“Sex is not a taboo. We should not be ashamed to talk about it.” This is what a Cameroonian girl told my colleagues last month. She is one of the lucky few: she participates in a program supported by the International Women’s Health Coalition that educates young people about their bodies. Yet in many places and contexts, open conversations about sex and sexuality are shunned, especially when girls are in earshot. As a result, girls remain one of the groups most at risk of HIV infection in the global South.
As we mark World AIDS Day, we must ensure no one is left behind—including and especially adolescent girls, who are disproportionately affected in sub-Saharan Africa. In South Africa alone, nearly 2,000 girls and young women are newly infected every week. How can we stop this?
In 2015, 193 countries pledged to end AIDS by 2030 as part of their commitments to the Sustainable Development Goals. To achieve this objective over the next 14 years, we must stop the violation of girls’ sexual and reproductive rights.
Many girls don’t have access to sexual and reproductive health education and are not adequately informed about HIV, how it is transmitted, and how it can be prevented. Those who know about and can access condoms often lack the power in their sexual relationships to ensure their partners use them. Many are in relationships with older men, from whom they receive cash or other gifts. Girls face high rates of sexual violence in those relationships, significantly increasing their risk of HIV infection.
One of the biggest failures in the U.S. response to HIV/AIDS during George W. Bush’s Administration was abstinence-only-until-marriage education. Between 2003 and 2013, the United States spent $1.4 billion on international programs that promoted abstinence and the belief that sexual activity outside of marriage is harmful and wrong. A Stanford University study, released earlier this year, looked at such programs in 22 countries; it found no evidence that they were effective in changing sexual behavior or reducing HIV risk. Not only was this a colossal waste of money, but young people, particularly girls, were deprived of lifesaving information about their health and rights, from mutual respect to contraception to safer sex.
Unfortunately, abstinence-only education is poised for a come-back under President Trump and Vice-President Pence. But we cannot go down this wasteful path again. We have to instead deepen our investment in comprehensive sexuality education. We have to challenge dangerous gender norms that encourage sexual violence, sexism, and homophobic hatred. We have to provide young people with the necessary skills and information to make free and informed decisions about their health and enjoy safe and satisfying relationships. Comprehensive sexuality education includes not just discussions about biology, but also about gender equality and power in relationships. A recent study found that comprehensive sexuality education is five times more likely to reduce sexually transmitted infections and unwanted pregnancies than programs that do not include these topics.
Girls around the world are claiming their rights to lead healthy and safe lives. We have to live up to their expectations. If not, we have no hope of ending HIV and AIDS by 2030.
Photo: Louise Gubb/UN Photo