Yes, SA girls aged 15 to 19 are up to 8 times more likely to be HIV+ than boys

Researchers are still figuring out why exactly girls are more susceptible to HIV infection than boys but sex with older men is thought to play a role, together with biological and sociological reasons.

Calling on sugar daddies and so-called “blessers” to stop dating young girls, South African deputy president Cyril Ramaphosa launched a three-year national HIV prevention campaign aimed at girls and women in June.

In an article on the launch, the South African government news agency reported that “girls between the ages of 15 and 19 are up to eight times more likely to be HIV+ than males of the same age”.

Could the difference be that high?

5.6% of girls & 0.7% of boys HIV+

A file picture of the Dapivirine vaginal ring, used to release antiretroviral drugs into the body to ward off HIV infection. Photo: AFP/STEPHANE DE SAKUTIN
A file picture of the Dapivirine vaginal ring, used to release antiretroviral drugs into the body to ward off HIV infection. Photo: AFP/STEPHANE DE SAKUTIN

Ramaphosa is the chair of the South African National Aids Council. The council’s monitoring and evaluation manager, Lifutso Motsieloa, told Africa Check the claim was based on South Africa’s 2012 National HIV Prevalence report.

The report, released in 2014, is the “most recent and credible population-level survey” on HIV among South Africa’s population groups, technical specialist on HIV and sexual and reproductive health integration at the United Nations Population Fund (UNFPA) in South Africa, Leonard Kamugisha, told Africa Check.

A team of scientists led by the Human Sciences Research Council interviewed more than 38,000 household members to collect data. The study is the fourth in a series that started in 2002.

The researchers found that an estimated 6.4 million people, or 12.2% of the population, were living with HIV/AIDS then.

More than 3,000 young people between 15 and 19 were tested for HIV. Based on this, 5.6% of the women and 0.7% of the men in this age group in South Africa were estimated to be HIV+, working out to an eightfold difference between the sexes.

Sex with older men

Professor Olive Shisana, co-chair of the International Aids Conference starting in Durban next week, was one of the survey’s principal investigators. She told Africa Check that women in the age group of 15 to 19 have a higher HIV prevalence because they start having sex early and with older men.

“The tendency in South Africa is for young women to have sex with men at least five years older whose chances of being HIV+ are higher,” Shisana said. She explained that one can see it in the fact that HIV prevalence among men aged between 20 and 24 was an estimated 5.1% which was closer to the prevalence among the girls aged 15 to 19.

The report stated that more needs to be done to challenge communities’ acceptance of these relationships. And as they have been associated with financial gain, “it is necessary to ensure that girls and young females are empowered and have access to education and employment to break the cycle of poverty”.

Stark gender disparities

Yet women across the board are more vulnerable to HIV infection than men. The survey found HIV prevalence was higher among women in 10 out of 11 age groups.

Between the ages of 0 and 14, there was a relatively low difference in HIV prevalence between girls and boys. Of the girls, an estimated 2.4% were HIV+ and of the boys, 2.3%. But from the ages of 15, the prevalence among girls rose significantly.

Men only had a higher prevalence (an estimated 15.5%) in the 50 to 54 age group, where an estimated 14.8% of the women were HIV+.

The disparities in HIV prevalence between men and women have been observed in other African countries but they are stark in South Africa, the director of research at the Wits Reproductive Health and HIV Institute, Professor Sinead Delany-Moretlwe, told Africa Check.

Delany-Moretlwe said behavioural factors play a role but added that girls in the age group 15 to 19 are also affected by biological and sociological reasons. She said immature genital tracts, greater use of hormonal contraceptives and pregnancy increase susceptibility to HIV infection. Some of the women have violent partners who are less likely to use condoms, more likely to have multiple sex partners and to be HIV+.

“Women in these partnerships may be more exposed to HIV and less able to protect themselves,” she said.

Deputy director general of the department of health, Dr Yogan Pillay, said independent researchers have conducted studies to determine why young women get infected more quickly after fewer sexual encounters. The findings will be released at the International Aids Conference next week.

Conclusion: Girls between 15 and 19 far more susceptible to HIV than boys

South Africa’s most recent national population-based survey found that 5.6% of young women between 15 and 19 were HIV+, compared to 0.7% of young men in this age group. The claim that “girls between the ages of 15 and 19 are up to eight times more likely to be HIV+ than males of the same age” is therefore supported by the latest data.

Researchers are still working out why exactly girls are more susceptible than boys but sex with older men is thought to play a role, together with biological and sociological reasons.

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