Boys are not exempt: Sexual exploitation of adolescents in sub-Saharan Africa

Abstract

Research on youth sexual exploitation in Africa has largely neglected the experiences of exploited boys. To date, much of the research in sub-Saharan Africa continues to consider boys mainly as exploiters but not as exploited. Using the only publicly available population-based surveys from the National Survey of Adolescents, conducted in four sub-Saharan African countries — Burkina Faso, Ghana, Malawi, and Uganda—we assessed factors associated with transactional sexual behaviour among never-married adolescent boys and girls. We also examined whether boys’ reported sexual exploitation was linked to similar risky sexual behaviours as has been noted among girls in sub-Saharan Africa. Results from our analyses indicated that even though adolescent girls have a somewhat higher likelihood of reporting sexual abuse and exploitation, the odds of trading sex were significantly elevated for previously traumatized boys (that is those with a history of sexual and physical abuse) but not for their female counterparts. Just like adolescent girls, transactional sexual behaviour was associated with the risk of having concurrent multiple sexual partners for boys. These findings support the reality of boys’ sexual exploitation within the African context, and further highlight the importance of including males in general and boys in particular in population-based studies on sexual health, risk, and protective factors in the sub-Saharan African region. Understanding the factors linked to sexual exploitation for both boys and girls will help in developing policies and programs that could improve the overall sexual and reproductive health outcomes among adolescents and youth in sub-Saharan Africa.

Introduction

Adolescent sexual relationships that involve the exchange of money, material goods, or services for sex, described variously as transactional sex, survival sex, or sexual exploitation, have long been linked to HIV/AIDS and other sexual risk behaviours (Dunkle et al., 2006, Luke, 2003, Pettifor et al., 2005). Under the United Nations Convention on the Rights of the Child (adopted by the UN General Assembly in 1989) and one of its optional protocols (adopted in 2000), purchasing sex from adolescents under the age of 18 with money or other consideration is defined as child prostitution or sexual exploitation, even when the purchaser is also a youth (Office of the High Commission on Human Rights, 2000, 1989). Nearly all countries in the world have signed onto the optional protocol, which commits them to enacting laws and creating policies and programs to prevent sexual exploitation and assist victims. In this study, we use “sexual exploitation” when studies (including this one) describe transactional sex experienced by those under age 18, and transactional sex when the youth reporting exchanging sex include both those younger and older than 18.

Although there has generally been gender asymmetry in the prevalence of reported cases of sexual exploitation, with girls reporting higher rates than boys, evidence from more population-based studies in Western countries indicates that boys constitute a significant portion, sometimes even equal prevalence, of the sexually exploited population (see e.g., Edward, Iritani & Hallfours 2006; Homma, Nicholson & Saewyc 2012; Lavoie et al., 2010, Pedersen and Hegna, 2003; Saewyc, MacKay, Anderson & Drozda, 2008; Svedin & Priebe 2007). While the reality of boys’ sexual exploitation has been recognized and studied in Western research, albeit less commonly than among girls, it remains quite nebulous in the sub-Saharan African context where boys are often excluded in sexual exploitation victimization studies.

The neglect of boys in the sexual exploitation victimization literature in sub-Saharan Africa could largely be attributed to the often problematic description of transactional sexual behaviours as something akin to the traditional bride price system in sub-Saharan Africa. Though motivations for exchanging sex for material benefits are complex and not always made explicit by study participants, some researchers have tended to conflate transactional sexual behaviour among adolescents in sub-Saharan Africa with the normative gift-giving common in traditional African marriages or romantic relationships (Nobelius et al., 2010).

Rooted in the “bride wealth” or “bride price” practice, where the groom and his kin group present monetary and other material gifts to the bride and her family as a token to certify the marriage, gift-giving within sexual relationships is common practice in sub-Saharan Africa. Even though these traditional bride price payments occur during the marriage process and involve formal negotiations between families (Dunkle et al., 2007, Nukunya, 2003), some researchers have explained and attempted to ‘normalize’ sexual relationships involving the exchange of sex for material resources among unmarried youth in sub-Saharan Africa by drawing on this traditional bride price system, and concomitantly perceiving adolescent transactional sexual behaviour in a unidirectional manner: females as recipients and males as givers (Masvawure, 2010, Nobelius et al., 2010).

Unsurprisingly, the general research on sexual exploitation in sub-Saharan Africa continues to focus almost exclusively on adolescent females as victims, with males as perpetrators. For instance, the most recent editions of the Ghana Demographic and Health Surveys (2008 and 2013) incorporated a question about sexual exploitation by asking male respondents whether they “have ever paid anyone in exchange for sex” but failed to enquire whether they have ever received something from anyone in exchange for sex. In the few available population-based surveys where adolescent boys were also asked (in their own native languages) whether they have received money or gifts from someone for having sex, some researchers have treated their affirmative responses with suspicion, arguing that the boys might have misunderstood the question, and then proceeded to exclude their data from further quantitative analyses, while assuming girls understood the question as worded (see e.g., Moore et al., 2007).

As a consequence, population-based research on adolescent boys’ sexual exploitation in sub-Saharan African countries is lacking. This neglect is unfortunate. As Saewyc (2012) argued, when we limit sexual and reproductive health research to only girls and young women, we effectively omit half of the sexually active population, and consequently miss them in health care practices, sexual health education, sexual health policies, as well as sexual violence support services. It is therefore important to analyze the responses of boys, to assess whether the factors associated with sexual exploitation are common for both adolescent boys and girls in sub-Saharan Africa.

Sexual exploitation is a form of sexual violence or sexual abuse, although not all adolescents will identify it as such (Edinburgh, Harpin, Pape-Blabolil, & Saewyc, 2015; Holger-Ambrose, Edinburgh, Langmade, & Saewyc, 2013), nor do some adults, even those in law enforcement (Mitchell, Finkelhor & Wolak, 2010). There are a number of antecedents or contextual factors that have been associated with sexual exploitation globally. Homelessness, extreme poverty, and family displacement (including through armed conflicts) increase the risk of sexual exploitation among children and adolescents (Ndulo, 2009; Chettiar, Shannon, Wood, Zhang, & Kerr, 2010; UNICEF, UNESCAP, & ECPAT, 2006). Sexual abuse by family members or other adults that is not explicitly sexual exploitation, i.e., without exchanging sex for material goods, has also been identified as a common antecedent to sexual exploitation (Saewyc et al., 2008, Walls and Bell, 2011), as has early onset of alcohol and other drug use (Saewyc, Drozda, Rivers, MacKay, & Peled, 2013; Edward et al., 2006; Edinburgh et al., 2015). These antecedents have been noted for both boys and girls in some studies; to the extent that boys reporting sexual exploitation in sub-Saharan Africa report similar backgrounds and risk exposures, it seems likely to expect their responses to have indicated victimization through selling sex, rather than being the exploiter who is purchasing sex.

In addition to examining the potential differences and similarities in risk and protective factors for both boys and girls, another way to assess the reliability of boys’ responses to sexual victimization questions in surveys is to examine whether boys’ sexual exploitation is linked to similar risky sexual behaviours as those noted among girls. One potential marker could be the increased risks of concurrent multiple sexual partnerships among adolescents involved in exploitative sexual relationships. As Kuate-Defo (2004) noted, sexually exploited adolescents generally enter into sexual relations with their exploiting partners for financial or material gain, and not for sexual pleasure per se. Among sexually exploited youth, sexual fulfillment is often sought by keeping other romantic partners. Indeed, Silberschmidt and Rasch (2001) have observed that among adolescent girls in Tanzania, they do not consider sexual intercourse with financially endowed older men as an activity by which their own sexual desires would be met. Silberschmidt and Rasch (2001) noted the adolescents admitted they rather enjoyed sex much better with other partners.

This helps explain why research in a number of sub-Saharan African contexts has observed that girls who exchange sex for material resources are significantly more likely to be involved in other risky sexual behaviours, such as maintaining concurrent multiple sexual partners. We argue that adolescent boys who indicate that they have received money or gifts from someone for having sex will also manifest similar risky sexual behaviour since, like their female counterparts, they may also be trapped in situations where they would have otherwise not have chosen to be sexually active (Dunkle et al., 2007, Hunter, 2002, Kaufman and Stavrou, 2004).

This research therefore aims to contribute to the literature on adolescent sexual exploitation in sub-Saharan Africa by investigating whether there are differences in the factors associated with transactional sex among adolescent boys and girls in sub-Saharan Africa. We further ask whether boys’ sexual exploitation is linked with similar risky sexual behaviours such as having concurrent multiple sexual partners, as noted among girls in sub-Saharan Africa. Given the HIV/AIDS epidemic and other reproductive health challenges in sub-Saharan Africa, our findings could provide useful insights for the design and implementation of future research projects in the African context and inform policy guidelines for improving sexual and reproductive health outcomes in the region.