Care and support for people living with HIV/AIDS

Report on the global HIV/AIDS epidemic – June 2000already infected by her 15th birthday. Obviously, the girls were becoming infectedduring their earliest sexual exposures.Figure 18. HIV prevalence rate among teenagers in Kisumu,Kenya, by age3533.33029.42522HIV-infected (%)201517.9boysgirls108.38.653.62.20 0015 16 17 18 19age in yearsSource: National AIDS Programme, Kenya, and Population Council, 1999The other crucial factor pushing up HIV rates in young women is age-mixing. If thegirls’ sole sex partners were boys their own age, they would run little risk of becominginfected; as Figure 18 shows, there are few if any HIV infections among boysbefore the late teens. However, girls also have sex with older men – men who havebeen sexually active for many years and who therefore tend to be more heavilyinfected than younger males.In rural areas of the United Republic of Tanzania, some 17% of unmarried teenagersreported having had sex with a man at least 10 years older than themselves. In anationwide study in Zambia, over a quarter of the men who had extramarital encountershad casual sex with women 10 years or more their junior. Men who have sexwith younger women may also have other high-risk partners. Among men identifiedas clients of sex workers in a study in four African cities, for example, around onethirdhad also had casual sex with teenage girls.While there are many cultural and economic reasons for this kind of cross-generationalsex, the fear of HIV seems to be prompting some men to seek out partnersthey believe are less likely to be infected – young girls. There is a double deadly ironyhere. Men who are fearful of acquiring HIV may be infected themselves without48