HIV and AIDS Among Youth
Half of new HIV infections worldwide are in women, and in 2007, young people, ages 15–24, accounted for about 40 percent of new HIV infections among people age 15 and older. Globally, there are 5.4 million young men and women who are living with HIV, and nearly 60 percent of them are female.

Unfortunately the 2007 published data from The Joint United Nations Programme on HIV and AIDS do not address the age group 15–19 specifically. The 2002 data indicated much higher rates of infection in girls than in boys in this age group in urban areas of southern and eastern Africa.

In sub-Saharan Africa, on average, three young women, ages 15–24, are infected with HIV for every young man; in some countries in the Caribbean, young women, ages 15–24, are more than twice as likely to be infected with HIV than young men.

In Cambodia, three times as many women and girls, ages 15–24, are living with HIV as their male counterparts.

In South Africa, an estimated 14 percent of young women and four percent of young men, ages 15–24, are living with HIV.

In Lesotho, fewer than ten percent of girls ages 18 and 19 are living with HIV, but by age 24 almost 40 percent of them will be HIV-positive.

Adolescent Girls’ Experiences of Sexual Coercion and Violence

Girls are highly vulnerable as children and adolescents to sexual abuse and violence in their homes, neighbourhoods, schools, and communities. Early sexual initiation is strongly associated with sexual coercion in many places.

In Lima, Peru, 45 percent of women who first had intercourse before age 15 said they were coerced. Comparable figures for provincial Tanzania and Bangladesh are 43 percent and 36 percent, respectively.

In South Africa, the most prevalent crime reported against children is rape. Forty percent of rapes or attempted rapes reported to the police are of girls under age 18.

Among primary school students in Malawi who reported having experienced forced sex, 71 percent said that it had happened at school. More than 80 percent of the students said they knew someone who had been sexually victimized by a teacher in return for good grades. Girls reported higher rates of sexual coercion than boys overall.

Among sexually experienced Kenyan boys and girls ages 10–19, 45 percent of girls and 17 percent of boys had been forced into non-consensual sex at least once. Boys who had been coerced themselves were four times more likely than those who hadn’t to admit to persuading or forcing girls to have sex against their will.

Sexual initiation within marriage may also be forced. Substantial proportions of Ethiopian and Bangladeshi women said their sexual initiation was forced (see table), and virtually all of these girls experienced sexual initiation within marriage.

Sexual Violence and Girls’ Vulnerability to HIV and AIDS

The use of physical force or emotional coercion during a sexual act greatly increases the risk of HIV transmission to the female if the male is infected. The female genital tract is highly susceptible to sexually transmitted infections (STIs), including HIV. Violence and rape can further increase HIV risk by causing abrasions, bleeding, and tearing, especially among young girls whose genital tracts are not yet fully mature.

Many girls and young women, especially the very young, cannot refuse unwanted sex or negotiate protection from pregnancy and STIs, including HIV, particularly when they fear retaliation. They can suffer multiple adverse physical, social, and emotional outcomes. In situations of force or coercion, whether by strangers, acquaintances, family members, boyfriends, “sugar daddies,” or husbands, negotiating condom use is virtually impossible.

A study in South Africa which included young women ages 16 and over found that women who are in relationships with violent or domineering men are 50 percent more likely to contract HIV than women not involved in abusive relationships.

For girls who marry young, physiological vulnerability is compounded by exposure to frequent, unprotected, and also forced sexual intercourse within marriage. Young girls married to older men are at especially high risk because their husbands are more likely than younger men to have had other partners and to be HIV-positive. In Uganda, the risk of HIV infection doubles for girls ages 15–19 who have male partners ten or more years older.

Some abusive men control their female partners by forbidding them to leave the house, contact friends or family members, or attend health clinics or other community services. Young married girls are often particularly isolated, but most adolescent girls who experience sexually abusive relationships or encounters have difficulty accessing services.

Violence can be both a cause and a consequence of HIV infection. Women in some studies report fear of being beaten or abandoned by their partners as their main reason for not obtaining an HIV test, not disclosing the results, or not requesting that their partner be tested, use condoms, or be faithful.

Read full report on International Women's Health Coalition Website