World AIDS Day celebrates its 30th anniversary this year with the theme of ‘Know Your Status’.
Great progress has been made since the first World AIDS Day in 1988 – 3 in 4 people living with HIV today know their status.
However, the work is not yet done – especially for women. Women account for more than half of the people living with HIV worldwide. In particular, adolescent girls (10-19 years) and young women (15-24 years) are significantly affected by HIV and have high prevalence rates.
In Eastern and Southern Africa, women make up 26% of new HIV infections despite making up only 10% of the population. Statistically, young women will acquire HIV five to seven years earlier than their male counterparts.
Why are women and girls at high risk of infection?
HIV disproportionately affects young women and girls because of their unequal social, cultural and economic status in society. These challenges include gender based violence, laws and policies that undermine women, and harmful cultural and traditional practices that reinforce stigma and the dynamic of male dominance.
Here some other reasons why gender inequality leaves women vulnerable to HIV:
- Lack of access to healthcare services – women encounter barriers to health services on individual, interpersonal, community and societal levels.
- Lack of access to education – studies show that educated girls and women are more likely to make safer decisions regarding sexual and reproductive health and have lower risk of partner violence.
- Poverty – an existing and overarching factor that increases the impact of HIV.
- Gender-based violence & intimate partner violence – these types of violence prevent young women from protecting themselves from HIV.
- ‘Blesser/Sugar Daddy’ culture and transactional sex – sex with older men for monetary or material benefits, exposes young women and girls to low condom use, unsafe sexual practices and increased rates of STIs.
- Child marriage – girls who marry as children are likely to be abused by their husbands and forced into sexual practices.
- Biological factors – adolescent girls are susceptible to higher rates of genital inflammation, which may increase the risk of HIV infection through vaginal intercourse.
Importance of HIV testing
HIV testing in young women and girls is essential. Many receive access to treatment and care services after testing. Some important determinants of testing are:
- Going through antenatal care
- Being married
- Having primary and secondary education
We need to aim for more young women and girls to being tested so that they know their status, and can access adequate care and treatment services. HIV testing is necessary for expanding on treatment and ensuring that people with HIV have healthy, productive lives.
Addressing the Impact
To address the impact of HIV on young women and girls we need to have approaches and interventions that incorporate the diverse perspectives of women and girls. This is needed on all platforms from campaigning and policy-making to program design. As the World Health Organization recommends, a woman-centred approach that includes women as participants is required, so that our needs, rights and preferences are considered.
Better strategies are needed across all health system to improve accessibility, acceptability, affordability, uptake, equitable coverage, quality, effectiveness and efficiency of services, particularly for adolescent girls worldwide.