• Their sexual and reproductive health and rights are often neglected
Gender inequalities, harmful masculinities and discrimination against key populations are major stumbling blocks in the HIV response, according to the United Nations.
"Adolescent girls and young women between 15 and 24 years are three times more likely to acquire HIV than adolescent boys and young men of the same age group in sub-Saharan Africa," said Winnie Byanyima, UNAids executive director, speaking during the launch of a United Nations report in Dar es Salaam, ahead of World Aids Day.
Titled 'Dangerous Inequalities', the report, delivered under the theme "Equalise" showed that women accounted for over 60 per cent of new HIV infections in Africa, in 2021.
While there was good news regarding the overall decline of the disease, this news, too, was clouded for adolescent girls and young women (15-24 years) among whom the decline was 42% between 2010 and 2021, while among boys and young men of the same age, the decline was 56 per cent.
The report called on governments to urgently make policy reforms that increase access to essential HIV services for girls and young women and greater investment in their education, citing a study that showed women who stayed in school until they completed secondary education reduced their vulnerability to HIV by up to 50 per cent.
Besides gender inequalities, discrimination against and criminalising of key populations also contributed to the lowering of HIV service coverage. Key populations include gay men, sex workers, transgender persons, people who inject drugs and prisoners.
According to the report, patriarchal norms also prevented men and adolescent boys from seeking the healthcare services they needed.
Byanyima stated, "Harmful masculinities are discouraging men from seeking care. While 80 per cent of women were accessing treatment in 2021, only 70 per cent of men were on treatment."
The report found that improving service provision and uptake among men as an HIV response could positively spill over to women and adolescent girls.
"Transforming harmful gender and masculinity norms among men and boys will help reduce their HIV risks, but it will also reduce risks and vulnerabilities to HIV among women and adolescent girls, including by respecting their sexual and reproductive health and rights and upholding zero tolerance for any violence against them."
Africa is, however, fairing better in HIV management, with the report indicating the region registered a decline in new infections.
Additionally, the report highly ranked Madagascar, Rwanda, South Africa and Zimbabwe as countries where married women or those in unions could make informed decisions about sexual relations, contraceptive use and health care.
"Such a trend should be encouraged as it shows the commitment by countries, including many in Africa to bridge inequalities, especially on a gender basis," explained Byanyima.
Botswana, Ghana, Lesotho, Malawi, Mozambique, Nigeria, South Africa, South Sudan, Togo and Tanzania were also positively highlighted for increasing domestic funding for HIV management between 2018 and 2021.
"In countries such as Angola and Kenya, where PEPFAR and Global Fund resources have flatlined or even declined, national governments were still able to increase domestic funding for HIV during the same period," the report read in part.
"What world leaders need to do is crystal clear," said Byanyima. "In one word: Equalize. Equalize access to rights, equalize access to services, equalize access to the best science and medicine. Equalizing will not only help the marginalized. It will help everyone."