Adolescence

lence for both sexes continue to rise for the following twofive-year cohorts (20–24 years and 25–29 years). 24The higher incidence of the virus among girls and women isnot solely a result of their greater physiological susceptibility.In many settings, adolescent girls and young women face ahigh risk of sexual violence and rape, both inside and outsideof marriage. Child marriage, though often intended byfamilies to shield girls and young women from physical andsexual risks, often fails to protect them from HIV and othersexually transmitted diseases because condom use tends to belower in long-term relationships. Moreover, the available evidenceindicates that adolescent girls in child marriages, andwomen in general, have less say than their partners over theuse of contraception or over whether sex takes place at all.Enhancing HIV services and knowledge is essentialto empowering and protecting adolescentsInvestment in HIV prevention and treatment is criticalto reversing the spread of HIV in adolescence. Offeringadolescents and young people high-quality reproductivehealth services, and ensuring that they have sound knowledgeof sexually transmitted infections, empowers themin their choices and behaviours. Making such servicesand knowledge available in early adolescence, particularlyfor girls, is imperative; by late adolescence, the risk ofinfection for young people in high-prevalence countries isalready considerable.Encouragingly, efforts to enhance knowledge of HIV acrossthe developing world are beginning to bear fruit. Analysisof 11 developing countries with available trend data showsthat in 10 countries adolescent girls were more likely toknow where to go for an HIV test in the latter half of the2000s than they were in the early years of the decade. 25Testing remains low, however, among both sexes. Incontrast to testing, when it comes to comprehensiveknowledge about HIV prevention, adolescent males consistentlyedge ahead of their female counterparts; andclosing this divide is a particular challenge. For bothFigure 2.6: Young women in late adolescence (15–19) are more likely to seek an HIV test and receive their resultsthan young men of the same age groupPercentage of young people aged 15–19 years who have been tested for HIV in the last 12 months and received resultsin selected countries22Zambia10Kenya1813United Republicof Tanzania111514Malawi1113Namibia612Dominican Republic510Swaziland2Uganda59Guyana49Ukraine587South Africa5Moldova66ZimbabweHaiti3425Lesotho 13India212CambodiaFemale11MaleViet Nam 10% 5 10 15 20 25Source: DHS, MICS and national surveys, 2003–2009.realizing the rights of adolescents 25