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325. Girls under age 15 are five times more likely to die from maternity-related causes than women over age 20, and pregnancy and childbirth are the leading cause of death for women of childbearing age in Africa and South Asia. 205 326. From 2001 to 2012 HIV prevalence declined globally among young people, both females and males. 206 Across sub-Saharan Africa, the region with the highest prevalence of HIV, prevalence declined by 42 per cent. Dramatic decreases have been noted across all low- and middle-income countries. Variations are significant, however, with increases in HIV prevalence noted for male youths in Eastern Europe and Central Asia, and increases noted for both male and, in lesser proportion, female youths in the Middle East and North Africa.206 327. Furthermore, in regions where HIV is endemic, such as Africa, where almost three quarters of all people living with HIV reside, female youth have higher prevalence rates of HIV than males,206 particularly at the youngest ages, and males do not have comparable prevalence levels in many African countries until age 30 or more. These patterns are reversed in regions where HIV is predominantly transmitted through men having sex with men or intravenous drug use, where young males are at higher risk than young females.206 328. Despite progress, in 2009 young people aged 15-24 years accounted for approximately 41 per cent of new HIV infections worldwide, 207 highlighting the urgency for renewed efforts towards ensuring availability of targeted sexual and reproductive health information, education and services that keep young people informed of their risks and provide them access to condoms, screening and treatment for sexually transmitted infections, and HIV testing and care. Regarding data coverage, 29 countries, representing only 29 per cent of the adolescent population globally, collect data on HIV prevalence among youth aged 15-24, with data collected predominantly from sub-Saharan Africa and parts of Central and Southern Asia, and a selection of wealthy countries with comparatively lower HIV rates. 208 HIV data on young adolescents aged 10-14 years old is very limited, hindering advancements towards the prevention of new infections within this group. 209 329. The 2013 UNAIDS report on the global AIDS epidemic also reported that there are limited data on rates of comprehensive knowledge of HIV transmission, with data available for only 35 per cent of the global adolescent population. 210 Knowledge levels are low in many countries with generalized HIV epidemics, generally falling below 50 per cent of the national adolescent population, and no country exhibited comprehensive HIV knowledge among more than 65 per cent of their adolescent population. Significantly, females in sub-Saharan African countries __________________ 205 206
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UNFPA, “Giving birth should not be a matter of life and death” (see footnote 14 above). UNAIDS, Global Report: UNAIDS Report on the Global AIDS Epidemic 2013, pp. 16-17 (see footnote 16 above). Unpublished estimates from Global Report: UNAIDS Report on the Global AIDS Epidemic 2010, cited in UNAIDS, Securing the Future Today: Synthesis of Strategic Information on HIV and Young People (Geneva, 2011). Patton and others, “Health of the world’s adolescents: a synthesis of internationally comparable data”, p. 1667. UNAIDS, Global Report: UNAIDS Report on the Global AIDS Epidemic 2013, p. 18. Ibid., Patton and others, “Health of the world’s adolescents: a synthesis of internationally comparable data”, p. 1671.
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