**Intergenerational Sexual Relationship in Nigeria: Implications for Negotiating Safe Sexual Practices**

Oyediran, K.A., Odutolu, O. and Atobatele, A.O. *MEASURE Evaluation/JSI, World Bank/Nigeria and USAID/Nigeria Nigeria* 

#### **1. Introduction**

48 Social and Psychological Aspects of HIV/AIDS and Their Ramifications

World Health Organization [WHO]. (2003). *Adherence to long-term therapies: Evidence for* 

*action*. WHO, ISBN 92 4 154599 2, Switzerland

1090-1981

women. *Health Education & Behavior*, Vol.27, No.5, (October 2000), pp. 539-565, ISSN

In Nigeria, young people aged 15-24 years old contribute significant number to the new HIV infections with the majority of those infections occurring in young women and girls. From NARHS 2007, HIV prevalence rate among young women is approximately 2.5 times that of young men within the age group. This disproportionate rate of HIV infection in young women is similarly found in many other countries in sub-Saharan Africa. For instance, data show that in general young women age 15-24 in sub-Saharan Africa are three times more likely to be infected with HIV than young men of the same age (UNAIDS, 2006). In Zambia and Zimbabwe, young women are four and five times respectively more likely to have HIV infection compared to their male counterparts (UNAIDS 2004). While biological factors may account for women's greater susceptibility to HIV; the difference is marked and cannot be explained on the basis of biology alone. It therefore raises the question of differences in sexual behaviour among the group within the context of cultures; lifestyle; and structural and environmental factors. As a result of this alarming HIV infection, the sexual behavior of this population is of great public health concern.

Within this premise and in order to understand the sexual behaviour of young women, intergenerational sex has been widely explored in literature. There is clear empirical evidence that age-mixing between young women and older men plays an important role in the differences in the observed epidemiological pattern (Gregson et al., 2002). Studies indicate that relationships between young women and older men are common in many parts of sub-Saharan Africa and are significantly related with unsafe sexual behaviour and increased vulnerability to HIV infection (Glynn et al., 2001; Kelly et al., 2003; Longfield et al., 2004). For instance, Langeni (2007) in the study of 800 men in Botswana found that for every year's increase in the age difference between partners there was a 28 percent increase in the odds of having unprotected sex. Similar studies reveal that such relationships are largely premised upon material gains, the greater the economic asymmetries between partners and the greater the value of a gift, service, or money exchanged for sex, the less likely the practice of safer sex (Luke, 2003; Wojciki, 2005). In this regard, intergenerational sex is similar to transactional sex because sex is exchanged for money and other materials, but the concept of intergenerational sex is clearly differentiated from commercial sex or

Intergenerational Sexual Relationship in Nigeria:

*(Moore and Biddlecom 2007)* 

woman who was 15 years younger than her partner:

**2.1 Reasons for engaging in intergenerational sex** 

*'He would pick me from home secretly and take me for film shows in town. I would always lie to my mother that I had gone to my Auntie's place and would spend nights with him. At the end of it all he asked me to show him that I loved him by having sex with him and I complied. I could not refuse because I was ashamed of all the things he had done for me.'* 

practice has continued to thrive despite the risk of STI and HIV infection.

observed that the man is not interested in marriage (McLean, 1995).

Implications for Negotiating Safe Sexual Practices 51

power to negotiate condom use is often compromised by age disparities and economic dependence. Young women have reported that they often cannot insist on safe sex practices, and doing so would jeopardize their economic goals in the relationships (Glynn, et. al., 2001; Luke, 2005; Longfield, et. al., 2004). According to a 17 year old out of school Ugandan young

The young women oblige to have sex within the relationship more out of a feeling of 'pay back' or appreciation of what the man has done or being in a position to meet his needs, more or else taking responsibility to please him. Men are also known to threaten to abandon the young women for another. The next section explores these and other reasons why the

