The limits of awareness campaigns: persistent age-disparate relationships in KwaZulu-Natal more than a decade after the 2012 sugar daddies destroy lives campaign

In 2012, the KwaZulu-Natal (KZN) Department of Health launched a comprehensive public health campaign “Sugar Daddies Destroy Lives” discouraging adolescent girls and young women from forming relationships with substantially older men due to teenage pregnancy and the persistently rising HIV rates [1]. A study conducted in KZN reported that women reporting an age-disparate partnership in any of their three most recent relationships were 58% more likely to test HIV-positive [2]. These relationships often reflect power imbalances, economic dependence and are associated with teenage pregnancy and reduced ability to negotiate safer sexual practices [3, 4]. KZN, which continues to shoulder a disproportionate share of South Africa’s HIV epidemic, has long targeted age disparate partnerships in prevention efforts [1, 5]. The 2012 “Sugar Daddies Destroy Lives” campaign had hundreds of billboards and an accompanying public-information push that sought to reframe relationships with older men as shameful and dangerous rather than desirable, linking sexual choices to HIV risk and social harm.