Addressing HIV risk in adolescent girls and young women

Addressing HIV Risk in Adolescent Girls and Young Women CSIS Report.pdf

A global consensus is emerging around the urgency of going beyond biomedical interventions to address the social and economic factors driving HIV risk for adolescent girls (AG) and young women (YW).

In Eastern and Southern Africa, girls account for 80% of all new HIV infections among adolescents.

HIV/AIDS is the leading cause of death for girls aged 15–19.

7,000 girls and young women aged 15–24 acquire HIV every week.

This report, written by Janet Fleischman and Katherine Peck, of the Center for Strategic & International Studies (CSIS), cites STRIVE's work and endorses the emphasis on addressing structural drivers in order to tackle adolescent girls’ and young women’s HIV risk. Quoting SASA! as an example of preventing gender-based violence, the report also emphasises the complex dynamic between violence and HIV in adolescent girls and young women.

Adolescent girls and young women (AG and YW) have become a priority focus for HIV prevention. Tracing this development, Fleischman and Peck review current approaches, evidence and gaps. The discussion includes:

The exciting part about this paper is that they frame the failure to address structural drivers as one of the key issues around HIV prevention and adolescent women and girls. 

Deborah Baron, Wits RHI

Why this new, global focus? The paper identifies factors including:

  • attention to data and the stark, disproportionate burden of HIV among AG and YW
  • alarming demographics and the youth bulge which has made Africa the world’s youngest continent. In 2010, 70% of the region was under the age of 30
  • failure to address structural drivers as AG and YW continue to face a lethal mix of legal, economic and social factors which interfere with their ability to use and adhere to biomedical prevention technologies
  • limitations of new biomedical approaches/trials and the need to pursue a more holistic approach that includes longer-acting tools that require less ongoing adherence, in addition to finding ways to engage AG and YW to support greater adherence
  • PEPFAR 3.0 and its goal of epidemic control in prioritising programmes and targeting geographic hotspots with the highest disease burden for key populations 

The emergence of DREAMS and other international partnerships represent an ambitious effort to address structural factors for AG and YW. However, say the authors, it remains to be seen if these initiatives can demonstrate impact in a short timeframe and build toward sustainable programmes. 

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