In the fight to end AIDS, girls and young women matter


Former US President George W. Bush speaking during an event to mark the 20th anniversary of PEPFAR at the United States Institute of Peace on Feb 24, 2023, in Washington DC. — TNS

THE President’s Emergency Plan for AIDS Relief, or PEPFAR – which has saved 25 million lives over the past 20 years and allowed 5.5 million babies to be born HIV-free – demonstrates what’s possible when leaders, countries and communities hold each other accountable and work together to advance health systems and increase access to care for vulnerable populations.

However, there’s more work to be done. Many of the babies born HIV-free are now adolescent girls or young women who once again face significant risk of HIV exposure. This group accounts for almost two-thirds of all new infections in sub-Saharan Africa.

PEPFAR is an extraordinary example of the compassion and leadership of the American people. Congress should reauthorize PEPFAR this year so that it can finish the unprecedented work it started. And one place to level up is in our work with adolescent girls and young women: About 4,000 around the world from 15 to 24 years old became infected with HIV each week last year – more than seven times the average population of an American public school.

United Nations member states have set a goal of ending HIV/AIDS by 2030, and we’re halfway there. What was once a moonshot is now within reach. But the stakes have never been higher. To truly reach epidemic control, we must prioritise the needs of girls and young women, especially in regions such as sub-Saharan Africa, where 78% of the girls and young women being infected live.

Africa is home to the largest youth population in the world, with almost 75% of the people across the continent younger than 35. Half of them are female. That’s why sustainable programmes that overwhelmingly benefit women and children throughout their lives – such as PEPFAR – are so important.

Empowered girls become strong women. Strong women build vibrant, peaceful and prosperous societies. But to contribute, they need to remain healthy.

HIV risks for girls and young women are exacerbated by external factors such as conflict, climate change and economic crisis.

Poverty and severe food insecurity – which disproportionately affect women and girls – contributed to a “twofold increase in risk of recent HIV infection” for females in six African countries, according to a Columbia University study.

Antiretroviral drugs, which suppress HIV, are very expensive, and without programmes like PEPFAR, many young women would be forced to choose between paying for their medication or their next meal. And some HIV treatments are physically unbearable on an empty stomach, causing many to forgo treatment to avoid the side effects.

Lack of access to education is also an HIV risk factor for girls and young women in sub-Saharan Africa, which has the largest population of adolescents and youths out of school in the world. This population is growing – and girls and young women are less likely to be in school than male peers.

Another very concerning risk factor for HIV is the growing rates of gender-based violence. Coercion, sexual assault, domestic violence, transactional relationships and early marriage all stayed the same or increased during the Covid-19 pandemic amid regional and global instability.

Almost 29% of young women between 15 and 19 have already experienced some form of physical or sexual violence in their lifetimes, a study of 20 African countries by the Center for Global Development shows. Various studies reveal a significant number of young people across Africa have experienced at least one instance of sexual coercion before the age of 18.

The region also ranks high comparatively for rates of child marriage, intimate partner violence and femicide, again increasing the vulnerability of HIV transmission for girls and young women.

Programmes like PEPFAR have laid an incredible foundation for success, enabling nearly 2.9 million girls and young women to access critical support. This has included significant focus on closing equity gaps and engaging communities to increase access to HIV prevention and treatment services, as well as promoting education, peer networks, mentorship and economic opportunities.

Twenty years ago, Americans answered the call to save lives under the common value that to whom much is given, much is required. The United States must renew our commitment to this cause.

We stand at a precipice in the battle to end the HIV epidemic. But the world won’t win this fight if girls and young women in sub-Saharan Africa continue to be left behind.

In conjunction with the World AIDS Day on Dec 1, we need to remember that in the battle against HIV/AIDS, ongoing awareness, education, and support for those affected is vital.

It’s time to demonstrate that these women and girls’ lives matter just as much now as they did when they were babies born HIV-free. — Chicago Tribune/TNS

Natalie Gonnella-Platts is the director of women’s advancement and Hannah Johnson the programme manager of global health at the George W. Bush Institute.

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