Inequalities of age interact with the inequalities of socio-economic background, gender and sexuality to determine young people's vulnerability to STIs including HIV. We have already seen how this is the case for younger women who may be sought as sexual partners by older men in the belief that they are less likely to be infected. But age and generation just as strongly influence the vulnerability of young men, not only those who sell or trade sex, but also those who engage in sexual activity as a means of gaining adult status and the privileges it offers. Recent research in Tanzania, for example, has suggested that young men may attempt to address intra-generational inequalities through engaging in sexual activity, which represents adulthood and enhanced social status (Seel, 1996).

Beyond these behaviours which carry clear HIV-related risks are others no less embedded in local cultures and traditions. These include female genital mutilation (FGM) and male circumcision, both of which are perpetrated upon young people by those who are older. When practised as part of group initiation ceremonies or in ways involving the sharing of razors, knives and other cutting instruments, the risk of HIV infection being transmitted from one person to another can be considerable (see Petchesky & Judd, 1998). The World Health Organisation and other bodies have condemned the practice of FGM on both medical and human rights grounds and, in 1993, passed a resolution at the 46th World Health Assembly calling for member states to act to eliminate harmful traditional practices (World Health Organisation, 1993). Where male circumcision continues to take place, it should be practised in ways commensurate with the need both to prevent HIV and other blood borne infections and the rights of young people to be involved in decisions about their bodies and what becomes of them.