Girls left behind: Redirecting HIV interventions toward the most vulnerable

As we enter the third decade of the HIV pandemic in sub-Saharan Africa, young women—often adolescent girls—are the new face of the disease. In particular, HIV/AIDS is threatening those girls and young women with limited social and economic assets—those who are unable to avoid, manage, or leave unsafe sexual relationships inside and outside of marriage. Girls at risk of sexual exploitation are not a small minority; they are counted in the hundreds of millions. Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 23 explores: structural determinants of risk, failure to reach the most vulnerable, moving ahead with the assets we have, and reframing adolescent girls’ opportunities. This brief concludes by noting that the social support and opportunity structures of adolescent girls can be systematically altered, and with these, the shape of the HIV pandemic. It also notes that girls are important partners in this endeavor, but families and communities must be included. Otherwise, the youngest, poorest females will continue to bear a rising and disproportionate share of this human tragedy