What Works for Women and Girls

Gap noted, for example, in South Africa (Anderson et al., 2007, Stadler et al., 2007);Laos (Toole et al., 2008); and Burkina Faso, Ghana, Malawi and Uganda (Biddlecom etal., 2007).3. Sex education and condom promotion programs need to take into account the differentmotivations among young men and women for engaging in unsafe sex. Studies found thatboys complained about reduced sensation with condoms to cover their fear of losing theirerection when putting on a condom; girls believed that unsafe sex proved their love andtrust in their partner.Gap noted, for example, in Thailand (Vuttanont et al., 2006); Brazil (Mane et al., 2001,Juarez and Martin, 2006); South Africa (Moyo et al., 2008); Mozambique (Machel,2001).4. Clear policies supporting access to information and services are needed to reduce the riskof HIV transmission among young people. Studies found that sex education was lacking.Gap noted, for example, in India (McManus and Dhar, 2008; Yesudas et al., 2008).5. Interventions are needed to counter gender norms, such as those that value girls’ sexualignorance and virginity, which place girls at risk for HIV transmission. [See also Chapter11A. Strengthening the Enabling Environment: Transforming Gender Norms] Studies foundthat gender norms valued sexual ignorance of girls and therefore girls were at risk of HIVacquisition. Some studies found that women did not know anything about HIV until theybecame HIV-positive.Gap noted, for example, in 29 countries in Africa and Latin America (Clark et al., 2006);a review of more than 150 studies (Collins and Rau, 2000; Gupta et al., 2003 cited inGillespie and Kadiyala, 2005); Zimbabwe (Feldman and Masophere, 2003); Ethiopia,Malawi, and Haiti (Mathur et al., 2003); and Tanzania (Silberschmidt and Rasch, 2001).6. Interventions are needed to reduce cross-generational sex. Studies found that young womenrelied on older men to pay their school fees in exchange for sex. Numerous studies foundsignificant numbers of young girls having sexual relationships with older men, who aremore likely to be HIV-positive and seek sexual partnerships with younger women.Gap noted, for example, in a review of 45 quantitative and qualitative studies inSub-Saharan Africa (Hope, 2007). Cameroon (Hattori and DeRose, 2008); South Africa(Reddy et al., 2008a, Jewkes et al., 2002 cited in Jejeebhoy and Bott, 2003); South Africaand Uganda (Geary et al., 2008; Katz and Low-Beer, 2008); Democratic Republic ofCongo (Akilu, 2008a); Tanzania (Komrower et al., 2008, Silberschmidt and Rasch,2001); Burkina Faso, Ghana, Malawi and Uganda (Bankole et al., 2007); Botswana(PHR, 2007a); Kenya (Longfield et al., 2004); Ghana (Goparaju et al., 2003); Zimbabwe(Gregson et al., 2002).136 CHAPTER 5 PREVENTION FOR YOUNG PEOPLE