The High Numbers of New Infections Among Young People Remains a Serious Concern

Despite positive signs that HIV incidence is declining overall among young people, in a global context, Sub-Saharan Africa remains the region most affected by the epidemic. Young people, particularly girls, are most at risk of infection.

Although new HIV infections are on the decline across the region, these reductions remain insufficient. Significant numbers of young people, predominantly adolescent girls and young women, are still becoming newly infected.

Discrimination

HIV-related stigma and discrimination, including attitudes based on laws and policies, continue to impede responses to the epidemic and very often prevent young people from accessing sexual and reproductive health services.

At the same time, young people in the region are demanding access to comprehensive sexuality education (CSE) and health services.

Early and Unintended Pregnancies

Early and unintended pregnancy rates among adolescent girls aged 15-19 remain high across the region, ranging from 39% in Tanzania to 59% in Kenya. This is largely as a result of a lack of access to contraception due to factors such as cultural and religious opposition, poor quality of available services, gender-based barriers, and spousal disapproval. Pregnancy almost always means an end to education for most girls; with at least 95% of ever pregnant girls being out of school across four study countries.

Health and Education

The health sector needs to be part of the discussion to ensure that the education is complemented and consistent with the services being provided in the region.

While the mandate of the Health and Education sectors are clearly different, the linkages between the two are critical for ensuring a holistic approach to influence and ensure young people’s sexual reproductive health and rights.

Gender Based Violence

Gender-based violence remains high across all countries. Sexual violence puts girls at higher risk of HIV infection and has knock-on effects on educational and health outcomes for women and children. In Southern African countries, where one in every three girls has been forced to have sex by the age of 18 years a very large proportion of the population have limited agency in making choices regarding their sexual health. Young people experience violence and harassment in, around, and on the way to school.

Child Marriage

The African Charter on the Rights and Welfare of the Child (ACRWC) prohibits the marriage of any child under the age of 18 years. However, in the majority of countries in the ESA region, traditional or customary law continues to support early marriage and more than one third of women aged 20-24 years (6.5 million) have been married or in a union before the age of 18. Child marriage is associated with higher rates of teenage pregnancy and higher fertility, resulting in girls having to care for many children while they are still young. The African Union has launched a Continental Campaign to End Child Marriage in Africa. Regional efforts to end child marriage include a model law on child marriage developed by SADC for countries to adopt across the Southern African sub-region.