“The Stories Behind the Statistics” is a series we developed for the Gates Foundation blog, “Impatient Optimists.” The following post is the first in our series on young people and HIV. The original post, located on “Impatient Optimists,” is available here.
In the approximately two minutes it will take you to read this post, four young people will become infected with HIV.
Five million young people are living with HIV, and youth (ages 15‒24) account for 41 percent of all new HIV infections. Approximately 79 percent of new HIV infections among youth occur in sub-Saharan Africa, and adolescent females make up more than 60 percent of all young people living with HIV. Young men who have sex with men, young people who sell or trade sex, and young injecting drug users are also disproportionately affected by the HIV epidemic.
There are many factors that contribute to the high rates of HIV among young people including lack of appropriate sex education, lack of access to condoms, economic disparities, sexual violence, early marriage, stigma surrounding HIV, lack of access to counseling and testing, and criminalization of risky behaviors. Globally, only 34 percent of young people ages 15‒24 have a comprehensive understanding of how HIV is transmitted. Many young people living with HIV do not know they are infected; stigma associated with HIV infection can prohibit young people’s willingness or ability to seek testing. The behaviors of adolescents most at risk of HIV infection (young people who inject drugs, young people who sell or trade sex, and young men who have sex with men) are also often stigmatized or criminalized, which further marginalizes these young people, undermining their self-efficacy, their confidence in health and social services, and their willingness to make contact with service providers.
Income and gender inequality, sexual violence, and harmful traditional practices like early marriage, also fuel the HIV epidemic among adolescent girls. Economic disparity can lead to involvement in cross-generational or transactional sexual relationships, which limit young people’s ability to negotiate condom use and increase the likelihood of multiple partners and sex with older partners. Married adolescent females have little to no decision-making power related to condom use or sexual activity. In developing countries, 80 percent of unprotected sex among adolescent girls occurs within marriage. In some settings, young married girls (ages 15 to 19) have been shown to have higher rates of HIV infection than sexually active unmarried youth of the same ages.
HIV is preventable, but to halt the epidemic, young people need access to information and the tools to protect themselves. These include condoms, counseling and testing centers, and other preventive services. Interventions that provide young people with opportunities to stay in school, develop life skills, and avoid early marriage are essential to addressing the risk factors that increase young people’s vulnerability to HIV infection. The 2,500 young people who are infected with HIV every day are a glaring example of the insufficient attention to HIV prevention among this population. Young people deserve better.
In the next post in this series, we will hear from one young person in Kenya, about the factors that contribute to HIV among young people in his community and what he sees as the necessary solution to the global HIV pandemic among youth.