title: "They just whisper in their hearts that he's doing a bad thing": a qualitative study of Tanzanian perceptions of cross-generational sex.
abstract: HIV prevalence among young Tanzanian women is twice that of men, and risk doubles if a partner is ten or more years older. Cross-generational sex (CGS) is typified by transactions, economic asymmetries, power differentials, and inconsistent condom use. By investigating perceptions of CGS in families, schools, and communities, this study explored the role each plays in addressing or condoning CGS and where interventions are needed. Qualitative data were collected in Tanzania's Iringa and Pwani regions after a campaign to reduce CGS. Community leaders suggested key informants and provided household lists used to randomly select participants. Individual interviews were conducted with 20 women (M age = 20.7, SD = 3.1, range = 15 to 26) and 20 men (M age = 37.1, SD = 7.3, range = 30 to 56), focus groups with 15 women (M age = 20.4, SD = 2.9, range = 17 to 25) and 26 men (M age = 39.2, SD = 7.9, range = 30 to 55), and key informant focus groups with 10 women (M age = 47.6, SD = 10, range = 37 to 70) and 16 men (M age = 55.5, SD = 9.5, range = 37 to 67). CGS was viewed as detrimental to girls' education and a financial loss to parents, but barriers, including reluctance to approach parents and older men, prevented community action. Interventions may involve community leaders transcending restrictions on confronting older men and promoting communication between teachers, communities, parents, and young women regarding CGS.
authors.affiliation: a Bloomberg School of Public Health, Center for Communication Programs , Johns Hopkins University.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kaufman
authors.forename: Alyssa
authors.initials: A
authors.lastname: Mooney
authors.forename: Najmeh
authors.initials: N
authors.lastname: Modarres
authors.forename: Susan
authors.initials: S
authors.lastname: Mlangwa
authors.forename: Anna
authors.initials: A
authors.lastname: McCartney-Melstad
authors.forename: Adiel
authors.initials: A
authors.lastname: Mushi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D016901:Intergenerational Relations; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012725:Sexual Behavior / Q000208:ethnology*; D013636:Tanzania / Q000208:ethnology; D055815:Young Adult