A systematic review summarises published evidence on the association between early sexual debut and women’s risk of HIV infection in sub-Saharan Africa.
Early sexual debut may increase women’s risk of HIV infection in four different ways. Women who started sex early:
Findings from the SASA! Study
A cluster-randomised trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda.
SASA! achieved important community-level impacts on attitudes and behaviours relating to violence and HIV-risk, according to this study. Importantly, intervention impacts were seen at the community level – not just among people reporting exposure to the SASA! intervention – suggesting that social diffusion worked to disseminate SASA! ideas and behaviours throughout the community.
The effect of increased primary schooling on adult women's HIV status in Malawi and Uganda
Results indicate that a one-year increase in primary schooling decreases the probability of an adult woman testing positive for HIV.
Using data from the 2010 Malawi Demographic Health Survey and the 2011 Uganda AIDS Indicator Survey, the study takes advantage of a natural experiment: the implementation of Universal Primary Education policies in the mid 1990s. In Malawi the probability of a woman testing positive for HIV was shown to decrease by 0.06 and in Uganda by 0.03 after one additional year of primary school.
Teaching and learning: Achieving quality for all
UNICEF’s Education for All Global Monitoring Report includes data and analysis in relation to addressing the global gender imbalance in education. Priya Pillai of Karnataka Health Promotion Trust (KHPT) selected findings and messages that are relevant to STRIVE’s evaluation of Project Samata and to other interventions supporting adolescent girls to complete high school.
Gender inequality and HIV transmission: A global analysis
Compelling evidence indicates that improvements in gender inequality can lead to the abatement of generalised epidemics.
Worldwide, young women aged 15–24 are infected with HIV at rates twice those of young men. Young women alone account for nearly a quarter of all new HIV infections. The disproportionate HIV incidence in young – often poor – women underscores how social and economic inequalities shape the HIV epidemic.
Social forces that prevent equal access to therapies and effective care, as well as constraining women’s agency, include:
Galeshewe Stories: A booklet produced by the Northern Cape community alcohol advocacy project
STRIVE affiliate member, Soul City, trained young people to collecct personal stories on the impact of alcohol on their families, their friends and themselves. In Galeshewe in the Northern Cape, these young people gathered data about alcohol advertising along with their stories about the role of alcohol in people’s lives.
My mother drinks a lot and she does things without even herself being aware of these things – at times even asking me what she did when she is sober.
Understanding the masculinities, gender norms and intimate partner violence affecting the female sex workers of northern Karnataka
Existing norms – male dominance, infidelity, violence as a legitimate form of discipline – increase sex workers’ risk of contracting HIV while in intimate relationships.
This qualitative inquiry with the intimate partners of female sex workers aims to:
Community mobilisation and empowerment of female sex workers in Karnataka State, South India
A series of behavioural-biological surveys in 2008 and 2011 in four districts of Karnataka found that mobilising female sex workers is central to effective HIV prevention programming
Defining community mobilisation exposure as low, medium or high, the study revealed female sex workers with high exposure to community mobilisation are:
Women’s land ownership and risk of HIV infection in Kenya
Theory predicts that land ownership empowers women to avoid HIV acquisition by reducing their reliance on risky survival sex and enhancing their ability to negotiate safer sex.
Using a sample of 5511 women working in the agricultural sector from the 1998, 2003 and 2008-09 Kenya Demographic and Health Surveys, the authors examined the relationship between:
- women’s land ownership
- participation in transactional sex
- multiple sex partnerships
- unprotected sex
- HIV infection status
Women’s land ownership was associated with: