What Works for Women and Girls

Gaps in Programming—Encouraging Behavior Change1. Effective programs (as described in this compendium) must be expanded to reachmany more young people, especially young people who are most neglected such asvery young adolescents, out-of-school youth, young people living with HIV, homelessand rural youth.2. Greater efforts are needed to help young people personalize HIV risks.3. Sex education and condom promotion programs need to take into account thedifferent motivations among young men and women for engaging in unsafe sex.4. Clear policies supporting access to information and sexuality education are needed toreduce the risk of HIV transmission among young people.5. Interventions are needed to counter gender norms, such as those that value girls’sexual ignorance and virginity, which place girls at risk for HIV transmission.6. Interventions are needed to reduce cross-generational sex.7. Intensified efforts are needed to increase condom use and reduce multiple partnershipsby people who know their HIV-positive status or who are on ARV treatment, includingyoung people.1. Effective programs (as described in this compendium) must be expanded to reach manymore young people, especially young people who are most neglected such as very youngadolescents, out-of-school youth, young people living with HIV, homeless and rural youth.[See also Chapter 12B. Care and Support: Orphans and Vulnerable Children] Studies foundadolescent girls did not know that anal sex increased the risk of HIV acquisition, did notuse condoms, and did not know that oral sex carries a low risk of HIV acquisition. Out-ofschool-youth were at high risk of early sexual debut.Gap noted globally for girls 15 to 19, as the proportion of these girls in school is quitelow (Haberland and Rogow, 2007). Gap also noted, for example, in Nigeria (Fajola etal., 2008; Anyanti et al., 2008a); Egypt (Soliman et al., 2008); Nicaragua (Manji et al.,2007); Ethiopia (Alemu et al., 2007; Erulkar et al., 2006); over 30 countries in Africaand four countries in Asia (Dixon-Mueller, 2009); and Côte d’Ivoire, Senegal, Kenya,Tanzania, Uganda, Ethiopia, Sudan, Zambia and South Africa (Thomsen, 2007).2. Greater efforts are needed to help young people personalize HIV risks. Studies found thatknowledge about HIV prevention was superficial and that young people believed that theywere not personally at risk of HIV acquisition despite risky behaviors.WHAT WORKS FOR WOMEN AND GIRLS135