Several qualitative and few small-scale quantitative studies have explored factors luring young girls to engaging in intergenerational sexual relations in sub-Saharan Africa. Studies from Cameron, Kenya, Nigeria, Tanzania, Ghana, Swaziland and Uganda among others find that young women engage in sexual relationship with older partners for economic survival; funds to cover education-related expenses; enhanced status and connections in social networks; improved life opportunities and options; security; love and probably the option of marriage(Calves et al., 1996; Weiss et. al., 1996; Komba\_Malekela and Lijestorm, 1994; Nyanzi, et. al., 2000; Akuffo, 1987; Stavrou and Kaufman, 2000; Gage, 1998; Orubuloye, et. al., 1992; Meekers and Calves, 1997). Scholars have documented that girls are motivated to engage in sexual relations with older partners due to their perceived view that older men are marriageable types and more likely to marry or support them in case of unintended pregnancy (Weiss, et. al., 1996; Komba-Malekela and Liljestrom, 1994; Nyanzi, et. al., 2000; Gorgen, et. al., 1998). Also of significant importance is the fact that parents often pressurize girls to form relationships with older, established partners that may lead to marriage – or at least where the partner can support their daughter if she becomes pregnant unintentionally (Gage, 1998). As shown by other studies, parents could indirectly encourage the relationship by warning their daughters not to bear a poor boy's child (Gorgen, et. al., 1998; Gorgen, et. al., 1993). On the other hand, parents disapprove of girls' relationship with older men when

A study conducted in Swaziland among girls 14 years and older reported that 20 percent of the girls reported being sexually active because of financial reasons (McLean, 1995). Another study in rural Tanzania found that 52 percent of female primary school students and 10 percent of female secondary school students reported that the reason for having sex was for money or presents (Matasha, et. al., 1998). In addition, in a study in rural Ghana, the majority of both in-school and drop-out girls admitted that the most important reason for having boyfriends was financial, and a further one-third said the reason was for the purchase of clothing and other goods (Akuffo, 1987). With respect to economic survival,

prostitution. The former is based on material support mainly through relationships with 'sugar daddy or sugar mummy' (Moore & Biddlecom, 2006).

### **2. Intergenerational sex**

Intergenerational sex is similarly referred to as cross-generational sex or age-mixing or agedisparate relationships in literature. It is a pattern of sexual behaviour between young women and older men within or outside of marriage. The term suggests wide variation in the ages of the partners with the men being commonly the older partner. The phenomenon is observed also between young men and older women; but this is less common, less overt and has not been linked with high HIV prevalence among the young men. Intergenerational sex has been more clearly defined, within both the UNAIDS general population survey and the Demographic and Health Surveys (DHS) AIDS modules, as '*Young women ages 15 to 19 who "have had non-marital sex in the last 12 months with men who are 10 or more years older than themselves."* But the definition is being expanded to include sexual relationships in which the age difference between the partners is only five years by other researchers. This revision is based on the observation that having sexual relations with a man only five years older has been clearly associated with increased risk of HIV in girls.

The practice of intergeneration sex is pervasive and is inherent in many cultures and traditions. Although, intergenerational sex is not limited to sub-Saharan Africa, the high prevalence of HIV infection in the region, especially among young adults, has led to studying behaviours that are associated with increased incidence thus making most available data on the practice to be in the region as it is associated with a higher risk of HIV infection. Furthermore, relationships between young women and older men are considered to be the norm in some cultural contexts. However, women in sexual relationships with older male partners have been found to have poor reproductive outcomes, including increased risk for HIV infection (Kelly, et. al., 2003; Gregson, et. al., 2002; Jewkes, et. al., 2002). Dissassortive sexual age mixing patterns can provide entryway for HIV and STIs into the younger generation (Jewkes, et. al., 2002). In the context of poverty and gender inequality, intergenerational sex often involves sex in exchange for money or goods and characterised by less condom use and greater sexual coercion (Gregson, et. al., 2002; Luke, 2005; Longfield, et. al., 2004). The risks associated with intergenerational sex may be, in part, due to the power imbalances between the partners (Blanc, 2001; Mensch and Lloyd, 1998). Particularly if a young woman is dependent on an older man for financial support, she may have little power to negotiate safe sex (Luke and Kurz, 2002). Furthermore, in instances where a young woman does assert herself, she may face sexual and physical violence (Kaufman and Stavrou, 2002; Wood, Maforah and Jewkes, 1998).

