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New Study Identifies Best Ways to Reduce HIV in Adolescent Girls Worldwide

July 16, 2014

Increasing education, reducing violence among most effective strategies


The best way to reduce HIV among adolescent girls worldwide? Help girls stay in school. This is just one of a set of strategies that a new study has proven to be effective in reducing the risk of HIV among teenage girls.

The study is published in an article, “What HIV Programs Work for Adolescent Girls?" as part of special issue of JAIDS, the Journal of Acquired Immune Deficiency Syndromes. The special issue, entitled “Ending HIV and AIDS in Adolescents," was developed by the United Nations Children's Fund (UNICEF) and the U.S National Institutes of Health (NIH). The findings will also be released at the 20th International AIDS conference, held in Melbourne, Australia, July 20-25.

The study’s authors, Jill Gay and Melanie Croce-Galis of the What Works Association, a program of the Public Health Institute; Karen Hardee of the Population Council and Nana Ama Afari-Dwamena, a former George Washington University graduate student, examined 150 studies and evaluations from 2001 to 2013 to identify which strategies worked best to prevent HIV in girls ages 15 to 19.

The numbers paint a compelling and devastating picture of the need to specifically address adolescent girls in HIV prevention efforts. Approximately 2.1 million adolescents are living with HIV around the world. Among teens aged 15-19, two-thirds of new HIV infections are in girls.

As a 36-year-old Tanzanian man said in the report, “I have read about HIV… I think the young girls do not have this problem … If I meet somebody whom I don’t know much, I may use a condom, but not with a young girl.”

Yet few HIV prevention strategies specifically focus on adolescent girls. This represents the first study to address girls’ unique needs, and to compile evidence on the most effective strategies for reducing their risk.

In addition to keeping girls in school, other proven strategies include:

  • promote gender equity

  • reduce gender-based violence

  • increase legal protections for girls

  • promote strong and caring relationships with adults

  • provide access to age-appropriate sex education, condoms and other prevention strategies

  • support the most vulnerable girls, including adolescent girls who have been orphaned

“By compiling the research and analyzing the data to focus specifically on what works for girls, the study’s authors and What Works for Women & Girls are providing valuable insight to aid public health and public policy programming around the world,” said Mary A. Pittman, DrPH, president and CEO of the Public Health Institute (PHI), which houses What Works for Women & Girls, part of a portfolio of PHI programs to help make girls around the world stronger and more resilient. “This information has the potential to not only improve the health and build the resilience of countless young women, but also to direct programming that can make lasting contributions to the way girls are viewed, and treated, in societies around the world,” Pittman added.

Other PHI programs supporting girls internationally include Let Girls Lead, which has moved to strengthen child marriage laws in Malawi and Liberia; Champions for Change, which focuses on education for girls in Nigeria; and GOJoven, a program that uses leadership and capacity building to build reproductive health in Mexico and Central America.

These programs, and this study, offer many significant examples of the vital leadership role the U.S. plays in promoting equality for women and girls worldwide—a strategy recently announced to be a priority of the U.S. State Department.

In the HIV prevention study, education emerges as the most effective prevention strategy for several reasons. Girls worldwide have less correct information about HIV than boys because of lower literacy rates and lower rates of attendance at secondary school, where sex education is more likely to be taught.

The study delineates multiple strategies that have proven effective to help keep girls in school. These include eliminating the fees that are required to attend school in many countries, providing financial support for orphaned girls so that they are able to attend school and offering cash incentives to encourage girls to stay in school.

The benefits of staying in school also went far beyond lowering girls’ risk of HIV. Girls in school were 40% less likely to be married and 30% less likely to get pregnant.

What Works for Women & Girls has also published a brief summarizing the evidence and offering policy recommendations for HIV prevention in adolescent girls. It’s available online from the Public Health Institute.

About What Works for Women & Girls

What Works for Women & Girls is supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and Open Society Foundations and is being carried out under the auspices of the USAID-supported Health Policy Project, Population Council, Public Health Institute, and What Works Association, Inc.

About the Public Health Institute 
The Public Health Institute, an independent nonprofit organization, is dedicated to promoting health, well-being and quality of life for people throughout California, across the nation and around the world. For more information, visit www.phi.org.