A recent study of HIV infection in Uganda revealed that young women are much more likely than young men to become infected with the AIDS virus. Although previous studies have documented the higher proportion of young women than young men in sub-Saharan Africa who are HIV-infected, this study is one of the first that looked specifically at factors contributing to acquisition of the virus. The published study reports that “Among young women, HIV prevalence in 2011 was 2.8% in 15-19 year olds and 6.3% in 20-24 years olds. HIV prevalence was 1.1% in men 15-19 years old and 3.2% in men 20-24 years old.” The study found that gender disparity was greatest in 15-19 year olds, with the incidence in women more than 4 times greater than in men. Interestingly, among young women who were formerly married, there was an increased risk of HIV acquisition compared to currently married women, in which the risk was decreased. Being a student was also a factor contributing to decreased risk. Gender disparities decreased with increasing age, as HIV risk increased as men got older but not with increasing age in women. The article cites a recent qualitative study of young women in the same region of Uganda, which revealed that previously married women are more likely than their married or never married counterparts to have had multiple partnerships, to communicate poorly about HIV with sexual partners, to have experienced domestic violence and infidelity, to experience loss of family financial and social support, and to rely on partners for financial support.
The results of this study are not surprising. It has been known for some time that young African women are at greater risk for HIV infection than men in the same age range. Yet the importance of this study lies in identifying specific risk factors. Perhaps the most useful going forward is the finding that being a current student decreases risk of HIV. The article notes that a low proportion of youth are enrolled in school, and suggests that “innovative conditional cash transfer interventions and others that encourage school retention appear warranted.” But what kind of policy or other remedy can help to lower the incidence of HIV acquisition in previously married young women? This is clearly a situation that demonstrates the need for empowering women. It would be interesting to learn whether any women’s NGOs in sub-Saharan Africa are dedicated to providing support for young women with the risk factors for acquiring HIV infection identified in this study. Here, as in any other situation in which gender disparities in health status exist, there is an injustice in need of a solution.