World AIDS Day focuses our attention both on successes, and on those whose needs remain urgent and unmet.
Although successful strategies have halved AIDS-related deaths since 2004 and increased access to treatment for those living with HIV, there is a vital swathe of the population who do not know how to protect themselves from infection. UNAIDS data from 37 countries show that only 30 per cent of young women and 36 per cent of young men have comprehensive and correct knowledge on how to prevent HIV infection. The combination of that lack of information and education with a lack of power to negotiate safer sex has disastrous consequences - demonstrated by the extent of new HIV infections among young women. Turning this situation around is an imperative for young women, and for their communities.
The effects of inequality are at their starkest when they compromise young lives. One such effect is the huge number of new HIV infections among young women aged 15-24. This age group is just 12 per cent of the world’s population, but accounts for nearly 20 per cent of new HIV infections, with the vast majority (80 per cent) living in sub-Saharan Africa (UNAIDS 2018). These young women simply do not have the resources to protect themselves.
The reported lack of knowledge on how to prevent infection joins other aspects of inequality, such as the likelihood of being out of school without a finished education; being married early with responsibility for care of the home and family, living in varying degrees of poverty, and—like so many young women all over the world—being in relationships of unequal power and control.
Every day, young women face barriers to seeking information about HIV and how to prevent it; as well as to accessing services. Comprehensive sexuality education is not available to everyone; there are restrictions for girls in accessing sexual and reproductive health services, for example, the need for parental permission; and gender-sensitive, youth-friendly services are in limited supply, as are safe spaces and peer networks where young women can discuss their health needs.
Knowing about HIV—including knowing one’s status—is a key to making informed choices. To bring the end of the epidemic in sight we need everyone to be able to seek testing, prevent new infections, access treatment, and acquire the skills to negotiate safer sex.
We need governments to make strong commitments towards ending the epidemic, prioritize the needs of young women in national HIV policies and local actions, and support women and girls to feel confident and empowered to demand that their HIV and other health needs are met.
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