For many young women and girls, making safe and informed choices, which could limit their exposure to HIV, is no simple task. A young woman in poverty may be forced to exchange sex for favours, or to accept a marriage proposal from an older man.
Those seeking health care may be turned away due to their age, driven away by stigma, or be unable to afford it. In some countries, girls are old enough to marry and become pregnant while considered too young to access sexual and reproductive health services on their own.
Every day, 460 adolescent girls become infected with HIV worldwide. Empowering young women to make safer, more informed choices is often hailed as the way to turn this catastrophic situation around. But what does the path to empowerment look like? And who should be leading the charge?
Not just health
In Zimbabwe, new HIV infections among young women aged 15–24 years are almost four times higher than in men their age. Encouraging young women to remain in school and pursue a career, receive healthcare without fear of discrimination, or to find protection in the legal system is not a matter for the health sector alone.
It requires comprehensive support which addresses the HIV-related vulnerabilities of women and girls. UNDP and the Global Fund to Fight AIDS, Tuberculosis and Malaria are working with the National AIDS Council in Zimbabwe to address the drivers of gender inequalities, help young women mobilize, and ensure laws and policies reflect their lives.
Education is important
Getting and keeping girls in school is important. In countries with generalized epidemics, young people with higher levels of education are more likely to use condoms and less likely to engage in casual sex than their less educated peers. The recent educational subsidies for 6,000 girls is not only keeping them in school, it is also reducing their risk of HIV.
We must also ensure that teachers and schools are committed to addressing these issues head on. Which is why Zimbabwean teachers are now being trained to introduce comprehensive sexuality education in school curriculums.
Supporting community initiatives is another crucial part of the puzzle. ‘Sista2Sista’ clubs have provided a safe space for 30,000 adolescent girls to get health information and receive referrals to HIV services. For women affected by domestic violence, free medical and legal services are made available through one-stop centres. Community leaders and men are also being sensitized in safe spaces for open conversations on issues of gender and HIV.
Challenging stigma and providing healthcare alone will not solve the issue. Ensuring laws and policies safeguard the health rights of young people are the cornerstone of empowerment initiatives. This requires young people to be heard by those in power. With support from the Netherlands, UNDP supported dialogues between young women and girls and members of parliament which allowed them to hear first-hand about the challenges that can cause new infections among young people. The aim is to ensure the meaningful involvement of adolescent girls and young women in the drafting of laws, policies and guidelines that directly affect them.
The path to empowerment starts by addressing the social, cultural, economic, and political aspects of risk and vulnerability. It must involve families, communities, law makers, health workers, teachers, development agencies and most importantly, young women and girls themselves. Ultimately, it means recognizing that there are many pieces to the empowerment puzzle, and everyone has a role to play.