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DATA BRIEFS:  (continued)

At highest risk today: Teenage girls

In many countries, evidence points to a much higher prevalence of HIV among teenage girls than teenage boys.

In a recent study in western Kenya, 25% of girls between the ages of 15 and 19 were found to be HIV positive, compared to 4% of boys in the same age group. In Botswana's major urban areas, more than 30% of all pregnant adolescent women are infected, and in South Africa, Swaziland and Zimbabwe the infection rate is over 20% (see chart). Surveys in Zambia showed that the rate among all teenage girls (12%) is nearly three times that of teenage boys.

Higher prevalence rates among girls reflect their biological vulnerability to infection, their social and physical vulnerability in sexual relations and the impact of gender discrimination. The rates make it clear that much more needs to be done urgently to protect the rights of girls and women. Discrepancies in HIV rates between girls and boys also indicate that girls are more likely to be infected by older men than by boys their own age.

The rate of HIV infection among teenage girls in Asia is low compared to those in Africa, although rates in Asia are on the rise: In India, a Mumbai antenatal clinic is reporting 5% of pregnant teenagers who are HIV positive, twice as many as in 1994. Teenage girls in high-risk groups show alarming prevalence rates: In 19 provinces in Cambodia, more than 40% of sex workers under the age of 19 are HIV positive. In urban areas in Myanmar, the rate among teenage sex workers is 25%. However, in Thailand, early intervention proved successful in reducing prevalence among all high-risk groups, including teenage sex workers.

Epidemiologists find that, since infections are likely to be relatively recent among young people, a rising rate of infection in this group signals a growth in the spread of the disease. It is also an ominous sign that education and prevention programmes are not in place or not working.

In both industrialized and developing countries, interventions aimed at the young have proven to be the most effective and cost-efficient method for addressing the crisis in the long term. In the most comprehensive review of sexual health education undertaken to date and involving 68 countries, UNAIDS found that good education does help delay first intercourse and protect sexually active young people from HIV, other sexually transmitted diseases and pregnancy. It does not, as some fear, lead to earlier or increased sexual activity.

The benefits of education have been proven most explicitly in Uganda, the first African country with a staggering AIDS burden to respond to the crisis. There, the biggest decrease in prevalence has been among 15- to 19-year-olds, dropping from 38% in 1991 to 7.3% in some areas in 1996.