KwaZulu-Natal, South Africa
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.