Several factors have been identified within age-mixing relationships that increase the risk of sexually transmitted infections (STIs) and HIV infection. Firstly, for both partners *risk perception* is often very low. According to Longfield et al. (2004), men in Kenya often report a preference for young sexual partners, basically because they are adjudged more likely to be free from HIV infection. While in South Africa, young women viewed older men in much the same way; as 'safe' partners because they appear to be less risk-taking, more stable and more responsible (Leclerc-Madlala, 2003). Young women are also found to be more concerned about the risk of becoming pregnant or of being 'found out' in their relationships with older men, than of STI or HIV (Silberschmidt and Rasch, 2000; Jones, 2006; Nkosana and Rosenthal, 2007). Secondly, in this relationship of unequal partners, young women's

prostitution. The former is based on material support mainly through relationships with

Intergenerational sex is similarly referred to as cross-generational sex or age-mixing or agedisparate relationships in literature. It is a pattern of sexual behaviour between young women and older men within or outside of marriage. The term suggests wide variation in the ages of the partners with the men being commonly the older partner. The phenomenon is observed also between young men and older women; but this is less common, less overt and has not been linked with high HIV prevalence among the young men. Intergenerational sex has been more clearly defined, within both the UNAIDS general population survey and the Demographic and Health Surveys (DHS) AIDS modules, as '*Young women ages 15 to 19 who "have had non-marital sex in the last 12 months with men who are 10 or more years older than themselves."* But the definition is being expanded to include sexual relationships in which the age difference between the partners is only five years by other researchers. This revision is based on the observation that having sexual relations with a man only five years older has

The practice of intergeneration sex is pervasive and is inherent in many cultures and traditions. Although, intergenerational sex is not limited to sub-Saharan Africa, the high prevalence of HIV infection in the region, especially among young adults, has led to studying behaviours that are associated with increased incidence thus making most available data on the practice to be in the region as it is associated with a higher risk of HIV infection. Furthermore, relationships between young women and older men are considered to be the norm in some cultural contexts. However, women in sexual relationships with older male partners have been found to have poor reproductive outcomes, including increased risk for HIV infection (Kelly, et. al., 2003; Gregson, et. al., 2002; Jewkes, et. al., 2002). Dissassortive sexual age mixing patterns can provide entryway for HIV and STIs into the younger generation (Jewkes, et. al., 2002). In the context of poverty and gender inequality, intergenerational sex often involves sex in exchange for money or goods and characterised by less condom use and greater sexual coercion (Gregson, et. al., 2002; Luke, 2005; Longfield, et. al., 2004). The risks associated with intergenerational sex may be, in part, due to the power imbalances between the partners (Blanc, 2001; Mensch and Lloyd, 1998). Particularly if a young woman is dependent on an older man for financial support, she may have little power to negotiate safe sex (Luke and Kurz, 2002). Furthermore, in instances where a young woman does assert herself, she may face sexual and physical violence

Several factors have been identified within age-mixing relationships that increase the risk of sexually transmitted infections (STIs) and HIV infection. Firstly, for both partners *risk perception* is often very low. According to Longfield et al. (2004), men in Kenya often report a preference for young sexual partners, basically because they are adjudged more likely to be free from HIV infection. While in South Africa, young women viewed older men in much the same way; as 'safe' partners because they appear to be less risk-taking, more stable and more responsible (Leclerc-Madlala, 2003). Young women are also found to be more concerned about the risk of becoming pregnant or of being 'found out' in their relationships with older men, than of STI or HIV (Silberschmidt and Rasch, 2000; Jones, 2006; Nkosana and Rosenthal, 2007). Secondly, in this relationship of unequal partners, young women's

'sugar daddy or sugar mummy' (Moore & Biddlecom, 2006).

been clearly associated with increased risk of HIV in girls.

(Kaufman and Stavrou, 2002; Wood, Maforah and Jewkes, 1998).

