#EndHIV4Her: Addressing the needs of young women and girls

While pursuing a degree in development and social anthropology, I participated in a course on HIV/AIDS and development. What seemed like a short dive into the subject would end up being the spark to a future career in global health. I found a passion in the realization that there exist deep-rooted links between such disparate topics as human behavior, culture, infrastructure, economics, and gender, to name a few.

However, the discourse on HIV/AIDS was quite different back then, compared to what it is now.

Back then, the price of antiretroviral treatments (ARTs) had for the first time, begun to decline dramatically. The sudden potential of access to treatment-for-all was exhilarating, and full of promise.

Progress lies not in enhancing what is, but in advancing toward what will be.”
Khalil Gibran

Ten years later, while attending a course on sexual and reproductive health and rights, HIV was now covered in a mere 2-hour lecture.

This, I believe, is indicative of some of the progress made in the availability of access to ARTs and more recently to pre-exposure prophylaxis PrEP, which has been shown to be effective in clinical trials for HIV prevention.

Despite active prevention efforts, annual incidence of new HIV infections has not decreased since 2005, according to a 2015 Global Burden of Disease study published in the Lancet.

Additionally, no one country was reported as achieving the UN’s Millennium Development Goal 6 by 2015, to halt and reverse the spread of HIV and provide universal access to treatment for all.

The latest UN’s Sustainable Development Goal 3 now aims to end HIV/AIDS by 2030, an ambitious goal, considering the halted decline in infections.

Gender as a risk factor

UNAIDS has estimated that 7,500 young women and girls, 10 to 24 years of age, become infected with HIV every week, with the highest rates in southern and eastern Africa.

New insights have been uncovered from studies such as by the Center for the AIDS Programme of Research in South Africa (CAPRISA), demonstrating that a “cycle of infection” exists linked to young women engaging in sex with older men.

The higher rates found among girls display a clear sign of gender bias in the risk for HIV infection, where girls make up 71% of all new infections among adolescents.

Evidence such as this highlights the need to address sensitive topics in prevention efforts such as gender-based violence, cross-generational sex, and transactional sex.

Last month, the 21st International AIDS Conference held in South Africa, brought the focus back to girls and women as a key population of interest.

Tuning our compass

One initiative focused on young women and girls is DREAMS, a partnership to reduce HIV infections among adolescent girls and young women in 10 sub-Saharan African countries.

The #EndHIV4Her twitter campaign is another effort that has advocated for HIV programming that specifically addresses the needs of women and girls.

Momentum is needed towards holistic approaches to HIV prevention and treatment that acknowledge the intersectionality of risk factors faced by female adolescents.

We may no longer need an entire course on HIV/AIDS, but if we hope to get anywhere near the UN Sustainable goal to end HIV by 2030, a lot of work still remains, most urgently in tackling the greater vulnerability of girls.