XIX International AIDS Conference (AIDS 2012) Washington D.C. Wednesday Plenary Session GeetaRao GuptaUNICEFUnited StatesUSA and Canada
© IAS/Ryan Rayburn – Commercialimage.net
A report by Deborah Cohan, MD, MPH, associate professor, Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF:
Dr. Geeta Rao Gupta, deputy executive director of UNICEF, spoke this morning about the roadmap to turning the tide for women and girls. Women and adolescent girls bear the burden of the HIV epidemic globally.
Women and girls are particularly vulnerable to HIV because of limited access to education, limited control of productive resources including income, land and employment, and limited social capital.
Adolescent girls are particularly at risk. There are an estimated 4.8 million young people (15-24 year olds) living with HIV, 3 million of whom are girls. Of the 2.2 million adolescents (10-19 year olds) living with HIV, 60 percent are girls. An even higher proportion of HIV-infected adolescents are girls in sub-Saharan Africa.
There are many biological and social reasons for this. Compared to boys, girls are more likely to be sexually active by the age of 15. In particular, girls are more likely to be sexually active with sexually experienced older men. One in three 20 to 24 year olds in the developing world are married before the age of 18.
A high proportion of these women also experience young motherhood with comes with a host of physical and emotional demands. Sexual violence also drives the HIV epidemic among girls and women. An estimated 150 million girls experience sexual violence every year. Much of this violence occurs while traveling to school or at school and is a common reason for dropping out of school.
Given the magnitude of this problem, what can be done to turn the tide? Dr. Gupta discussed the 2011 HIV Investment Framework, including funding basic program activities, such as promotion of condoms, male circumcision, prevention of mother to child transmission, treatment, and behavioral change among key populations in the context of capitalizing on critical enablers and synergistic programs.
She cited modeling estimates that if the HIV Investment Framework were applied to work on adolescents, HIV incidence would dramatically drop in this population by 2015. Effective strategies in this population include adult-led sexual health education programs, use of radio, TV and other mass media, youth-friendly health services and peer-led community-based educational interventions.
Dr. Gupta urged implementation of five steps including:
1) investment in relevant national plans that target adolescents and girls,
2) working with the education sector to ensure that girls not only receive the education that need but the confidence to act on the knowledge they have,
3) including adolescents in monitoring and routine data systems,
4) investment in innovative programs that use social media and technology to reduce the risk of social isolation and increase access to evidence-based services such as HIV testing and
5) engaging adolescents as partners.
Dr. Gupta spoke passionately about the importance of acknowledging that girls are sexual beings and that they should be a visible part of the solution. By capitalizing on girls’ boundless energy and curiosity and acknowledging that they are sexual beings, we can facilitate their transition into a healthy adulthood.
Dr. Gupta urged us all to aim for not only an AIDS-free generation but justice. That must be our legacy.