Sexual transmission of HIV

A powerful message about the need to progress on both the response to HIV and the sexual and reproductive rights of young people came out of the seventh Africa Conference on Sexual Health and Rights, which took place in Accra, Ghana, from 8 to 12 February.   

The theme of the conference was “Realizing demographic dividend in Africa: the critical importance of adolescents and youth sexual and reproductive health and rights”. It was hosted by the First Lady of Ghana, Lordina Mahama, who is also the President of the Organisation of African First Ladies against HIV/AIDS (OAFLA), and brought together a broad range of stakeholders from government, the diplomatic community, youth groups, organizations of people living with HIV, the private sector, academia and the media.

The conference concluded that it was possible to end AIDS as a public health threat by 2030 only if the sexual and reproductive rights of young people were respected. The need for multisectoral investment in services for young people, including comprehensive sexuality education, was underlined.

Of the total number of adolescents living with HIV globally in 2014, 83% lived in sub-Saharan Africa. AIDS is now the leading cause of death among adolescents in Africa, and adolescents are the only age group in which AIDS-related deaths are not decreasing. In low- and middle-income countries, one in every three girls is married before reaching the age of 18, and one in nine is married before reaching their 15th birthday. Only a quarter of girls and a third of boys are reported to have a full understanding of how HIV is transmitted or how it can be prevented.

During the conference, Ms Mahama championed OAFLA’s launch of the continental All In campaign to end AIDS among adolescents. OAFLA also launched an initiative to end child marriage by 2020. 

Geneva, 11 December 2015—UNAIDS and the International Planned Parenthood Federation (IPPF) have signed a memorandum of understanding to Fast-Track access to HIV services by 2020. Under the partnership, UNAIDS and IPPF will support the delivery of high-impact HIV advocacy, prevention and treatment services, particularly in sub-Saharan Africa.

The partnership will boost collaboration in four specific areas: integrating HIV and sexual and reproductive health services and ensuring that people can realize their sexual and reproductive rights; stopping new HIV infections among children and keeping mothers alive; expanding HIV services for young people; and ensuring key populations—gay men and other men who have sex with men, transgender people, sex workers and people who inject drugs—are reached with life-saving HIV prevention, treatment, care and support. In each of these areas UNAIDS and IPPF will work jointly to ensure that there is prompt and concrete joint action on the ground.

“This partnership is about turning targets to results so that no one is left behind,” said Michel Sidibé, Executive Director of UNAIDS. “Many young people, women and key populations are still out of reach and in need of access to sexual and reproductive health and HIV services.”

UNAIDS and IPPF will aim to ensure that young people have the knowledge, agency and means to protect themselves from HIV and that all women have access to sexual and reproductive health and rights, including HIV, services. Ensuring that all people live in equality and dignity, free from discrimination and violence, will also be a goal. Progress on the objectives of the partnership will be reviewed annually.

“We are delighted that we are entering this partnership with UNAIDS,” said IPPF’s Director-General, Tewodros Melesse. “It isn’t about making a difference in London or Geneva. It’s about making a real difference on the ground, so we are able to work together to provide more integrated HIV prevention, testing and treatment services, especially for the most marginalized and underserved in society.”

The partnership will advance the UNAIDS Fast-Track Strategy to end the AIDS epidemic as a public health threat by 2030. To do this will require front-loading investments over the next five years, reaching the UNAIDS 90–90–90 treatment target, expanding access to HIV prevention and ensuring zero discrimination.

The memorandum of understanding was signed at UNAIDS headquarters in Geneva during an event on the rights, roles and responsibilities of men in Fast-Tracking the end of AIDS, organized by UNAIDS, IPPF and Sonke Gender Justice. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP,  UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely  with global and national partners to end the AIDS epidemic by 2030 as part of the Sustainable  Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter and Instagram.

IPPF

International Planned Parenthood Federation (IPPF) is the world’s largest sexual and reproductive health and rights provider. Since 1958, IPPF has served the poorest and most vulnerable, delivering health services that empower women and girls, including 149.3 million services to 61.8 million people in 2014.

Young people in eastern and southern Africa, like many of their peers around the world, often receive conflicting and inaccurate information about sex. This can lead to badly informed decisions about how, when or with whom to have sex and how to protect themselves against HIV. 

With support from UNAIDS, UNESCO and SAfAIDS a major regional series of radio and TV programmes has been launched to address this gap. It is designed to deliver comprehensive sexuality education to young people and give them a forum to discuss issues around sex and sexuality, in a region where HIV prevalence is high. Across Africa, AIDS-related illness is still the leading cause of death among adolescents, and adolescent girls and young women are especially vulnerable to new HIV infections.

According to Charity Banda, HIV/AIDS Coordinator at Zambia’s Ministry of Education, this move is very important. “By facing puberty without being prepared, young people are left confused and unsupported. This ultimately makes them vulnerable to high-risk behaviours that increase their chances of contracting HIV. That’s why this new initiative is so timely.”