**2. Intergenerational sex** 

power to negotiate condom use is often compromised by age disparities and economic dependence. Young women have reported that they often cannot insist on safe sex practices, and doing so would jeopardize their economic goals in the relationships (Glynn, et. al., 2001; Luke, 2005; Longfield, et. al., 2004). According to a 17 year old out of school Ugandan young woman who was 15 years younger than her partner:

*'He would pick me from home secretly and take me for film shows in town. I would always lie to my mother that I had gone to my Auntie's place and would spend nights with him. At the end of it all he asked me to show him that I loved him by having sex with him and I complied. I could not refuse because I was ashamed of all the things he had done for me.' (Moore and Biddlecom 2007)* 

The young women oblige to have sex within the relationship more out of a feeling of 'pay back' or appreciation of what the man has done or being in a position to meet his needs, more or else taking responsibility to please him. Men are also known to threaten to abandon the young women for another. The next section explores these and other reasons why the practice has continued to thrive despite the risk of STI and HIV infection.

#### **2.1 Reasons for engaging in intergenerational sex**

Several qualitative and few small-scale quantitative studies have explored factors luring young girls to engaging in intergenerational sexual relations in sub-Saharan Africa. Studies from Cameron, Kenya, Nigeria, Tanzania, Ghana, Swaziland and Uganda among others find that young women engage in sexual relationship with older partners for economic survival; funds to cover education-related expenses; enhanced status and connections in social networks; improved life opportunities and options; security; love and probably the option of marriage(Calves et al., 1996; Weiss et. al., 1996; Komba\_Malekela and Lijestorm, 1994; Nyanzi, et. al., 2000; Akuffo, 1987; Stavrou and Kaufman, 2000; Gage, 1998; Orubuloye, et. al., 1992; Meekers and Calves, 1997). Scholars have documented that girls are motivated to engage in sexual relations with older partners due to their perceived view that older men are marriageable types and more likely to marry or support them in case of unintended pregnancy (Weiss, et. al., 1996; Komba-Malekela and Liljestrom, 1994; Nyanzi, et. al., 2000; Gorgen, et. al., 1998). Also of significant importance is the fact that parents often pressurize girls to form relationships with older, established partners that may lead to marriage – or at least where the partner can support their daughter if she becomes pregnant unintentionally (Gage, 1998). As shown by other studies, parents could indirectly encourage the relationship by warning their daughters not to bear a poor boy's child (Gorgen, et. al., 1998; Gorgen, et. al., 1993). On the other hand, parents disapprove of girls' relationship with older men when observed that the man is not interested in marriage (McLean, 1995).

A study conducted in Swaziland among girls 14 years and older reported that 20 percent of the girls reported being sexually active because of financial reasons (McLean, 1995). Another study in rural Tanzania found that 52 percent of female primary school students and 10 percent of female secondary school students reported that the reason for having sex was for money or presents (Matasha, et. al., 1998). In addition, in a study in rural Ghana, the majority of both in-school and drop-out girls admitted that the most important reason for having boyfriends was financial, and a further one-third said the reason was for the purchase of clothing and other goods (Akuffo, 1987). With respect to economic survival,

Intergenerational Sexual Relationship in Nigeria:

**Country, Year of DHS** 

Source: DHS Reports ORC MACRO

recommendations.

**3. Methods** 

Table 1. Recent DHS Surveys on intergenerational sex

Implications for Negotiating Safe Sexual Practices 53

countries shown in a table 1 below. Significantly there is the practice of early marriage in the northern part of the country and more often than not the young women are married to men who are much older than themselves. In general terms the practice is cultural; so also is polygamy. Could it be a situation of double jeopardy? Unfortunately, the subject has not

> **Percentage of sexually active women aged 15-17 with partner at least 10 years older in the past year**

**Ghana 2003** 1.7 7.9 **Nigeria 2003** 21.3 4.2 **Malawi 2004** 0.9 2.4 **Tanzania 2004** 4.9 7.8 **Lesotho 2004** 7.5 7 **Uganda 2004-2005** 9.4 9.9

Consequently, there is a knowledge gap on the spread of the practice; factors promoting the practice; the ability of the young women to negotiate safe sex and HIV infection in the age group. Hence, understanding the underlying factors and prevalence of the intergenerational sex is a priority study for Nigeria. The main thrust of this paper is to examine the prevalence of, and factors associated with intergenerational sexual relationship among young women aged 15 – 24 years and examine the implications of the practice on safe sex and HIV infection. The study will analyze the 2008 Nigeria Demographic and Health Survey (NDHS) to explore the relationship between young women's individual socio-demographic attributes and behaviour. Lastly, the paper will proffer programmatic and policy

