Why HIV infections are high among girls, young women
As Aisha* was attending her first prenatal clinic, she discovered she was HIV positive. At 17 years then, her main questions were how and when she got the virus, queries she is yet to answer three years later.
For most girls at that age, their priority is to succeed in life and they are all aware that education is the catalyst from poverty to a better life.
And it was not any different for Aisha, as she pegged all her hopes on her education to uplift her family in Muamarani village, Kilifi county. “I was the first born in a family of eight children. Life was not easy for us. Affording basic needs like food and decent clothing was an uphill task,” she reveals.
And for the girls in that family, the situation was worse due to unavailability of essential needs such as sanitary towels
Unwanted relationship
This, among other reasons, made Aisha look for ways of acquiring basic commodities. And since she was not working, she found herself in an unwanted relationship with a boda boda rider.
“Within no time, I broke up with him as I felt he was not providing what I needed. I got into another relationship with another rider. He would pick and drop me from school, and give me small gifts, mostly little amounts of money,” she says.
In her sexual encounters, her main fear was on getting pregnant, and not on the risks of being infected with sexually transmitted infections (STIs) due to unprotected sex. “I used to have sex without protection because my worry was mainly on pregnancy. I would take emergency contraceptives afterwards,” she recalls.
Aisha’s hopes of proceeding to high school were shattered by poverty after completing Class Eight primary level education. She sought other means of survival, such as taking up casual labour.
When she met a man who proposed marriage, Aisha did not think twice. A short time after moving in with him, Aisha realised she was four months pregnant.
She therefore visited the nearby hospital for prenatal check-up and underwent several health tests. “It was mandatory to undergo HIV testing, where I discovered I was positive. I was shocked,” she narrates.
She was asked by the doctor to bring her husband, who upon testing was discovered to be negative. This led to their separation, amid claims of infidelity. “I’m now raising our healthy son alone,” she notes.
Aisha’s story is not unique, especially for girls her age in Eastern and Southern Africa where recent reports paint a gloomy picture of new HIV/AIDS infections a.
A report by UNAids shows the region has made major strides in controlling infections more than any other across the globe.
But the same cannot be said for young women and girls — a key population indicated by the 2022 report to have high infection rates compared with other age groups.
The study shows young women and girls accounted for 63 per cent of Sub-Saharan Africa’s new infections in 2021.
UNAids says six in seven new infections among adolescents aged 15-19 years were among girls. The infections were three times higher among girls and women aged 15 to 24 years than among their male counterparts in the same age group.
The organisation estimates that 4,900 young women of this age set are infected with the virus every week. This is an addition to the fact that 54 per cent of people living with HIV were women and girls.
High-risk group
The report further shows a key population — which includes sexual workers and their clients, gay men and men who have sex with men — to account for 51 per cent of new infections in Sub-Saharan Africa.
Sex workers accounted for 15 per cent of new infections, their clients and sex partner’s 26 per cent, gay men and men who have sex with men (6 per cent) while people who inject drugs, and trans-gender, accounted for three (3) per cent and one (1) per cent of the infections, respectively.
In Kenya, 42 per cent of new HIV infections in 2020 were of young people between 15 and 24 years old. And as of 2021, 1.43 million people were living with HIV in the country, whereas 2.9 per cent were men and 5.5 per cent were women.
According to the National Aids Control Council, 54 per cent of reported cases of sexual violence were among adolescent girls between 12-17 years, raising the possibility that new infections among young women result from sexual violence.
Health advocate Joyce Ouma says there are a number of factors that might be contributing to the high numbers of HIV cases among girls and young women in Africa.
She notes that poverty has pushed these women into early sexual experiences where they do not have powers to negotiate, especially in cross-generational sex.
She further says cross-generational sex has become transactional and it’s being embraced even by families.
Joyce adds that the society is yet to embrace female protection methods such as condoms. “Unlike male condoms, which have evolved over time, female condoms remain boring and infamous,” she notes.
Girls and young women also face higher risks of sexual abuse, hence the rising numbers of new HIV infections. Life coach Thuo Kabii says the top contributor to new infections among girls and young women is peer pressure and desires for good lifestyles, which push them to married men. These relationships, referred to as “sponsors or mubabaz”, are now common.
Joyce says there is a need to introduce comprehensive sex education to young people, something that has been opposed by parents and religious leaders.
* Not her real name
He says girls in this age group are mainly in high school or college and are easily swayed by money and gifts in exchange for unconditional sexual favours. Since they lack family guidance, they find themselves in the wrong hands.
“Most of the new infections are from older men who can sleep with many girls as they have expandable money,” he notes.
The situation has been made worse by acceptance of such lifestyles by families, who turn a blind eye to transactional sex after the girls become family bread winners, he adds.
Joyce says there is a need to introduce comprehensive sex education to young people, something that has been opposed by parents and religious leaders.
“We should stop burying our heads in the sand. Teaching them sex education will inform the choices they make. Let’s teach them the negative and also the positive side of sex,” she notes.
The health advocate further recommends setting up of a social protection fund, such as cash transfer scheme, which will be used to cushion girls from poor families.
“The society has normalised bad habits such as prostitution in the name of sponsors. For most of them, their fears are getting pregnant and not contracting HIV and that is why condom is not a priority,” he notes.