The series was first launched in Zambia on 21 February 2015 and is set to be broadcast in five other countries later this year: Malawi, Mozambique, Namibia, South Sudan and United Republic of Tanzania. The Zambian series has 26 TV episodes,  13 radio episodes and includes a 15 minute live talk show every Saturday called The Sexuality Talk Challenge.  

It is being aired on the largest television and radio network in the country, the Zambia National Broadcasting Corporation, which reaches more than 4 million people every day on TV alone. The programmes are being translated into several local languages.  

Guests on the show include young people, youth-led organizations, teachers, government officials, policy-makers and civil society representatives. Topics discussed on air have touched on: love, sex and healthy relationships; self-esteem and understanding yourself and your rights as an adolescent; peer pressure; and challenging misconceptions. One episode has also been dedicated to improving communication between young people and the significant adults in their lives.   

“Evidence has shown that teenagers who have discussed issues with their parents or guardians are more likely to make safer, smarter decisions about sex and their sexuality,” said Patricia Machawira, UNESCO’s Eastern and Southern Africa Regional Advisor on HIV and Education. “This includes waiting longer to begin having sex, having fewer sexual partners, using contraception and having the confidence to say “no” to doing anything they are not comfortable with,” she added.

The series’ frank and open discussions have already been sparking debate. The partners hope that by the time the programme finishes its run in Zambia at the end of June such discussions will have helped break down barriers to communication, with access to accurate information empowering young people to make informed choices for a better, healthier future.

As Medhin Tsehaiu, UNAIDS Country Director for Zambia, sums up, “Information is power and young people need to be equipped with the right information and skill to make right decisions.”

GENEVA, 18 November 2014—UNAIDS welcomes the recent ruling by the High Court of Botswana upholding the right of an organization that supports lesbian, gay, bisexual, transgender and intersex (LGBTI) people to register in the country.

In its groundbreaking judgement, the court held that the refusal by the government in 2012 to register the organization known as LEGABIBO (Lesbians, Gays and Bisexuals of Botswana) violates the rights to freedom of expression, assembly and association protected by the country’s constitution. The ruling represents the first time a high jurisdiction in Africa has upheld the freedom of assembly and association for LGBTI people.

“Through the courage of civil society organizations and the boldness of its judiciary, Botswana is sending an important message of inclusiveness and freedom,” said Michel Sidibé, UNAIDS Executive Director.

A valuable lesson learned in over 30 years of the HIV response is that civil society, particularly organizations of people living with and vulnerable to HIV, is essential to advancing health, dignity and development.

While Botswana has sharply increased access to antiretroviral therapy in the past decade, HIV prevalence in the country is still one of the highest in the world, at 21.9%. In response, Botswana is implementing a national strategic framework that includes the protection of human rights for all as a guiding principle.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Now a 19-year-old university student in South Africa, Noxolo Myeketsi started receiving a social welfare grant in 2005. Part of a state-run programme to assist poor households, the cash transfers allowed her to stay in school and her grandmother to buy food and pay their bills.

The grant changed Noxolo’s life for the better. Other girls turned to having sex, often with older men, in exchange for basic needs, and potentially exposed themselves to sexually transmitted infections and HIV.

“I believe that without the grant assistance, I would not have been able to make healthy decisions in my life. Maybe I would have ended up being a sugar daddy’s girl, like others from my area, or ended up contracting HIV,” Noxolo said.

Social protection schemes, including financial incentives, can make a difference in a number of ways. The World Bank reports that, globally, there is strong evidence that cash transfers improve the education, health and lifelong income of beneficiaries. 

“Cash transfer programmes work for HIV prevention and a host of other human development outcomes as well, and they are scalable,” said David Wilson, Director of the World Bank’s Global HIV/AIDS Program.

Studies conducted in South Africa show that small cash grants provided to poor households allow teenage girls to make safer sexual choices and can significantly reduce the number of new HIV infections. When psychosocial care and support are added to the cash, the results for girls are even better.

At the UNAIDS Programme Coordinating Board (PCB) meeting held in Geneva in July a thematic session was organized on addressing the social economic drivers of HIV through social protection, at which Noxolo spoke about the positive impact grants can have.

Following up on the PCB meeting, UNAIDS and the World Bank pledged to assist governments in the process of scaling up social protection programmes, including cash transfers, for HIV prevention in eastern and southern Africa, covering Botswana, Kenya, Lesotho, Malawi, South Africa, Swaziland, United Republic of Tanzania and Zambia.

“It is befitting that South Africa is the centre of the initiative because the country accounts for 23% of sub-Saharan Africa’s new HIV infections, 18% of the global HIV burden and has one of the world largest social protection programmes,” said Benjamin Ali, UNAIDS Country Director for South Africa.

Countries and partners will be urged to collaborate in a comprehensive review of social protection systems. Proposals to make such systems HIV sensitive include modifying age bands and other inclusion criteria to ensure that the groups most affected and at risk of HIV infection are covered, providing some cash directly to girls and young women and linking cash incentives to their adherence to HIV prevention and treatment programmes.