South Africa

Refocusing HIV efforts in sub-Saharan Africa

'Progress for Children' interview series

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Dr. Alan Whiteside of South Africa’s University of Kwa-Zulu-Natal.

The 2010 edition of UNICEF’s 'Progress for Children' shows that despite advancement towards the Millennium Development Goals (MDGs), many of the poorest and most disadvantaged children are still missing out. UNICEF invited several experts to offer their insights on what can be done to realize the MDGs for all.

NEW YORK, USA, 13 September 2010 – In the push to reverse the spread of HIV and AIDS by 2015, as called for by the United Nations Millennium Development Goals – a set of internationally recognized targets for reducing poverty worldwide – success may depend on forging connections with young African women, so that they are able to protect themselves and their partners against the epidemic.

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That was one of the key points raised by Dr. Alan Whiteside of South Africa’s University of Kwa-Zulu-Natal in a recent interview with UNICEF, tied to the organization’s release of its 2010 flagship ‘Progress for Children’ report.

Pivotal population

The report shows that about four million young people aged 15 to 24 were living with HIV in sub-Saharan Africa in 2008. The region also has the largest number of new HIV infections.  If the epidemic is to be reversed in time to meet the deadline, change must happen there – and it must happen now.

But Dr. Whiteside, who serves as the director of the university’s Health, Economics and HIV/AIDS Research Division, believes that young women in sub-Saharan Africa are one crucial group that is missing out on efforts to prevent the spread of HIV.  

Including them is vital – not only because all people affected by HIV and AIDS must be treated equally, but also because the 2015 MDG target cannot be achieved without them.

“What we know is that HIV infection rises dramatically in young women between the ages of about 15 and 25,” Dr. Whiteside said. “So if we could address this, then I think we could go a long way towards stopping the epidemic.”

Challenges to change

This year’s ‘Progress for Children’ report makes clear the extent of the burden these women bear.

In 2008, 70 per cent of young people living with HIV in the region were women aged 15 to 24, while young men accounted for just 30 per cent.  In most sub-Saharan African countries, women in this age group were about two to four times more likely to be infected with HIV than young men of the same age.

And men in the region are more likely to know how to protect themselves against infection than women. Although accurate knowledge about HIV and AIDS is still too scarce across the developing world, 32 per cent of young men in sub-Saharan Africa can demonstrate knowledge about prevention – in sharp contrast to 24 per cent of their female counterparts.

But lack of knowledge isn’t the only area in which young women are at a disadvantage. Dr. Whiteside says it is especially hard to translate HIV prevention efforts into behavioural change among women. The reasons lie in the way cultural standards shape women’s role in society.

“How do you empower women?” he asked, noting that the question is one of the central challenges to helping women protect themselves against HIV. “How do you give them respect?  How do you give them the ability to control their sex and sexuality?”

Fresh thinking

Innovative thinking may provide the answer to these and other essential questions. Dr. Whiteside believes the international community should “think big and think out of the box” about ways to challenge societal dynamics that prevent women from taking control of their sexuality.

Money can be part of that big thinking. “In a number of settings, there are some very interesting experiments going on around providing cash incentives to young people to stay in school, to not fall pregnant and to not get STDs,” said Dr. Whiteside.

Those experiments might suggest ways to move forward, using encouragement rather than the threat of negative consequences to bring about change.

“It’s not just about the disinhibition of not being infected,” said Dr. Whiteside. “It’s about some positive reward for not being infected and for showing you’re not infected.”


 

 

Audio

9 August 2010: Researcher, author and professor Dr. Alan Whiteside speaks to UNICEF Radio about the Millennium Development Goal related to HIV.
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Here's a transcript of the interview. [PDF]

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