When Sandra Tembo walk to market vegetables Mbare Harare, the Zimbabwe, it passes a display panel: "your future is brighter without a sugar daddy," he said. Tembo, a student of couture 20 years, said some friends "realize the risk" that comes with the relations of sugar daddy, that are common in sub-Saharan Africa and involve young girls who have sex with older men in exchange for gifts and cash. "But they say be broken all the time also has its hazards, as you could die of starvation."
With prostitution and promiscuity, sugar daddy arrangements are fueling the AIDS epidemic in sub-Saharan Africa. Older men have a much higher HIV prevalence than their younger cohorts. In the Zimbabwe, for example, less than 5% of men aged 15-19 test positive for HIV, while the number soars to about 30 percent for 30-to-34-years, according to the United States Agency for International Development.
The World Bank is now proposing to pay the girls as a way to keep school and prevent AIDS. In a study that began in 2008 in Malawi, where about one in eight adults has disease, the Bank paid a group of girls for $10 per month in average, more money for the fresh school if they regularly attended class. A year and a half after the start of the program, the rate of infection of girls was 60 per cent below the rate of a control group received no payment: 1.2%, compared to 3%. Recipients also had partners sexual and younger, the report of the World Bank.
Experts say that although girls were not explicitly required to refrain from sugar daddy relationships, cash payments helped avoid the temptation to take donations from older partners, which was on average $ 6.50 per month for girls who have participated in the study of Malawi. "Because they got money, they did not need to interact with older men," says Mayra Buvinic, Director of the World Bank gender and development. Buvinic says that the payments are the first biomedical approach to the prevention of AIDS that he knows of who had a "significant impact" on the decline in the prevalence of HIV in Africa.
Distribution of money for the less wealthy in exchange for certain commitments - such as keeping children in school or doing regular medical examinations - a tactic that has been used successfully in the countries of the Mexico to the Brazil. Cash can be the "ethical policy instrument" of the 21st century, said Mead Over, a health economist at the Center for Global Development, a Washington research organization. Another study by the World Bank in Tanzania paid cash to participants, when they proved to be negative for a group of sexually transmitted diseases
Some aid agencies and health experts say that approach could the opposite effect. Peter r. Lamptey, a Ghanaian physician at the level of Family Health International non-profit group, argues that most African countries cannot cash paid tickets. "Incentives medical are not for us," he said. "You can keep them in Washington." We could eventually create a dependency that cannot be sustained. ?
There is also a non-monetary item to sugar daddy relationships, for cash payments only end is not them. Rosemary Zulu, who teaches the sexual and reproductive health for development Restless non-profit London-based remembers married men how in his native Zambia would go to school and lavish gifts of clothing, mobile phones and cash on their paramours teen. "Be a teenager very hard" to resist the pressure to accept donations, said Zulu, 26. Sophie Harman, lecturer in international politics at the City University of London, adds: "Paying people to influence their sexual behaviour will solve wider problems of abuse, self-esteem, negligence and inequality that cause to get HIV."
The bottom line: Cash paid tickets can be the first successful non-biomedical approach to reduce the prevalence of HIV in sub-Saharan Africa.
Clark is a reporter for Bloomberg News.
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