strategy for HIV prevention in the long term. UNICEF and partners are assessing early experiences of delivering early infant medical male circumcision using maternal, newborn and child health platforms that may lead to an expansion of this intervention in high HIV prevalence countries. Adolescents face many barriers to accessing health and support services, and they are routinely neglected in national and global AIDS strategies. This must change. Without increased attention to the needs of adolescents, an AIDS-free generation cannot be achieved.
Inequities and barriers to services Three broad groups of adolescents face major barriers accessing prevention, treatment and care interventions: adolescent girls, adolescent key populations and adolescents living with HIV. The core vulnerability of these groups lies in structural, socioeconomic and gender inequality, including failures in child protection and social protection. This can be exacerbated where providers lack skills or are unwilling to work with at-risk and vulnerable adolescents, which too often results in limiting their access to accurate information and the services they need.
1 in 5
women globally has had a child by the age of 18.v
In 2012, approximately two thirds of new HIV infections in adolescents aged 15–19 years were among girls, mainly in sub-Saharan Africa.119 In three countries in this region more than 80 per cent of the adolescents aged 15–19 years who were newly infected with HIV in 2012 were adolescent girls – South Africa (82 per cent female), Sierra Leone (85 per cent female) and Gabon (89 per cent female).120 Social and economic inequalities play a marked role in the vulnerability of adolescent girls and the disproportionate levels of HIV among them. Low social status, household poverty and food insecurity, poor-quality education and violence all limit opportunities for girls. The death of caregivers and the caregiving role that is so often assumed by women and girls can be limiting. The promise of gifts and other financial and social benefits, including the potential for upward social mobility, can affect early sexual debut and motivate girls to engage in age-disparate sexual relationships, transactional sex or marriage at a young age. Where HIV prevalence is high, these factors combine with increased biological vulnerability, limited knowledge about HIV and low risk perception to enhance the risks and limit the choices girls and their families make.121
29%
20%
In UNICEF’s Eastern and Southern Africa region, of females and of males aged 15–19 years have ever tested for HIV and received their results.vi
210,000
An estimated children under 15 died from AIDS-related illnesses in 2012.
Social and economic inequities drive HIV in adolescent girls
150 million
73 million
girls and boys vii under the age of 18 have experienced sexual violence.
13%
9%
In sub-Saharan Africa, where HIV prevalence is high, of girls and of boys aged 15–19 years reported sexual debut before the age of 15. Slightly higher rates are reported for adolescent girls in West and Central Africa (16%).viii
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