Population Council Programs Offer Evidence-Based Approaches to Protecting Adolescent Girls at Risk of HIV
Despite decades of investment in HIV prevention, adolescent girls remain underserved and at disproportionate risk of HIV infection. UNAIDS reports that in 2010, 26 percent of new HIV infections worldwide occurred in girls aged 15 to 24, and that the number of girls aged 10 to 14 living with HIV had increased six-fold-to 300,000--between 1999 and 2010.
There is an urgent need to restructure HIV investments and develop evidence-based approaches for protecting the large populations of adolescent girls who remain at risk of HIV infection. Population Council senior policy analyst Judith Bruce, Council consultant Miriam Temin, and Council researcher Kelly Hallman recently outlined the steps needed to reduce girls' risk of acquiring HIV. They recommend three key strategies: mining available data to find girls at risk of HIV, reframing investments to respond to girls' needs, and developing infrastructure to support girls. The Population Council is designing and assessing programs that demonstrate the feasibility of putting girls first.
Use available data to identify girls at exceptional HIV risk
Many policymakers do not realize that existing data can help them identify communities with large populations of adolescent girls at high risk of exploitation, human rights abuses, and HIV infection. In many settings, a high prevalence of risky conditions--such as being in a child marriage, living apart from parents, or being between the ages of 10 and 14 years and not enrolled in school--correspond closely to high HIV prevalence and high female-to-male infection ratios.
The Population Council and the United Nations Population Fund published a series of briefs for 50 countries that provide guidance on which girls are at risk, and where, likely drawing on census and Demographic and Health Survey data. The briefs, titled The Adolescent Experience In-Depth (http://www.popcouncil.org/publications/ serialsbriefs/AdolExpInDepth.asp), include data disaggregated by age. This information shows the ages at which girls are likely to experience harmful and sometimes irreversible events, such as child marriage or HIV infection. Policymakers and program managers can use this information to design protective programs that reach girls in time to prevent these outcomes.
Create girls-only safe spaces
Creating dedicated social spaces for girls is a proven approach for transforming the circumstances that put them at risk of acquiring HIV (see box, page 5). Vulnerable girls and young women--who often suffer from social isolation--gather regularly in these spaces to meet friends, consult with mentors, and acquire knowledge and skills to help them avoid or mitigate crises (such as threats of child marriage, leaving school, or forced sex). These spaces--which can be established inexpensively at community facilities like schools (after hours) and community centers--serve as locations for the delivery of non-formal education, services and support, and information about rights. Safe spaces can also be places for girls to develop safety plans and discuss private aspects of their lives with peers and mentors.
Investing in projects that respond to girls' needs
Governments and community organizations need to invest in programs that respond to girls' needs. The Population Council has developed, implemented, and evaluated a number of programs that demonstrate the feasibility and effectiveness of HIV prevention programs.
In Ethiopia, the Council's Biruh Tesfa ("Bright Future") program provides domestic workers, orphans, and migrants with HIV information and life skills in response to the high female-to-male HIV infection ratio among younger urban populations. Biruh Tesfa offers girls regular meetings with female peers and mentors, basic financial literacy, valid identification cards, and a wellness checkup. A recent evaluation showed significant benefits for participants: girls involved in the project were more likely to have accurate knowledge about HIV, were more likely to know where to go for voluntary counseling and testing, were more likely to want to get tested for HIV, and were twice as likely to have social support and safety nets as girls in a control site. …