What Works for Women and Girls

Disaggregated Data Is NeededEffective programs for young people need to understand how young people use services andwhat other barriers (e.g., community and provider attitudes) must be overcome. “Effectivenessis hindered by the lack of systematic attention to gender in designing programmes for most-atriskyoung people. Most countries do not have accurate data on the population of young menand women, nor do they maintain records by sex of young people’s use of services” (UNFPAInter-Agency Task Team on HIV and Young People, 2008: 4). To ensure an accurate picture ofthe sexual and reproductive health needs of young people, basic data on adolescents should bedisaggregated by gender with more precise age groups, such as ages 10–11; 12–14; 15–17; and18–19 (Dixon-Mueller, 2007). In addition, data should be disaggregated by marital status, asaccess to services and sexual behaviors differ in many countries based on marital status.Access to HPV Vaccinations May Benefi t Girls Who Become HIV-Positive Later in LifeA 2007 meta-analysis found that HPV infection is much more prevalent in women with HIV(De Vuyst and Franceschi, 2007). Clinical trials are underway to assess HPV vaccination inperinatally infected HIV-positive adolescents. Vaccination against HPV strains 16 and 18 iseffective and these strains cause approximately 70% of cervical cancers worldwide (The FutureII Study Group, 2007). However, HPV vaccines do not protect against all types of HPV strainsthat cause cancer and therefore, all women, even those who have received the HPV vaccine,should still get regular pap smears or screening for cervical cancer. It is critical to assess ifthe HPV vaccine will demonstrate efficacy for longer than five years (Kim and Goldie, 2008cited in Rothman and Rothman, 2009). HPV vaccination for adolescent girls has been rolledout in some countries in the Global North and initial efforts are underway to roll out HPVvaccinations for young girls in some countries in the Global South. Vaccinating young girlsagainst HPV may provide additional protection against cervical cancer, particularly if the youngwomen acquire HIV as they get older. Studies have shown a higher rate of cervical canceramong women living with HIV. Increasing access to HPV vaccinations is therefore an importantservice for young women. [See also Chapter 8. Meeting the Sexual and Reproductive HealthNeeds of Women Living With HIV]138 CHAPTER 5 PREVENTION FOR YOUNG PEOPLE