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http://www.ipsnews.net/2014/11/the-young-female-face-of-hiv-in-east-and-southern-africa/
The Young, Female Face of HIV
in East & Southern Africa Reflects Gender Inequalities
Gender
inequalities explain why prevention is failing to contain HIV infection among
young women in East and Southern Africa. UNAIDS calls for a major effort to
reduce their risk of infection. Credit: Mercedes Sayagues/IPS
NAIROBI, Nov 7 2014 (IPS) - Experts are raising
alarm that years of HIV interventions throughout Africa have failed to stop
infection among young women 15 to 24 years old.
“Prevention is failing for young women,” says Lillian Mworeko,
HIV expert with International Community of Women
Living with HIV in Eastern Africa, based in Uganda.
Among women in East and Southern Africa, four out of ten new HIV
infections among women aged 15 years and over happen among those aged 15
to 24, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS).
Worryingly, HIV infection rates among young women are double or
triple those of their male peers. In South Africa,
the HIV prevalence of 18 percent among women aged 20-24 is three times higher
than in men of the same age.
The
failure of prevention: young women and HIV in East and Southern Africa
In Lesotho, HIV prevalence of four percent among adolescent girls rises
four-fold by the time they are 24.
In Botswana, the number of women newly infected with HIV (6,200 in 2012) has
only declined by 14 percent since 2009.
The age of consent for marriage is 15 years in Malawi and Tanzania.
Nearly half of all girls in Malawi are married by age 19.
In South Africa, within the 25- 29 year age group, HIV prevalence among women
is 28% and 17% among men (UNFPA)
In Tanzania, young women are almost three times more likely to be HIV positive
than young men
In Malawi, the number of women acquiring HIV has not decreased since 2009, at
29,000 per year.
In Tanzania, HIV prevalence jumps from one percent among girls under 17 years
old to 17 percent by age 24.
In Sub-Saharan Africa, adolescent and young women account for one in four new
infections.
Source: UNAIDS
Equally alarming are surveys showing that fewer than two in ten
young women know their HIV status.
Experts attribute this high HIV prevalence to gender
inequalities, violence against women, limited access to health care, education
and jobs, and health systems that do not address the needs of youth.
Biology does not help. Teenage girls’ immature genital tract is
more prone to abrasions during sex, opening entry points for the virus, Dr
Milly Muchai told IPS.
Muchai, a reproductive health expert in Kenya, says it is not
just sex that drives HIV infections among young women but the age of the male
sexual partner.
“The risk increases steadily with male partners aged 20 years
and over,” she explains.
Older men are more likely to have HIV than teenage boys. The Kenya AIDS
Indicator Survey 2012 shows that male HIV prevalence remains low and
stable until the age of 24, when it shoots up significantly.
Due to intergenerational sex, women in this region are acquiring
HIV five to seven years earlier than men, says Muchai, because these
relationships are characterised by multiple sexual partners and low condom use.
In transactional sex, the young woman receiving gifts or money loses power to
negotiate safe sex.
But Kenya is not a unique scenario.
Shocking figures
In Swaziland, Lesotho and Botswana, more than one in 10 females
aged 15 to 24 are living with HIV, according to UNAIDS.
Dr Gang Sun, UNAIDS country director in Botswana,
says that, in spite of the country’s remarkable progress in reduction of new
infections and treatment, HIV is still a girls’ and women’s epidemic due to gender
inequality and unequal power dynamics.
Among Batswana youth aged 20 to 24 years, HIV infection among
women triples that of men, nearly 15 percent compared to 5 percent, he says.
Mary Pat Kieffer, senior director at Elizabeth Glaser Paediatric AIDS Foundation in
Malawi, told IPS that as teenage girls become older, the risk of infection
rises.
In Swaziland,
HIV prevalence is six percent for girls aged 15 to 17 but rises to a whopping
43 percent by age 24.
Source:
UNICEF
A package of interventions
Kieffer says that many of the issues – poverty, lack of
secondary education, few jobs, rape and intimate partner violence – that
underpin the unacceptably high HIV prevalence among young women are bigger than
what HIV programs alone can address.
Mworeko
observes major gaps in reproductive and sexual health services for young
people, when they are neither children nor adults, in the region.
“Whether it is prevention, treatment, care and support services,
young people do not have a youth friendly corner,” she says.
Paska Kinuthia, youth officer with UNAIDS in South Africa,
told IPS that sexuality education needs to be strengthened in schools across
the region.
“The regional average of comprehensive knowledge of HIV and AIDS
stands at 41 percent for young men and 33 percent for young women,” he says.
Experts agree there is no one single solution to protect young
women and a combination of interventions is needed.
Addressing restrictive laws on the age of consent for HIV
testing and for access to sexual and reproductive health services would be a
good place to start, experts say.
Promoting gender equality and providing jobs for young people
are part of the solution, says Sun.
In Tanzania, HIV infection among girls more than triples between
15-19 and 20-24 years.
This fact, says Allison Jenkins, chief of HIV/AIDS with the United Nations
Children’s Fund in Dar es Salaam, underlines “the importance of
orienting HIV prevention and economic livelihoods interventions during her
transition to adulthood.”
For all these reasons, UNAIDS is calling for “a major movement
to protect adolescent girls and young women from HIV infection.”
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