Context: "Sugar daddy" relationships, which are characterized by large age and economic asymmetries between partners, are believed to be a major factor in the spread of HIV in Sub-Saharan Africa. Information is needed about sugar daddy partnerships-and about age and economic asymmetries more generally-to determine how common they are and whether they are related to unsafe sexual behavior.

Methods: The sample comprised 1,052 men aged 21-45 who were surveyed in Kisumu, Kenya, in 2001. Data on these men and their 1,614 recent non-marital partnerships were analyzed to calculate the prevalence of sugar daddies and sugar daddy relationships, as well as a range of age and economic disparities within non-marital partnerships. Logistic regression models were constructed to assess relationships between condom use at last sexual intercourse and various measures of age and economic asymmetry.

Results: The mean age difference between non-marital sexual partners was 5.5 years, and 47% of men's female partners were adolescents. Fourteen percent of partnerships involved an age difference of at least 10 years, and 23% involved more than the mean amount of male-to-female material assistance. Men who reported at least one partnership with both these characteristics were defined as sugar daddies and made up 5% of the sample; sugar daddy relationships accounted for 4% of partnerships. Sugar daddy partnerships and the largest age and economic asymmetries we constructed were associated with decreased odds of condom use.

Conclusions: Although sugar daddy relationships are not as pervasive as generally assumed, age and economic asymmetries in non-marital partnerships are relatively common. All these types of asymmetries are associated with nonuse of condoms. Increasing women's power within asymmetric sexual relationships could improve their ability to negotiate safer sexual behaviors, such as condom use.

• P30 AG012836/AG/NIA NIH HHS/United States
• AG12836/AG/NIA NIH HHS/United States