HIV Girls

Sub-Saharan Africa’s youth population is exploding. The number of 15 to 24-year-olds in sub-Saharan Africa – both men and women – will have doubled by 2020 compared with 1990, and by 2030 it will have tripled, according to United Nations data. The irony of this success is that as these healthy children reach adolescence, they face deadly new risks. Girls are at particular risk: They account for 75% of new HIV infections among adolescents. More than 1,200 women between the ages of 15 and 24 globally were infected every day in 2016. The vast majority were in sub-Saharan Africa, where more than two-thirds of the world’s HIV-infected people live.

The way in which these teen girls and young women are infected and infect others enables the continual spread of the virus, according to researchers. Studies show that in their teens and early 20s women favour older male partners, both for economic and cultural reasons. Some poorer women rely on them for financial help. But many of these men are also infected with HIV and infect them.

As the now-infected women grow older, they develop relationships with men their own age, infecting them. Some of those men then spread the virus to the next generation of girls. Yet many of the existing products or approaches are for men – such as condoms or circumcision – or older women, who tend to have more control over their sexual activity. Products designed for women, such as a vaginal gel, haven’t worked so far. To face this challenge, researchers are testing products that may be easier for young women and girls to use. The Microbicide Trials Network, a collaborative funded by the U.S. National Institutes of Health, is studying a vaginal ring that contains an antiretroviral drug and would be used for a month at a time - easier than a daily drug.

This body of work explores these challenges through the story of women in rural villages and urban neighbourhoods of Kwazulu-Natal province, and the researchers and health workers who are trying to help them.

alt="© Miora Rajaonary "

Siphile Madlola, 22 yo, is HIV negative. She is having a blood sample withdrawn at the CAPRISA clinic in the rural area of Vulindlela in KwaZulu Nataln during a safety visit, as part of a research study. She decided to join one of the research programmes led by CAPRISA in Vulindlela after having unprotected sex with a man she did not trust. Vulindlela, South Africa. 7 November 2017.

alt="© Miora Rajaonary "

A view of the rural area of Vulindlela, in KwaZulu Natal, South Africa, 2017.

alt="© Miora Rajaonary "

Philile, 20 y.o. is unemployed. She has lived in the rural area of Vulindlela in KwaZulu Natal her whole life. She regularly comes to CAPRISA Research clinic in Vulindlela to get contraception and talk with other women. In the rural community, women don’t have any place to socialize besides the clinic. Philile has two boyfriends. A 25 year-old one who loves her and makes her happy and 45 year-old, a « blesser » who provides her with material goods in return for sex. The idea of having a sugar daddy, or "blesser", has become a widely normalised concept in South Africa. Both boyfriends use condoms sporadically. Vulindlela, South Africa, 2017.

alt="© Miora Rajaonary "

Graves in a house yard in Vulindlela, KwaZulu Natal. Today, HIV/Aids is the leading cause of death among adolescents in South Africa. An estimated 2000 South African young women between the age of 15-24 years get infected with HIV every week. Vulindlela, South Africa, 2017.

alt="© Miora Rajaonary "

Sizani Soni, 28 y.o., is HIV positive. She cleans roads for a living and has lived in Vulindlela her whole life. She was diagnosed in 2012, at the age of 23, and comes to the Vulindlela clinic once a month to collect her medicines. « I expected it (being tested positive). Everyone here is tested positive eventually ». Vulindlela, South Africa, 2017.

alt="© Miora Rajaonary "

Young girls are walking in the streets after the end of their school day in Vilundlela, in KwaZulu Natal. Nearly a third of all new HIV infections in South Africa occur in 15-24 year olds with adolescent girls being up to eight times more likely to be infected with HIV that their male counterparts. An estimated 2000 South African young women between the age of 15-24 years get infected with HIV every week. Vulindlela, South Africa, 2017.

A nurse shows a dapivirine vaginal ring at the CAPRISA urban clinic in Durban. The ring is a new HIV prevention method that slowly releases ARV (anti retro viral) drug, and designed to remain in place for at least one month to provide sustained and easy-to-use protection against HIV. Durban, Soutjh Africa, 2017.

Girls aged 10-14 attend a behavrioral change communications workshop, designed to prevent intimate partner violence and HIV-risk behaviours, in the township of Lamontville in Durban. During the session, questions of gender, sexuality, HIV/AIDS, gender violence, communication and relationship skills are addressed. Lamontville, Durban, South Africa, 2017.

On a large piece of paper, girls from the township of Lamontville in Durban hace written how they think they should behave with their family and their community during a behavioural change communications workshop. Lamontville, Durban, South Africa, 2017.

Two girls are role-playing to demonstrate how they should behave when approached by men who want to initiate sex, during a behavioral change communication workshop designed to prevent intimate partner violence and HIV-risk behaviours, in the township of Lamiontville in Durban. Lamontville, Durban, South Africa, 2017.