VULINDLELA, South Africa—A jovial nurse weighs a slim 20-year-old woman in a cramped room inside a hospital in Durban, South Africa.
The patient is wearing a scarlet top, her blue jeans fashionably tattered, her hair a tangle of braids. Her faux diamond earrings swing and sparkle under fluorescent tubes of white light.
Amehlo, as she asks to be called, is here for a checkup, and for one of her regular HIV tests.
She smiles shyly as she tells the nurse that she has two boyfriends: One her own age; the other eight years older than her.
Amehlo lives in Vulindlela, a rural settlement in the midlands of KwaZulu-Natal province, about 130 miles north of Durban in east of South Africa.
Amehlo says what drove her to develop a relationship with her older partner was her family’s poverty. She says her “bad dream” ended when she met her “blesser.”
“He’s married, but he has a job and that’s the most important thing. He bought me a cellphone; he buys me clothes. He buys groceries for my whole family,” she said.
In South Africa, older men like Amehlo’s boyfriend are colloquially called “blessers,” because they “bless” their young girlfriends with money and other material goods.
But there’s real risk to having a relationship with these “blessers”: contracting HIV.
Scientists at the city’s Center for the AIDS Program of Research in South Africa (CAPRISA), one of the most advanced HIV study facilities in the world, have found that more than six out of every 10 women older than 30 in Vulindlela have HIV.
The South African government manages the biggest HIV treatment program in the world, currently giving antiretroviral pills to more than four million infected individuals.
CAPRISA director Professor Salim Karim says “blessers” have become culturally acceptable across South Africa.
“If a 35-year-old man knocked on my door to ask for a date with my teenage daughter, I’d kick his backside and send him packing. That person is doing something that my community does not accept,” said Karim.
“But I had to understand in the communities that I work in, like Vulindlela, they don’t have that norm.”
Karim says CAPRISA’s research has exposed the “myth” that “blessers” are mostly wealthy middle-aged men. The center’s study in Vulindlela shows “blessers” are usually about nine years older than their younger girlfriends.
Gethwana Mahlase, an HIV counselor in KwaZulu-Natal for almost three decades, says she counsels girls as young as 13 who are involved with men in their twenties.
“It’s another cliche that the ‘blessers’ are rich. They’re working class, like construction workers, taxi drivers, shelf packers. So they can’t buy luxurious things for their young girlfriends,” Mahlase said.
“They buy them the real basic necessities like food, sanitary pads; a little pocket money. It could be as little as 5 rands [about $0.35] a week.”
But, as Mahlase puts it, the “blessers” are “rich in danger.”
CAPRISA’s work in Vulindlela shows women of about 30 are infecting men of about the same age with HIV. This is the very age group of men most likely to be “blessers.”
“That’s how they become the bridging population, transmitting HIV from older women to younger women. And they’re a very effective bridge because they don’t know they have HIV; they’ve recently acquired HIV and have very high viral loads, so they’ve very efficient transmitters,” Karim explained.
For Mahlase, the scenario in Vulindlela offers “proof” of the position South Africa currently occupies in the effort to stop HIV.
As long as the girls are being pushed towards the “blessers” because of poverty, “we will not prevent many new infections,” she said.