Young African women three times more likely to contract HIV than men

Gender inequality, harmful masculinity, and discrimination against key populations are major stumbling blocks in the response to HIV, according to the UN.

“Adolescent girls and young women between 15 and 24 years old are three times more likely to contract HIV than adolescent boys and young men of the same age group in Sub-Saharan Africa,” Winnie Byanyima, UNAids executive director, said.

She was speaking during the launch of a UN report in Dar es Salaam before World Aids Day.

Titled “Dangerous Inequalities”, the report, delivered under the theme “Equalise” showed that women accounted for more than 60% of new HIV infections in Africa in 2021.

While there was good news regarding the overall decline of the disease, this news was also clouded for adolescent girls and young women (15-24), among whom the decline was 42% between 2010 and 2021, while among boys and young men of the same age, the decline was 56%.

The report called on governments to urgently make policy reforms that increased access to essential HIV services for girls and young women and greater investment in their education, citing a study that showed women who stayed in school until they completed secondary education reduced their vulnerability to HIV by up to 50%.

Besides gender inequalities, discrimination against and criminalising of key populations also contributed to the lowering of HIV service coverage.

Key populations include gay men, sex workers, transgender people, people who inject drugs and prisoners.

The report said patriarchal norms also prevented men and adolescent boys from seeking the healthcare services they needed.

Byanyima said, “Harmful masculinity is discouraging men from seeking care. While 80% of women were accessing treatment in 2021, only 70% of men were on treatment.”

The report found that improving service provision and uptake among men as an HIV response could positively spill over to women and adolescent girls.

“Transforming harmful gender and masculinity norms among men and boys will help reduce their HIV risks, but it will also reduce risks and vulnerabilities to HIV among women and adolescent girls, including by respecting their sexual and reproductive health and rights and upholding zero tolerance for any violence against them.”

Africa is, however, faring better in HIV management, with the report indicating the region registered a decline in new infections.

Additionally, the report highly ranked Madagascar, Rwanda, SA and Zimbabwe as countries where married women or those in unions could make informed decisions about sexual relations, contraceptive use and healthcare.

“Such a trend should be encouraged as it shows the commitment by countries, including many in Africa, to bridge inequalities, especially on a gender basis,” Byanyima said.

Botswana, Ghana, Lesotho, Malawi, Mozambique, Nigeria, SA, South Sudan, Togo and Tanzania were also positively highlighted for increasing domestic funding for HIV management between 2018 and 2021.

“In countries such as Angola and Kenya, where the US President's Emergency Plan for Aids Relief and Global Fund resources have flatlined or even declined, national governments were still able to increase domestic funding for HIV during the same period,” the report said.

“What world leaders need to do is crystal clear,” Byanyima said.

“In one word: Equalise. Equalise access to rights, equalise access to services, equalise access to the best science and medicine.

“Equalising will not only help the marginalised. It will help everyone.” — bird story agency