Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
BBC News - Tuesday, 30 November, 2004
Africa is in the death grip of HIV/Aids and a generation of African girls is standing on the frontline of the carnage.
In the countries worst affected by HIV/Aids, girls and women are infected at higher rates than boys and men - in some age groups, up to five times higher.
As a young Zambian woman living with HIV, who has lost both her parents to Aids and is working with people affected by the disease, the plight of the girls and their continued vulnerability is heartbreaking to me.
The latest UNAids annual report only confirms what we know - Aids is a female epidemic.
There are 39.4 million people living with HIV across the globe - and increasingly, those becoming newly infected are women.
While there is evidence that women are more biologically prone to infection, there are cultural norms which are greatly increasing their risk of infection.
While there has been an education revolution in many countries about the dangers of Aids, there is evidence that even when girls are aware of the risks, it often does little to reduce their vulnerability.
Gender inequality
This alarming anomaly led World Vision to pilot research in two African countries, Tanzania and Zambia, to discover why global efforts to increase awareness are failing to protect women from HIV/Aids.
In Tanzania, the prevalence rate for girls aged 15 to 19 is more than three times higher than for boys, and in Zambia, it is higher still.
The research found that the ABC (Abstinence, Be faithful and use Condoms) strategy - which is a cornerstone of HIV/Aids prevention efforts in many countries - does not protect girls and women.
It has failed because they have not been allowed by men to practise this strategy.
To fight Aids successfully and to protect girls, the debate has to be broadened to tackle the issues of gender inequality, harmful cultural practices, discrimination and sexual violence.
By 2005, governments should have strategies in place to protect women's human rights and reduce their vulnerability to HIV/Aids through eliminating abuse, rape, and female trafficking.
This was the target set back in 2001 by the UN. Yet little progress has been made in countries where it is so desperately needed.
Prevention strategies
The sexual exploitation of girls is a significant factor in their vulnerability to HIV/Aids. Girls who are orphaned or who are caring for parents living with Aids are often responsible for meeting their families' economic needs.
In many cases girls engage in "survival sex" to earn money or necessities such as food and school materials. Unicef estimates there are now 12.3 million children orphaned by Aids in sub-Saharan Africa.
Another factor multiplying the risk to girls is the rape of virgins by some HIV-positive men who believe that this will cure them of Aids.
In cultural contexts where girls are largely monogamous but many boys are not, and where girls have little say in how and when they will practise sex, reliance on condoms as a preventative measure is not enough to reduce their vulnerability.
On the eve of World Aids Day, we should review our prevention strategies and ensure they include measures to expand the freedom of girls and women to negotiate their sexual activity, and engage boys and men in discussions about their assumptions regarding their own gender roles.
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