In South Africa, adolescent girls and young women are the first victims of HIV infection

Abigail was madly in love. When she got pregnant, her boyfriend became more and more jealous. He hit her. Abigail stayed. His brother tried to warn him: “This guy is dating other girls. » She didn’t want to hear anything. Then she caught him with a woman. She has forgiven. He had a child with another. Abigail never pressed charges about the beating but eventually left. “I knew I would get sick if this continued”says the young woman of 22 years.

Shortly after leaving her boyfriend, she pushed open the door of Childline, an association supporting youth in the township of Soshanguve, north of the South African capital of Pretoria. Abigail took a moment to make up her mind. “I was afraid of being judged, but we’re not judging you here because we know most girls go through the same thing.”, she says as evidence. South Africa is one of the most violent countries in the world towards women. According to the United Nations, in 2017 the country had a femicide rate that was five times higher than the global average.

A year later, Abigail has regained her confidence and is now the one advising neighborhood girls to end toxic relationships. But the young woman knows that she was lucky. Months after his sister warned him about the risks of STDs, she confided in him that she was HIV positive. “That’s when I realized how easy it was to catch him. My sister is a shy person, I didn’t think this could happen to her. »

The fear of the court

Like many HIV-positive young people, Abigail’s sister has kept her status secret for fear of being judged. However, this is far from an isolated case. More than 1,600 new infections are detected in adolescent girls and young women every week, or a third of all new infections in South Africa. Between the ages of 15 and 24, the likelihood of contracting HIV is three times higher than that of men of the same age.

Staff from the Childline Association, a youth support organization, hold a goals for the year briefing on July 1, 2022 in Soshanguve, Pretoria, South Africa.
Childline's child protection teams combine HIV prevention with the fight against violence against women.  Adolescent girls and young women exposed to violence are most vulnerable to contracting the virus.

“Many young women become infected after experiencing sexual violence or some form of coercion. And it is they who suffer the damage, not the attackers who contaminated them., analyzes Dr. Natalie Woollett. The psychologist, who specializes in trauma, conducted a study on the perception of health services by HIV-positive youth and is currently working with young pregnant women who have been victims of violence. “Nurses don’t respect them, girls are accused of being careless, undisciplined or lacking in morals”She says.

“In the clinics, you’re generally told that you only have yourself to blame because you’ve had multiple partners. What did you expect ? Sometimes people scoff when they see the treatment you came for, and within an hour the whole neighborhood knows about it.”, adds Abigail. Even though South Africa is the world’s first hub of the HIV epidemic – 7.8 million people are living with the virus – the disease remains taboo and the harshness of the public care system hits young people even harder than adults.

“Most of the time guys send their girlfriends to test. If it’s negative, that means they are too,” says Melokhule.

Consequence: in a study published in the journal in 2019 The lancet HIV, researchers estimate that less than half of young people who test positive for HIV in South Africa are receiving antiretroviral treatment. Still, the country has the largest antiretroviral program in the world. In the general population, 93% of those infected know their status and three-quarters of them are receiving treatment.

Fear of stigma also discourages young people from sharing their status with their partners. “Often when they try to talk, the other person ends the relationship by accusing them of infidelity or blaming them for their past sexual activity.”, Dr. Nataly Woollett continued. For their part, several young women report the difficulty of getting men to accept condoms: “We have to convince them, they imply that we don’t trust them”, says Melokhule. As for screening “Mostly boys send their girlfriends. If it’s negative, that means they are too.”the young woman continues.

“No is no”

Melokhule also realized she was in a toxic relationship thanks to Childline’s “No Means No” program, which educates young women about abuse. “I understand that some things you think are acceptable are not. When your friend tells you “stop drinking, you’re drinking my money” or that he thinks you are his because he gives you money to go out, that’s not normal.”, she says today. At 20, after three years of relationship, she left her seven-year-old partner.

Melokuhle, 20, was supported by the Childline association.  She ended the toxic relationship her boyfriend had with her.  At Soshanguve, Pretoria (South Africa), July 1, 2022.

“A lot of girls don’t understand that they’re in a forced relationship; for them it is normal. Also in the case of a transactional relationship with an older man. The families accept because he puts bread on the table. Often it’s not about buying nail polish or going to the hairdresser, it’s much more dramatic. Everyone knows but nobody says anything, silence is a form of acceptance »Details of Nataly Woollett stressing that it’s impossible to talk about sex within the family.

While the fight against sexually transmitted diseases has long remained on the sidelines, the prevention of violence against women is now at the heart of the fight against HIV in South Africa. Childline has specialized in child protection since the late 1990s and is one of the frontline associations. Since 2019, she has raised awareness or supported more than 13,000 young women through workshops ranging from professional support to learning self-defense, including budget management and psychological support. All in all, Nacosa hopes that the network of associations to which it belongs will reach 200,000 young people over the next three years.

Summary of our dossier AIDS in Africa: the time of hope

This article is part of a dossier produced in partnership with the Global Fund.

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