Intergenerational sex, gift giving and intimate partner violence in Lesotho

Inter-generational relationships (IGR)—defined as a 10-year age gap between partners—are thought to increase young women's vulnerability to HIV by limiting their agency and negotiating power. Particularly in transactional relationships, they may be at risk of sexual and physical violence and be less able to negotiate safer sex. The objectives of this study are to examine the associations between sexual and physical violence and condom use focusing on two key explanatory variables: 1) IGR, and 2) receiving gifts in exchange for sex. Data for this study come from a nationally representative sample of 821 young women aged 15-24, interviewed as part of an evaluation of an HIV/AIDS communication program in Lesotho. The analysis was conducted using multivariate logistic regression. IGR are associated with sexual violence, whether defined with a 5-year (OR=2.6) or a 10-year age-difference (OR=8.3). Receiving gifts for sex is associated with experiencing physical violence (OR= 3.0), but not sexual violence. IGR were not associated with condom use at last sex, however, condoms were twice as likely (OR=1.9) to be used in relationships where women received gifts in exchange for sex. This effect was more pronounced with non-cohabiting partners (OR= 3.3). Young women in IGR and receiving gifts in exchange for sex may be at greater risk for sexual and physical violence. In Lesotho, where nearly one-quarter of young women are HIV-infected, understanding the dynamics and complexities of relationships is critical to the formulation of comprehensive strategies that address young women's social vulnerabilities and decision-making within sexual relationships.