Young women and girls are more than twice as likely to contract HIV as young men and boys, a new report indicates.

The United Nations Children’s Fund (UNICEF) report notes that nearly 98,000 adolescent females worldwide tested positive for the virus in 2022.

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Experts suggest that cultural attitudes, gender discrimination, and socioeconomic factors are contributing to the spread of HIV among women aged 10-19, particularly in sub-Saharan Africa.

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According to the report, 384 females between the ages of 10 and 19 test positive for HIV every day across the globe.

UNICEF indicates that approximately 87 per cent of HIV-positive children between the ages of 0 and 14, and 82 of HIV-positive adolescents aged 10 to 19 live in sub-Saharan Africa.

This is likely due to the increased vulnerability of adolescent girls and young women to forced sex (14.7 per cent to 38.9 per cent of sexual debut is forced in seven sub-Saharan African countries) and economic circumstances that may lead to young women trading sex for money or food.

Experts say that cultural attitudes, gender discrimination, and socioeconomic factors play a role in the spread of HIV among women, and suggest the need for more awareness and better access to HIV treatment.

The Centers for Disease Control and Prevention (CDC) reports that forced sexual initiation is associated with being unmarried, violence victimisation, risky sexual behaviours, sexually transmitted infections (STIs), and poor mental health.

Early sexual debut was associated with lower education, marriage, ever witnessing parental intimate partner violence during childhood, risky sexual behaviours, and less HIV testing.

The report notes that nearly half of the 1.5 million children living with HIV were still not getting antiretroviral treatment. Coverage was 77 per cent among adults (15 years and older) but only 57 per cent among children (0–14 years).

UNICEF’s goal is to have that percentage down to 10 per cent by 2025, which indicates the amount of awareness that must be raised and implemented.

HIV status in Rwanda, prevention mechanism

In the HIV, STIs, and Hepatitis Programs annual report 2022-2023 by Rwanda’s Ministry of Health, HIV prevention remains the key pillar in the fight against HIV, reducing new HIV infections, and assuring that people living with HIV are diagnosed and initiated on treatment early.

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The HIV positivity rate is estimated at 3 per cent among high-risk adolescent girls and young women who were linked to health facilities, with a high positivity rate in Kigali (5 per cent) and lowest in the Western Province (1 per cent).

To align with the global target to end AIDS by 2030, the Government of Rwanda, through the Ministry of Health and its implementing partners, is instigating different HIV prevention integrated components such as HIV testing and counselling (HTC), prevention of maternal-to-child transmission (PMTCT), male circumcision, behaviour change communication (BCC), and HIV treatment for scaling up prevention and treatment services at all levels.

There are efforts to improve healthcare facilities’ capacity to provide friendly and effective services to Adolescent Girls and Young Women (AGYW) through a minimum package of services to empower healthcare providers and key implementers with tools and conditions to deliver and address the determinants of health about new HIV infection.

Additionally, by creating a welcoming, non-discriminatory, and supportive environment for AGYW, pre-exposure prophylaxis (PrEP) is widely integrated into existing healthcare services, the report notes.

According to the Ministry of Health report, community outreach efforts to raise awareness and reduce stigma, as well as health education campaigns aimed at AGYW emphasising the benefits of comprehensive HIV prevention and SRH, are all underway. Collaborations with community organisations and stakeholders increased access to PrEP services.

About 330 out of 584 trained health facilities are offering PrEP, and 2,936 AGYW had been enrolled and retained by the end of June 2023.

According to the MoH report, it is imperative for both the wider public and specific target groups to possess an understanding of the existence and attainability of HIV prevention, care, and treatment services.

During the fiscal year 2022-2023, diverse strategies were implemented to increase the awareness of HIV, sexually transmitted infections (STIs), and viral Hepatitis prevention.

These initiatives included the utilisation of media channels such as radio and television spot creation and broadcast newsletters, and leveraging the influence of social media and expansive promotional campaigns.

To reduce HIV incidence among key and priority populations, Rwanda has put in place preventive strategies through the Rwanda HIV National Strategic Plan (NSP) 2018-2024.

Civil society organisations, working closely with communities have been engaged to support government efforts to achieve set goals. Various strategies were put in place to implement activities in alignment with the NSP 2018-2024 and contribute to the achievement of the global targets by 2030.