We have come a long way in the fight against HIV/AIDS since the outbreak of the crisis, with institutions like the Global Fund and PEPFAR partnering with country governments to prevent mother-to-child transmission, allow those with HIV to access treatment, and ultimately save tens of millions of lives.
But despite these impressive efforts, there is still one demographic that is disproportionately likely to contract HIV. Globally, nearly 1000 girls and women ages 15 to 24 contract HIV every day, and the vast majority of them live in sub-Saharan Africa. Here, young women are twice as likely as young men to be living with HIV.
The Ong’ielo Health Center in Kenya is funded by the Global Fund and covers 10,300 people and offers a range of health services, including malaria and HIV testing and treatment.
And though those figures might be surprising at first, upon closer inspection we shouldn’t be surprised at all.
Risk Factors
The risk of contracting HIV is tied not only to physical health but to economic and social factors – and more specifically, layers of gender-based discrimination.
Across the globe, stigma and social taboos still surround girls being sexually active. This limits open conversation and education about safe sex and protection. As a result, girls often don’t have vital information they need to protect themselves against HIV and other sexually-transmitted diseases.
High rates of infection are also tied to girls’ economic vulnerability. Facing limited opportunities to earn income, girls face pressures to enter into transactional sexual relationships, where unprotected sex is exchanged for financial support. This is true both outside and inside of marriage, as many parents opt to marry their daughters off as children, due to a combination of economic constraints and social norms.
Finally, high rates of infection among women and girls are tied to their limited autonomy and bargaining power in their relationships; particularly at risk are those forced to marry as children. Even financially secure girls and women armed with information about protection face pressures from their partners to have unprotected sex.
The Global Fund
Fortunately, we know there are evidence-based ways to address all of these constraints, and the Global Fund and its partners are prioritising a holistic approach that gets to the root of all of them.
More than half of the Fund’s spending is now specifically targeted to programs for women and girls, contributing to a total investment of US$18 billion since 2002. The Global Fund launched a program called (HER) to mobilise additional resources to address the specific needs of adolescent girls and young women.
In Botswana, the Global Fund provides legal aid services and support to women and girls who are survivors of gender-based violence, while eliminating structural barriers to quality health care.
In Kenya, Swaziland, and South Africa, programs aim to keep girls and women ages 14-22 in school and to offer them additional educational and social support.
Sexual and reproductive health services have been integrated into HIV services in Lesotho so women can access both services in one place.
Quality secondary education (including comprehensive sexuality education), cash transfers that decrease girls’ economic insecurity, and interventions aimed at increasing girls’ agency and bargaining power all contribute to ensuring girls are less likely to contract HIV.
We Need to #StepUpTheFight
As we gear up for the Global Fund’s 2019 replenishment, let’s make sure the fund is able to access the financial resources it needs and eradicate HIV/AIDS once and for all, by continuing to put the needs and constraints of girls and women front and center in their investments.