This study used data from the 2008 Nigeria Demographic and Health Survey (NDHS), which was carried out by ORC Macro and the National Population Commission. The sample was selected using a stratified 2-stage cluster design consisting of 888 clusters taken from a list of enumeration areas developed for the 2006 Population Census. A nationally representative probability sample of 36,800 households was then selected from the clusters, with a minimum target of 950 completed interviews per state, in which all women aged 15 to 49 years were eligible to be interviewed. The men's questionnaire was administered to all men aged 15 to 59 years in a sub-sample of half of the households. The survey collected information between June and October 2008. The data are intended to furnish program

**Percentage of sexually active women aged 18-19 with partner at least 10 years** 

**older in the past year** 

been well researched as to its implication on STI and HIV infection.

**RECENT DHS SURVEYS ON INTERGENERATIONAL SEX** 

evidence from several studies indicates that many girls need resources from older men for basic needs or in times of economic crisis (MacPhail and Campbell, 2001; Stavrou and Kaufman, 2000; Feldman et. al., 1997). For instance, scholars reported that parents may directly pressurize their daughters to enter into relationships with older, well-off men because they demand assistance from their children, including the money given to girls by their older partners (Gage, 1998; Komba-Malekela and Liljestrom, 1994). Furthermore, numerous studies point to adolescent girls' motivations to secure life opportunities and enhance long-term goals of higher economic status and security through their involvement with older partners. Stavrou and Kaufman (2000) and Abang (1996) reported that some young women engage in relations with older partners to help pay for tuition, living expenses, university housing, clothes and food. Scholars further observed that older partners of young women help them to meet prestigious people and establish themselves in an occupation or career (Gage, 1998; Meekers and Calves, 1997a, 1997b; Orubuloye, et. al., 1992).

Evidence from a few relatively small-scale quantitative studies indicated that sociodemographic attributes could be used to explain the context of cross-generational sex. In Lesotho, an important finding is that there is a strong relationship between wealth index and urban-rural residence and the likelihood of engaging in intergenerational sexual partnerships: women in lower wealth quintiles and in rural areas are more likely than others to engage in cross-generational partnerships (ORC, Macro, 2007).

#### **2.2 Intergenerational sex and HIV infection**

Evidence from the literature clearly links intergeneration sex with high HIV infection in young women. Young women who engage in sexual relationship with older men are more likely to have HIV infection compared to their male counterparts who do not. A study in rural Rakai, Uganda (Kelly, et. al., 2001) analyzed the relationship between HIV prevalence and the age of adolescent girls' primary sexual partner, whether marital or non-marital. In a multivariate analysis, among girls aged 15 -19, the adjusted relative risk of HIV infection doubled among those reporting a most recent sexual partner 10 or more years older, compared to those with partner 0-4 years older. Among young women 20 – 24, the adjusted relative risk of HIV infection was 24 percent greater, and among young women aged 25 – 29, it was 9 percent lower. Additional results suggest that 12.4 percent of the HIV prevalence in girls aged 15 – 19, and 5.1 percent in young women aged 20-24, can be attributed to relationships with men 10 or more years older, largely within marital relationships. Another study in rural Zimbabwe (Gregson, et. al., 2002) also finds a significant positive effect of age difference, with most recent marital or non marital partner; on HIV infection for all adolescents aged 17 – 24. In a multivariate analysis, the authors conclude that a one-year increase in age difference between partners is associated with a 4 percent increase in the risk of HIV infection. In a related analysis of the effect of age difference between partners in town urban cities in Africa: Kisumu, Kenya and Ndola, Zambia, Glynn et. al. (2001) find a significant positive association between larger age difference with husband and HIV infection. The authors reported that for girls with less than a four-years age difference with their husbands, none are infected with HIV, whereas 38 percent in Kisumu and 34 percent in Ndola are infected if the age difference with their husbands is four years or greater.

