggested condom use, or if they refused sex. “[Sugar Daddies] buy you clothes, send you to high school. If you refuse you stay poor. If you take his money and refuse sex, he will rape you,” a 15-year-old girl said. Lead researcher Nancy Padian believes that the underlying cause of intergenerational sex is “largely economic”, which means that an intervention to support schoolgirls' economic self-sufficiency “is an essential element in any plan to stop the spread of HIV”. In Zimbabwe up to 26 per cent of 15 to 24-year-old women are estimated to be HIV positive. But young Zimbabweans wishing to protect themselves from HIV, as well as unplanned pregnancy, are blocked by a confusing and contradictory hodgepodge of laws, policies and customs that prevent them from accessing reproductive services. Health workers routinely turn away unmarried youth seeking dual protection (condoms and hormonal contraceptives), information and services unless parents are notified first. Such parental consent requirements present “almost insurmountable obstacles” for teens, according to a report, State of Denial: Adolescent Reproductive Rights in Zimbabwe, jointly produced by the US Center for Reproductive Law and Policy and the Harare-based Child and Law Foundation (CLF). “Adolescents claimed that it is easier to get an illegal abortion than to get [contraceptive] pills,” says CLF director and co-author of the report Naira Khan. Unable to get hold of condoms, some boys said they resort to useless substitutes such as plastic bread wrappers. The report blames Zimbabwe's youth-unfriendly laws as partly responsible for high rates of pregnancy, unsafe abortion and HIV infection among young people. Current practices also violate teen's human right — as set out in international conventions such the 1994 International Convention on Population and Development — to access private, confidential reproductive care in a country ravaged by AIDS: an estimated 34 per cent of adults are infected with the AIDS virus, according to UNAIDS. Khan blames a culture of consumerism that encourages school girls to choose wealthy men who can satisfy their desire for what are called the “three Cs”: a luxury car, a cell phone and cash to splash around. But for many poor girls — especially those orphaned by AIDS — sex may be their only desperate bargaining chip. More than 780,000 children in Zimbabwe have lost one or both parents, resulting in an increase in youth prostitution as adolescent girls try to fend for their younger siblings. “What choice did I have, both my parents died of AIDS, how was I going to feed the other children?” a young sex worker told State of Denial researchers. Low-income adolescent sex workers are particularly at risk of HIV infection. “Rarely do men put on condoms; others offer an attractive amount of money to do without. If the amount is good, you just take the risk,” another teen sex worker said. Sexually active young people in Zimbabwe are also sexually ignorant, due in large part to the government's reliance on promotion of abstinence until marriage rather than safer sex education by school and health care professionals. “We teach students how to abstain, how to put off sex until marriage. We never talk of condoms,” a representative of the Ministry of Education told researchers. As a result, teens are pitifully misinformed about their own bodies, and do not know how to prevent pregnancy or sexually transmitted infections. Sixty per cent of over 700 teens interviewed wrongly believed that female contraceptives can cause infertility and condoms can "weaken" sperm. Although young people interviewed had some awareness of AIDS, they did not know how to protect themselves. Some held cavalier misconceptions that certain post-sex rituals would protect them; others expressed fatalism, saying HIV infection is inevitable. Worldwide, teenage sexuality is a controversial, often taboo issue for parents, communities, churches and politicians. However, exclusive reliance on “Just Say No” strategies in Zimbabwe have clearly failed to prevent teens from engaging in sex: 30 per cent of 15-19 year-old girls interviewed reported sexual intercourse at least once and close to 40 per cent of girls in Zimbabwe are mothers by the age of 19. Many resort to dangerous illegal abortions: approximately 70,000 unsafe abortions are performed each year. Although the government has not directly commented on the State of Denial report, the Ministry of Education has approved it, while blaming parents and religious leaders for resisting sexuality education and services for young people. The report has challenged the government of Robert Mugabe to institute as a matter of urgency a comprehensive national youth policy so teens can protect themselves. Unfortunately, this may be wishful thinking. Zimbabwe is currently in political, social and economic crisis. The UN estimates that half the population faces severe food shortages. Nonetheless, "It is time to end the state of denial that has undermined adolescents' ability to protect themselves from serious, potentially life threatening health risks," the authors demand.
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