AGYW involved with both a Blesser and an age-disparate partner were significantly more likely to be HIV positive, experience IPV, have an STI diagnosis, and among adolescents, be pregnant, with combined relationships increasing odds of HIV (AOR: 1.31), IPV (AOR: 1.87), STI (AOR: 1.55), and adolescent pregnancy (AOR: 1.66).
Approximately 5.7% of AGYW reported a recent relationship with a Blesser, and 25.8% had an age-disparate partner.
AGYW involved with both a Blesser and an age-disparate partner had significantly increased odds of being HIV positive compared to those without such relationships.
AGYW engaged in both a Blesser relationship and an age-disparate partnership had significantly higher odds of experiencing intimate partner violence (IPV).
Combined involvement with a Blesser and an age-disparate partner was associated with significantly increased odds of a sexually transmitted infection (STI) diagnosis.
Among adolescents specifically, combined Blesser and age-disparate relationships were associated with significantly increased odds of adolescent pregnancy.
The study found that transactional and age-disparate partnerships heighten AGYW's vulnerability to the intertwined risks of HIV, pregnancy, and violence simultaneously.
This research examined a specific type of relationship common in South Africa called a 'Blesser' relationship, where an older, typically wealthier man provides gifts, money, or other material benefits to a younger woman in exchange for companionship or sex. The study surveyed nearly 5,000 young women and girls aged 15 to 24 across South Africa in 2024. It found that about 1 in 20 girls reported recently being in a Blesser relationship, and about 1 in 4 had a partner significantly older than themselves. Girls who were in both types of relationships at the same time faced notably higher risks across multiple health outcomes simultaneously. Specifically, young women involved with both a Blesser and an age-disparate partner were more likely to be HIV positive, to report experiencing intimate partner violence, to have been diagnosed with a sexually transmitted infection, and — among younger adolescents — to have experienced a pregnancy. The strongest association was with intimate partner violence, where the odds were nearly twice as high compared to girls not in such relationships. These risks were not isolated but appeared to cluster together, suggesting that these relationship dynamics create compounding vulnerabilities rather than just a single health concern. This research suggests that economic inequality and social factors push young women into relationships that put their health and safety at risk. Programs aimed at protecting young women need to address the root causes — such as poverty and lack of economic opportunity — that make these relationships attractive or necessary, while also giving young women practical tools and support to navigate safer choices. The findings highlight the importance of designing interventions that are sensitive to the specific social and economic context in which young South African women live.
George G, Gwala N, Bergh K, Mathews C, Jonas K. (2025). Determining the sexual health risks for adolescent girls and young women engaging in a transactional relationship with a Blesser.. AIDS care. https://doi.org/10.1080/09540121.2025.2562236