Understanding and responding to HIV risk in young South African women: Clinical perspectives

Young women (15 - 24 years) contribute a disproportionate 24% to all new HIV infections in South Africa – more than four times that oftheir male peers. HIV risk in young women is driven by amplifying cycles of social, behavioural and biological vulnerability. Those mostlikely to acquire infection are typically from socioeconomically deprived households in high HIV-prevalence communities, have limited orno schooling, engage in transactional sex or other high-risk coping behaviours, and have a history of sexually transmitted infections (STIs)and/or pregnancy. Despite the imperative to prevent HIV acquisition in young women, there is a dearth of evidence-based interventions todo so. However, there are several steps that healthcare workers can take to improve outcomes for this key population at the individual level.These include being able to identify high HIV-risk young women, ensuring that they receive the maximum social support they are eligiblefor, providing reliable and non-judgemental counselling on sexual and reproductive health and relationships, delivering contraceptives andscreening and treating STIs in the context of accessible, youth-friendly services