The Aids response has failed women and girls. According to UNAIDS (pdf), one in five new infections among adults are among adolescent girls and young women ages 15-24 - and almost all of these infections are sexually transmitted. The numbers are clear: Aids is the leading cause of death of women of reproductive age, globally.
Last year, world leaders committed to end Aids by 2030, and this month governments met at the UN in New York to discuss how they are going to achieve this key target of the Sustainable Development Goals. In order to realise this goal, governments need to put the health and human rights of adolescent girls and women at the centre of their efforts.
While the world has made considerable progress in providing adolescent girls and women with lifesaving treatment, HIV prevention efforts have largely fallen short. Governments have simply not been willing to invest in interventions that we know work and instead have been funneling money into old, tired strategies. One example of this is the US’ $1.4bn (£98m) investment in abstinence and fidelity programs in sub-Saharan Africa. According to a recent study, it has had absolutely no impact.
So, what is it that governments need to do? There are four things that would make a major difference.
Talk about sex
As a young woman recently said to me, “Sex is fun and it’s free. There is no way that young people are not going to do it.” By investing in education that addresses sexuality, gender norms, power in relationships, and sexual and reproductive health in an evidence-based and nonjudgmental way, they can help build the skills of young people, particularly adolescent girls, to be able to deal positively with their sexuality.
Programs that address gender and power in relationships have been shown to be five times more effective in reducing STIs, including HIV, and unintended pregnancy than those that do not.
Protect sexual and reproductive rights
Governments must support women and girls to exercise their right to control their sexual and reproductive lives, by providing them with information and high-quality sexual and reproductive health services. They need to eliminate the barriers that keep them away, like age of consent or marital restrictions, user fees, mandatory HIV tests, and stigma and violence in healthcare settings. If women and adolescent girls cannot get condoms or an HIV test - or they think twice about seeking maternal health services because of the fear of disrespect and abuse in health settings - then we won’t see much progress.
End gender-based discrimination, stigma, and violence
The evidence is clear that violence is a major driver of HIV infection among women and that women living with HIV are much more likely to experience violence at the hands of an intimate partner. Discrimination against girls leads to harmful practices, like child marriage, which put them at greater risk of HIV. We have seen that programs that challenge and change gender norms are the ones with the greatest impact.
Empower adolescent girls to take control of their lives
By supporting girls to stay in school, easing their transition to work, and providing social protection, we can significantly reduce their risk of HIV infection.
Governments have a choice: they can either commit to take the actions that will make a real and meaningful difference in the lives of women and girls, or they can continue to put their heads in the sand and pretend that sex just doesn’t happen. We call on them to be bold and to do what it will take to end the Aids epidemic once and for all.
Content on this page is paid for and provided by Anglo American, sponsor of the social impact hub
