Abstract
I cannot count the number of times I have heard women’s HIV risk in Sub-Saharan Africa explained as resulting from older men seducing or forcing young women to have sex in exchange for gifts or cash. Love, Money and HIV provides an important corrective to this overly simplistic “sugar daddy” narrative. Mojola applies a life course lens to “unpack the logic of partner choice” (p. 194) that accounts for persistently higher HIV rates among young women. She argues that this disparity results from social, economic, and ecological forces that make the transition from childhood to adulthood particularly risky for young women, at the same time it provides temporary protection for young men.
According to Mojola, a primary task of this transition is to become a desirable marital partner. While both women and men must traverse this path, fulfilling this role is particularly fraught for women. A successful transition from girlhood to womanhood entails attaining an education and conforming to modern standards of beauty; both of which require young women to become “consuming women” who pay school fees and purchase commodities that must be repeatedly replenished (i.e., cosmetics, sanitary pads). The problem is that young women have few opportunities beyond “small small jobs” (p. 162) to earn the money to buy these necessities. Young men’s earning potential is also limited, which constrains their ability to enter into sexual relationships. This, in turn, reduces their exposure to HIV, at least temporarily. Young women thus turn to older working-class men for sexual relationships and economic assistance. These “providing partners” act as a bridge that gives young women a chance to complete school and conform to expectations of modern femininity, but at the risk of pregnancy and HIV infection. The cycle of infection continues as young women ultimately marry (and potentially infect) men their own age, who, in time, become providing sexual partners for the next generation of young women negotiating the transition to womanhood.
Molojo makes deft use of her rich data set, which includes ethnographic fieldwork in Kenya’s Nyanza province, more than 200 interviews, and survey data from the Kenyan Demographic and Health Survey. She also uses published research to extend her analysis to other high-prevalence countries in the region.
The first three chapters provide in-depth epidemiological, historical, and theoretical examinations of HIV/AIDS in the region, the study design and setting, and transactional sexual relationships. Importantly, Mojola destabilizes two common misconceptions in these chapters. First, she shows how the “entanglement of love and money” (p. 32) is not a unique characteristic of sexual relationships in Africa, but rather a global gender dynamic. Next, her rich discussion of the Luo culture of consumption (“kula raha”) puts to rest any assumptions that consumptive culture is simply a Western import. In the strongest chapters of the book, Mojola examines schools (chapter five) and the gendered labor market (chapter six) to show how institutional practices, routines, regulations, and schedules structure intimate relationships in ways that increase HIV risk. Particularly exciting is the discussion of the ecological factors that reorganized the fishing economy along Lake Victoria, making it necessary for people to have multiple sexual/economic partnerships for fishing to remain an economically feasible enterprise. Mojola’s use of a life course framework provides a critical insight into young women’s sexual decisions. The value of this perspective and how it informs the recommendations in the final chapter would be more apparent to the reader if she had intertwined the theory throughout her analysis.
The remaining chapters are as thought-provoking as the rest of the book, but are slightly less successful. Each individual section of Chapter Four provides an important dimension of the entanglement of sex, love and money, and the shortcomings of prevention strategies in addressing this relationship logic. Unfortunately, the sheer volume of information and the organization of the chapter make it difficult to digest. Mojola’s research gives a new perspective and potentially more legitimacy to the individual and institutional-level interventions she recommends in the final chapter, but many of the strategies are familiar. One exception is her recommendation to create a stable ecosystem: an original contribution that brings to light the most often ignored ecological factors that contribute to HIV risk.
These shortcomings do not diminish the strength of Mojola’s analysis or my enthusiasm for the book. Love, Money and HIV provides an important contribution to understandings of HIV risk and helps to explain why the very women we would expect to be least at risk (i.e., educated, with incomes of their own) have the highest rates of HIV. This book will be of interest to sexuality and gender scholars, as well as policy makers and public health practitioners. It will also be a useful text for those who study and teach life course, medical sociology, and institutionalism.