HIV and the curse of the blessers

Nnasaretha Kgamanyane | Monday August 28, 2023 06:00

On social media, any talk of blessers is treated as a running joke but the Botswana AIDS Impact Survey (BAIS) V findings released recently, show a far more sinister side to the “trending topic”.

In fact, the blesser trend is more of a curse and a matter of life and death. So prominent has the “blesser and blessee” phenomenon been in recent years, that it is increasingly seen as acceptable or tolerable.

However, the terms “blesser” and “blessee” are convenient euphemisms to describe what health experts, especially those tracking the HIV epidemic, call intergenerational and often transactional sex. The terms are used to sanitise what is in reality an unhealthy relationship where older men, who represent the second highest age group living with HIV, use their finances to woo, coerce and trap young, financially weaker and often naïve teen girls and young women.

The statistics don’t lie, as shown in the latest BAIS, the country’s most authoritative study on HIV trends. By 2021, according to the report, it was estimated that 2,239 people are infected every year in the country, with women aged 15 to 24 years accounting for more than a third or 36%. In terms of prevalence, or the number of people living with HIV, adults aged between 50 and 64 account for nearly 27%.

Anectodal evidence suggests that some older men take advantage of young girls and use them sexually as most of the time these are young and have no power to bargain or refuse.

“Most often the perverts hold power and decide if they want to use protection or not,” a youth counsellor told Mmegi this week, preferring anonymity.

“In most cases, the old men have life partners or wives whom they return to once they are done using the young girls.

“As research has shown, it is often hard for girls to advocate for themselves and demand the use of protection because these men are old enough to be their fathers.

“In Setswana culture, sex is taboo and a child seen talking about sex to an elder may be deemed disrespectful as they cannot talk about sex with elders.

“When an older person sleeps with a minor or adolescent girl even if it was out of consent the onus lies with the men, as they are old enough to know better, especially when it comes to HIV/AIDS infection.”

As some have pointed out, some young women do seek out elderly men either for financial stability or the love of money, but ultimately, the elder is not expected to take advantage of a young person, according to Setswana culture.

While the cultural guardrails could have stifled the growth of the blesser phenomenon years ago, the explosion of social media has opened a Pandora’s box. Not only is exploitative intergenerational sex normalised and even promoted through euphemisms such as “blesser” but young girls are swept up in the desire to keep up appearances, in the process falling prey to the predators hiding in plain sight online.

According to the BAIS V study, HIV prevalence among subjects aged between 16 to 64 years old in Botswana was 20.8%, with females higher at 26.2% compared to males at 15.2%. Young women and teen girls in the study show the highest HIV prevalence than their male counterparts at 15 years of age, while HIV prevalence was higher amongst females than males in each age group from ages 20–24 years through 40–44 years. Looking at the same report, however, males’ HIV prevalence starts increasing tremendously from 50–64 years.

National AIDS & Health Promotion Agency (NAPHA) manager of research, monitoring, and evaluation, Robert Selato said despite Botswana’s commendable progress in combatting HIV and AIDS — having surpassed the 95-95-95 UNAIDS target — there is a disconcerting discrepancy in the high prevalence of HIV amongst women and teen girls as opposed to their male counterparts.

“Women find themselves at the receiving end of HIV,” he said, speaking at the BAIS V launch recently.

“This is attributed to many factors such as their biological make-up because men leave their semen in women, therefore, putting women at the receiving end as whatever comes out of men during a sexual activity is left in them.

“In addition, structural issues that include economics and the ability to negotiate safe sex because of how our community views women, do not allow women to voice out their views when it comes to safe sex.”

He further stated that the BAISV incidence data underscores a concerning trend among women aged 30 to 84, showing that 20% of them are living with HIV, as compared to the 6.5 percent prevalence observed in their male counterparts. He emphasised the urgency of implementing measures to safeguard the well-being of young women and girls, ensuring that those who are HIV-negative maintain their status.

Selato highlighted that if there is a notable surge in HIV cases amongst young women and girls, while the corresponding male demographic registers minimal infections, it implies transmission from older men. This observation stemmed from the study’s findings, revealing that men aged 35 and above exhibit a heightened HIV infection rate.

Worsening the situation is the fact that men are generally reluctant to test for HIV and tend to default on their treatment more than women. Selato emphasised that the study also demonstrates commendable adherence to treatment among women living with HIV. As a result, their viral load remains suppressed, leading to elevated CD4 counts. In contrast, men within the same age group exhibit elevated viral loads paired with diminished CD4 counts, primarily due to a tendency among men, unlike women, to underutilise medical services.

In light of these findings, Selato stressed the importance of targeting interventions towards older men, alongside addressing the needs of adolescent girls and young women, in the ongoing efforts to combat HIV and AIDS. “When women are pregnant, they are enrolled into the Prevention of Mother-to-Child Transmissions (PMTCT) programme and, therefore, many children are born HIV negative.

“It is not helpful when young people in their later life pick up infections.

“From birth, these people should live out their lives HIV-negative,” the NAHPA manager pointed out.

He revealed that many times when women contract HIV, NAHPA has realised that the transmission does not stem from individuals within their age cohort, but rather from older men. However, as they mature, the same infected women establish relationships with peers of similar age, whom they unwittingly also expose to HIV.

The research further indicates that a substantial number of girls engage in sexual activity at the age of 16, thereby acquiring HIV at a young age. The phenomenon of older men engaging in relationships with young girls, who are of an age comparable to their children, is jeopardising the prospects of a nation that aspires to remain free of HIV.

“This is concerning as when these young women eventually form unions with individuals within their age group, the risk of transmitting the virus increases significantly, particularly in instances where their treatment adherence is compromised.

“Consequently, this trend could potentially lead the country to experience a recurrence of the same pattern of new infections, if not an exacerbation of the situation,” Selato said.

However, the latest research shows a positive trend with new infections reduced to 0.2 percent in the last 12 months, compared to 1.35 percent in the previous BAIS IV.

Authorities have urged people living with HIV to ensure consistent adherence to ARV treatments, but ultimately, the fight is for behavioural change, especially among older men in relationships with younger women.

The key, authorities say, to go back to the basics and avoid unprotected casual encounters. HIV prevention principles like Abstain, Be Faithful, and Condomise (ABCs) remain relevant.