Reaching young men with prevention, treatment improves odds for female partners
AIDS is the leading cause of death for adolescent girls in eastern and southern Africa. Adolescent girls and young women are disproportionately affected by HIV compared to their male counterparts, accounting for 74 percent of new infections among adolescents in sub-Saharan Africa. This also is true globally, as about 400,000 new infections occurred in 2016 among adolescent girls and young women ages 15–24 years. The face of the AIDS epidemic on World AIDS Day 2018 is frequently female, and young.
One strategy for preventing HIV infection among this age group of women and girls is to prevent it among their male sexual partners who are HIV-negative, and reduce the viral load of their partners who are HIV-positive so there is less chance they will transmit the virus. This means answering the questions of where these men are, what their HIV status is, and how programs can reach them with preventive measures or treatment.
The task, then, is to work with adolescent girls and young women and their male sexual partners to unpack their sexual relationships—how they choose partners, the power differentials, and their risk of acquiring HIV in different types of partnerships. This information is critical to tailoring prevention messages for girls, and in defining the types of men who pose a transmission risk to them.
MEASURE Evaluation, funded by USAID, has just concluded a new study funded by the U.S. President’s Emergency Plan for AIDS Relief. The study, the first of its kind in Mozambique, sought to characterize the male sexual partners of adolescent girls and young women in that country, where HIV prevalence among female youth ages 15–24 years is 9.8 percent—more than three times higher than among males (3.2 percent). In Mozambique, contributors to vulnerability of adolescent girls and young women are early sexual debut; a lack of knowledge about HIV prevention; multiple sexual partners; low condom use; and, ultimately, poverty and gender norms that restrict choices.
Study results showed that men who have sex with adolescent girls and young women are diverse in terms of their demographic characteristics but are likely to be young (under 30 years) and unmarried and many are attending school. Many types of relationships were reported, and in most cases, men held the sexual decision-making power. Most male sexual partners of adolescent girls and young women were categorized as “high risk”—meaning that their sexual behavior puts them at high risk of acquiring or transmitting HIV. Several recommendations useful to HIV prevention programs emerged:
- Programs should target younger men.
- In-school HIV prevention and testing, workplace testing, and behavior change programs should be tested to see if they are effective.
- Youth-friendly family planning services combined with HIV services should be offered.
- Condom use should be promoted at child clinics and antenatal clinics.
- School-based and community programs should include adolescent girls and young women and offer life skills training.
Read the results of this study.
For more information visit MEASURE Evaluation
Jenifer Chapman, PhD, is a senior M&E advisor with MEASURE Evaluation, Palladium