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In sub-Saharan Africa, four out five new HIV infections among 15-19 year olds are in girls according to UNAIDS 2019 estimates. Surveys during 2011- 16 showed that more than half of rural women aged 15–24 in sub-Saharan Africa had been pregnant before their 18th birthday, and as recently as 2016, 40% of young women in sub-Saharan Africa and 30% in South Asia were married while still children. These examples highlight how gender power relations profoundly affect adolescent girls with lifelong consequences.