This article first appeared in the MediaplanetUSA Living With HIV and AIDS campaign, which was published in USA Today and online on Future of Personal Health.
As we strive for a world free from HIV and AIDS, we must confront a sobering reality: The burden of this disease weighs heavily upon girls and young women, particularly in sub-Saharan Africa. We must expedite interventions to reduce new HIV cases among girls and young women to achieve an AIDS-free generation.
Despite significant progress in combating HIV and AIDS globally, girls and young women in sub-Saharan Africa continue to face challenges in accessing prevention, care, treatment, and support. They continue to suffer from and die from the disease at an alarming rate, although antiretroviral treatment (ART) is widely available in many parts of the world.
In 2022, according to UNAIDS, an estimated 1.9 million adolescent girls and young women aged 15-24 years were living with HIV worldwide, with 82% of those cases in sub-Saharan Africa. This compares to 1.2 million adolescent boys and young men living with HIV in the same age bracket. In sub-Saharan Africa, approximately 6 out of 7 new infections occur among adolescents aged 15-19 years, and young women ages 15-24 are twice likely to be living with HIV compared to their male counterparts.
Contributing factors
The vulnerability of girls and young women to HIV is influenced by a mix of social, economic, and cultural factors. Gender inequality directly correlates with the vulnerability of girls and young women to HIV. Girls and young women often lack the autonomy to negotiate safe sexual practices, and with diminished access to comprehensive sex education, lack the knowledge to make informed decisions about their sexual health.
Girls and young women without money sometimes engage in transactional sex or become dependent upon their partners, exacerbating their vulnerability to HIV. Early marriage and early sexual debut expose girls to sexual relationships at a young age, often with older partners who may carry a higher HIV risk. Gender-based violence also heightens HIV risk.
Limited access to healthcare, including lack of transportation, financial constraints, provider bias, and stigma hinder girls and young women from accessing prevention, care, and treatment.
Addressing inequality, increasing access
To achieve the UNAIDS 95-95-95 targets, we must address the unique needs and circumstances of girls and young women. We can do this by borrowing from the success of the DREAMS initiative. The DREAMS interventions include access to: HIV testing, treatment, and prevention tools, such as pre-exposure prophylaxis and ART to reduce transmission; comprehensive sex education, including skills for negotiating safer sex practices, condom use, and partner communication; and economic empowerment programs and educational initiatives.
At the same time, DREAMS strengthens the delivery of healthcare services and mobilizes communities to address gender-based violence and harmful gender norms.
Addressing the HIV burden among girls and young women requires more than just resources; it requires political will and commitment. Governments, international organizations, and civil society organizations must prioritize the needs of girls and young women in HIV programs and policymaking. Only through collective action and solidarity can we create an environment conducive to ending the HIV epidemic.
The time to act is now. We cannot afford to ignore the high HIV burden among girls and young women any longer. By prioritizing their needs and rights in our HIV response, we can chart the path toward an AIDS-free generation.
