Why you should care
Because sugar daddies may give you more than nice clothes and money.
Let’s say you’re a teen. You want to have sex, but you don’t want HIV, and in your country there’s a pretty high risk of contracting the virus if you’re sexually active. So you opt for what you consider to be the safest choice — an older, financially stable man who seems to have his life in order, unlike the rowdy teenage boys at school. Makes sense, right?
Not so much. Turns out it’s the older guys, the so-called sugar daddies, who pose the risk. In Botswana, 45 percent of 40- to 44-year-old men are HIV-positive, compared with roughly 5 percent of teenage boys, according to the latest Botswana AIDS Impact Survey. And teenage girls are twice as likely to contract HIV as their male peers.
This might be trivia to most of us, but for Noam Angrist, a terrifyingly successful 25-year-old — MIT grad, Fulbright and Rhodes scholar — it was the basis for starting Young 1ove (pronounced “Young Love”) just over two years ago, with funding from around a dozen organizations, including the Global Innovation Fund and PEPFAR. Based in Gaborone, Botswana, the NGO’s mission is to bridge the gap between academic work around public health and the on-the-ground message nonprofits spread. The vehicle: cool, hip young people, locals to the project country who are charged with translating wonk into values. Young 1ove’s flagship is a program called “No Sugar,” which educates young girls about the likelihood of contracting HIV from sex partners in various age groups to shatter perceptions about who is “safest.” It’s all about the facts, no judgment allowed.
The team is “addicted to this hypermanic mission” to reduce HIV in young girls, says Laura Poswell, the executive director of J-PAL Africa, which partners with Young 1ove. Angrist secured an elusive mandate from the Ministry of Education to operate in schools across Botswana as an official HIV education partner. Angrist and co-founder Moitshepi Matsheng also hold a standing seat on the country’s National AIDS Council. Young 1ove just completed a 42,000-person study to see if its myth-busting led to reduced pregnancy rates, a predictor of HIV infections. Results are forthcoming and will determine whether Young 1ove scales, continues learning or moves on. Already, though, small-scale Young 1love pilots are being conducted in Zimbabwe and South Africa.
Botswana has the world’s third-highest HIV prevalence, and women are disproportionately affected. But these girls aren’t born with HIV — they’re getting it in middle or high school. “Girls are largely getting HIV from older men,” says Gang Sun, UNAIDS country director for Botswana. The data is not “perfectly conclusive,” says Angrist, but there is a considerable amount of research showing differential HIV rates among boys and girls of the same age. Turns out these so-called sugar daddies are giving away more than nice clothes and money in exchange for sexual favors.
But does the world really need more HIV-awareness NGOs? From condom promotion billboards to radio ads lamenting HIV statistics to social media campaigns and red ribbons, a hodgepodge of programs with varying results or little to no follow-up purport to change behavior. When a country is stuffed to its limit with well-intentioned international do-gooders, the question becomes not how to get more funding or more programs on line but how to make choices — which ideas are the best? Angrist has an edge, thanks to his data-geek personality. He didn’t run with a new idea, but took a decade-old one and added testing. Before launching Young 1ove, the Israeli-American scoured hundreds of published studies and randomized control trials and found that very little changed behavior. But there was one study of an hourlong program focusing on sugar daddies in Kenya that had reduced pregnancies by a third. It had never been replicated, scaled or tested. It seemed like an obvious fit in Botswana.
Young 1ove was born from poetry. Despite Angrist’s logical leanings, his favorite activity, he tells me, is “reflecting deeply about anything” with friends. One such night, a young Batswanan poet read Angrist a piece about an older man infecting a young girl with HIV. Moved by that experience, and motivated by the Kenyan study, Angrist launched into piloting the program almost immediately. He won a $20,000 D-Prize to formally launch the NGO. He was well-connected at just four months into his time in Botswana and already wrapping up his Fulbright research on education under his mentors, Gabatshwane Tsayang and Nkobi Pansiri, professors at the University of Botswana. His father is Joshua Angrist, a well-respected economist, who, he says, influenced his career in “too many ways to count.” The younger Angrist made his own way, says Harry Patrinos, practice manager for education at the World Bank, where Angrist interned. “We were blown away with him,” says Patrinos. Soon, managers from other teams started requesting Angrist for their projects.
Angrist’s interest in the economics of health came much earlier. As an adolescent, he was a competitive rower, but at age 18, he suddenly developed a life-threatening blood clot in his arm that landed him in the hospital for three weeks. One removed rib and countless treatments later, a solution arose: an experimental blood thinner that cost thousands of dollars … per hour. Angrist was fortunate to have top-notch insurance. He became fixated on insurance access; post-recovery, he worked under Jon Gruber, the architect of the Affordable Care Act, at MIT, where they analyzed the act’s knock-on effects. That led to a string of prestigious internships, including one at the White House.
Today, Angrist is anxious that I don’t overstate the impact of his early results. “We don’t want to feel good, we want to do good,” he says. He’s a numbers guy, after all.