An estimated 50 girls aged between 10 and 19 years old around the world die from AIDS-related causes daily, while around 460 adolescent girls become infected with HIV, according to a new report.
The findings were highlighted by the executive director of UNAIDS Michel Sidibé in the recently published Women and HIV: A spotlight on adolescent girls and young women report.
The report, released in March, measures the progress made in reaching goals set in the Fast-Track Strategy, which outlines actions needed to end HIV and AIDS by 2030.
The strategy, which supports the 2016 United Nations Political Declaration on Ending AIDS, is aimed at reducing the number of new HIV infections annually to below 500,000 — by ensuring that 90% of people who are at the greatest risk of being infected with HIV have access to comprehensive education and preventative measures.
The strategy also aims to get 90% of infected people on treatment and ultimately suppress their viral load so that it becomes undetectable. Infected people whose HIV is undetectable cannot infect their partners or unborn children.
However, as the Women and HIV report states, HIV/AIDS continues to be one of the greatest health risks faces by girls and young women. There are 19.1 million girls and women globally living with HIV.
“It is time to empower women and girls,” Sidibé said.
Sub-Saharan Africa has the highest incidents of HIV and AIDS globally. There were 19.6 million people living with HIV/AIDS and 800,000 new infections in 2017 in East and Southern Africa, according to the report — with 380,000 AIDS-related deaths.
In Central and West Africa, meanwhile, 6.1 million people are HIV positive, with 370,000 new infections and 280,000 AIDS-related deaths. Among newly-infected people aged 15 to 19 years in sub-Saharan Africa, 60% are girls.
“It is time to break the vicious cycle of gender inequities, gender-based violence, and HIV infection, once and for all,” Sidibé said. “Oppression and power imbalances must be reversed.”
The following 10 countries have the highest numbers of girls and young women living with HIV: South Africa (4.4 million), Nigeria (1.7 million), Mozambique (1.3 million), Kenya (920,000), Tanzania (870,000), Uganda (800,000), Zimbabwe (780,000), Zambia (670,000), Malawi (630,000), and Ethiopia (380,000).
“Services for adolescent girls and young women are especially failing to reach adolescent girls and young women who experience gender-based violence, who are sexually exploited, or who use drugs, among others,” said Sidibé.
One of the reasons girls continue to be infected with HIV at such alarming rates is gender-based violence, be it sexual abuse, early and forced marriage, marital rape, sexual exploitation, incest, female genital mutilation, and intimate partner violence.
“Women and adolescent girls belonging to especially marginalised groups face elevated risks of violence, discrimination and stigma, compounding the risks of HIV,” the report states.
The risk of gender-based violence is even higher for girls and women who live in conflict areas — with 70% of women in conflict settings and refugee populations reporting being exposed to gender-based and sexual violence, according to UNAIDS.
However, there is another challenge faced by girls and women that is believed to exacerbate the risk of HIV infections — laws and policies that don’t favour girls or women.
According to the report: “Restrictive laws and policies — including criminalisation, age of consent laws, and adult-oriented HIV services that are perceived as intimidating and of poor quality — discourage service uptake by adolescents.”
There’s also the lack of agency that girls have over their bodies and reproductive health. “Adolescent girls are especially affected when approval by a parent, guardian, or spouse is required before seeking basic health information and services,” the report says.
And even when the age of consent has been lowered — so that young people aren’t committing a crime by having sex — girls are often still stigmatised when seeking reproductive health services.
“The criminalisation of consensual sex among adolescents, as well as of same-sex sexual relations and sexual relations outside of marriage, further compounds the stigma and health risks that adolescents face,” the report states.
It adds: “In some settings, healthcare providers are obliged by law to report underage sex or activities such as drug use among adolescents, [and] 45% countries have laws that impose the need for parental consent for adolescents and young people below 18 years to access HIV testing.”
Furthermore, adolescents in 75 countries need parental consent to access sexual and reproductive healthcare, while only 26 out of 100 countries with a national HIV/AIDS strategy promote condom use in secondary schools.