The impact of HIV prevention interventions targeted at adolescent girls and young women (AGYW) on HIV incidence and other biomedical, behavioural and structural outcomes in sub-Saharan Africa: A systematic review
Date: 22 July 2020
Time: 14h00 – 15h30
Livestream via Zoom
Prof. Heidi van Rooyen – HSRC
Dr Ali Feizzadeh – UNAIDS
Dr Ali Feizzadeh – UNAIDS
Dr Tawanda Makusha – HSRC
Prof. Lucie Cluver – Professor at Oxford University and University of Cape Town
Dr Thato Chidarikire – Director for HIV Prevention Programmes in the National Department of Health, Co- chair for the Prevention Expert Working groups for PFIP and National HIV Think Tank, as well as the WHO HTS Guideline Development Group
Remarkable progress has been made in the global fight against HIV. UNAIDS estimates that the number of new HIV infections in the overall population in sub-Saharan Africa declined by about 40% between 1997 and 2018. Although promising, these declines are too small and too slow to alter the vulnerability of key populations disproportionately affected by HIV, including men who have sex with men (MSM), injecting drug users (IDU), sex workers (SW) and adolescent girls and young women (AGYW) aged 15-24 years in sub-Saharan Africa. Of the 10 countries that contribute two-thirds of all HIV infections globally, 7 are in eastern and Southern Africa. In these regions, women account for 60% of all people living with HIV. Of all HIV infections occurring among adolescents in sub-Saharan Africa, four in five are in girls aged 15–19 years – with HIV risk being six times higher among young women than among young men in Southern Africa and three times higher in Eastern Africa.
AGYW in Malawi, Zambia and Zimbabwe are up to 14 times more likely to become HIV-infected than their male counterparts. In sub-Saharan Africa, AGYW are also twice as likely to be living with HIV than young men of the same age. Progress towards achieving the United Nations’ (UN) goal of ending AIDS as a public health threat by 2030 will not likely be reached unless a major effort is made to reduce HIV incidence rates in AGYW. For AGYW in resource-limited settings, these individual and relational barriers are exacerbated by structural constraints and other social triggers – including, poverty, gender inequality, violence against women, which increase the vulnerabilities of women in Africa. This systematic review explores biomedical, behavioural and structural programmes for AGYW, which are needed to reduce HIV incidence in this high-risk population in sub-Saharan Africa. We conclude that while all intervention models play important roles in the reduction of HIV incidence among AGYW, they have their limitations. In this regard, we argue for combination prevention strategies that are evidence-based and contextually informed to reduce HIV infection in this vulnerable population group.
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