In the Nigerian context, there are empirical evidences of intergenerational sexual relationships; the 2003 DHS reported that the prevalence of intergenerational sex among girls aged 15-17 years is 21.3% percent. This represents the highest prevalence among the

evidence from several studies indicates that many girls need resources from older men for basic needs or in times of economic crisis (MacPhail and Campbell, 2001; Stavrou and Kaufman, 2000; Feldman et. al., 1997). For instance, scholars reported that parents may directly pressurize their daughters to enter into relationships with older, well-off men because they demand assistance from their children, including the money given to girls by their older partners (Gage, 1998; Komba-Malekela and Liljestrom, 1994). Furthermore, numerous studies point to adolescent girls' motivations to secure life opportunities and enhance long-term goals of higher economic status and security through their involvement with older partners. Stavrou and Kaufman (2000) and Abang (1996) reported that some young women engage in relations with older partners to help pay for tuition, living expenses, university housing, clothes and food. Scholars further observed that older partners of young women help them to meet prestigious people and establish themselves in an occupation or career (Gage, 1998; Meekers and Calves, 1997a, 1997b; Orubuloye, et. al.,

Evidence from a few relatively small-scale quantitative studies indicated that sociodemographic attributes could be used to explain the context of cross-generational sex. In Lesotho, an important finding is that there is a strong relationship between wealth index and urban-rural residence and the likelihood of engaging in intergenerational sexual partnerships: women in lower wealth quintiles and in rural areas are more likely than others

Evidence from the literature clearly links intergeneration sex with high HIV infection in young women. Young women who engage in sexual relationship with older men are more likely to have HIV infection compared to their male counterparts who do not. A study in rural Rakai, Uganda (Kelly, et. al., 2001) analyzed the relationship between HIV prevalence and the age of adolescent girls' primary sexual partner, whether marital or non-marital. In a multivariate analysis, among girls aged 15 -19, the adjusted relative risk of HIV infection doubled among those reporting a most recent sexual partner 10 or more years older, compared to those with partner 0-4 years older. Among young women 20 – 24, the adjusted relative risk of HIV infection was 24 percent greater, and among young women aged 25 – 29, it was 9 percent lower. Additional results suggest that 12.4 percent of the HIV prevalence in girls aged 15 – 19, and 5.1 percent in young women aged 20-24, can be attributed to relationships with men 10 or more years older, largely within marital relationships. Another study in rural Zimbabwe (Gregson, et. al., 2002) also finds a significant positive effect of age difference, with most recent marital or non marital partner; on HIV infection for all adolescents aged 17 – 24. In a multivariate analysis, the authors conclude that a one-year increase in age difference between partners is associated with a 4 percent increase in the risk of HIV infection. In a related analysis of the effect of age difference between partners in town urban cities in Africa: Kisumu, Kenya and Ndola, Zambia, Glynn et. al. (2001) find a significant positive association between larger age difference with husband and HIV infection. The authors reported that for girls with less than a four-years age difference with their husbands, none are infected with HIV, whereas 38 percent in Kisumu and 34 percent in

Ndola are infected if the age difference with their husbands is four years or greater.

In the Nigerian context, there are empirical evidences of intergenerational sexual relationships; the 2003 DHS reported that the prevalence of intergenerational sex among girls aged 15-17 years is 21.3% percent. This represents the highest prevalence among the

to engage in cross-generational partnerships (ORC, Macro, 2007).

**2.2 Intergenerational sex and HIV infection** 

1992).

countries shown in a table 1 below. Significantly there is the practice of early marriage in the northern part of the country and more often than not the young women are married to men who are much older than themselves. In general terms the practice is cultural; so also is polygamy. Could it be a situation of double jeopardy? Unfortunately, the subject has not been well researched as to its implication on STI and HIV infection.


#### **RECENT DHS SURVEYS ON INTERGENERATIONAL SEX**

Source: DHS Reports ORC MACRO

Table 1. Recent DHS Surveys on intergenerational sex

Consequently, there is a knowledge gap on the spread of the practice; factors promoting the practice; the ability of the young women to negotiate safe sex and HIV infection in the age group. Hence, understanding the underlying factors and prevalence of the intergenerational sex is a priority study for Nigeria. The main thrust of this paper is to examine the prevalence of, and factors associated with intergenerational sexual relationship among young women aged 15 – 24 years and examine the implications of the practice on safe sex and HIV infection. The study will analyze the 2008 Nigeria Demographic and Health Survey (NDHS) to explore the relationship between young women's individual socio-demographic attributes and behaviour. Lastly, the paper will proffer programmatic and policy recommendations.
