According to those findings 1.1 million AIDS-related deaths and 2 million people newly infected, almost 1.4 million are in sub-Saharan Africa, with women and girls infected at two and half times the rate of men. Regionally, HIV disproportionately affects young women.
More than four in 10 new infections among women were in young women aged 15 to 24 while those with the age of 15 to 19 year olds were particularly at risk equating to higher HIV prevalence rates when they are older.
In Tanzania, women were heavily burdened by HIV as 690,000 of the age of 15 years and over are living with HIV.
This situation attracted Bill Gates to speak out about the need to invest more on HIV prevention and treatment programmes for the young girls.
Gates was recently interviewed by the five selected journalists from Tanzania, Zimbabwe, South Africa, Kenya and Uganda after addressing the 21th AIDS Conference held last month in Durban, South Africa.
Gates who is also a co-Chair of the US based Bill and Melinda Gates Foundation, considered girls as part of the largest generation in history entering the age when they were most at risk from HIV.
He said young women and girls tend to become infected earlier, because among other things, they have older partners, get married earlier and face great difficulty in negotiating safer sex because of gender inequality.
He noted that in 1990 there were 94 million people between the ages of 15 and 24 in sub-Saharan region, currently the number has more than doubled.
By 2030 when the international community aims to end HIV and AIDS, there will be more than 280 million young people in the region.
In this regards, Gates noted that highly vulnerable age group will be around three times as populous in 2030 as it was back in 1990.
Gates says with this stagnating rate and if societies will only do what they have used to do in prevention and treatment programmes, there would be more people aged 15 to 24 living with HIV.
He insisted that developing and implementing girls’ proper educational programmes were some of better ways to prevent them from HIV infections.
“We are supposed to educate the young women about protecting themselves from HIV infections through various means like condom use,” he urged.
Gates further pointed out some of the contributing factors to HIV infections among young girls as biological factors and practicing sex with older men.
Knowledge gaps
On knowledge gaps, Gates said that the knowledge gaps related to HIV and AIDS in sub-Saharan countries were widening when it comes to women and girls.
“We simply don’t have good enough data for what directly and indirectly increases their HIV risk, either poverty, gender inequality, forced and early marriage, sexual violence or lack of education,” he wondered.
Gates concurred with his wife, Melinda Gates view who was recently quoted as saying that there was no data, and even where data existed, often women and girls were entirely ignored or their unique circumstances were misrepresented.
Gates says PEPFAR’s dream project and complementary initiatives by the Global Fund should help to learn more about the distinctive needs and wants of adolescents, girls and young women.
Rose Maige, programme coordinator for the Association of Tanzania Health Journalists (THJ) also supported Gates’ views by saying that a comprehensive knowledge about HIV was very low in the country.
Maige quoted various country reports which indicated that less than half of young people in the country had adequate knowledge on HIV and AIDS.
The Director of Dar es Salaam based Save your Generation Tanzania (SAGETA), Furaha Demetrious suggested the need for engaging young girls in behavioural change programmes as far as sexual relationships are concerned.
“It is absolutely true as Gates pointed out that the incidents of young girls to have sex with old men are increasing every day, as a result this situation has seriously affect the young girls for failing to achieve their future dreams,” he noted.
Halima Juma (not her real name) was among the girls infected with HIV after having sex with an old man in early 1990’s, while she was 15 years old.
Coming from Southern Highlands’ Iringa Region to work as a house maid, she was ‘employed’ by a man who had no wife, but lived with two sons.
She disclosed to be forced by her boss to have sex, and later they entered into sexual relationship. “Firstly he came into my room and forced me to have sex, I had nothing to do, but to accept, it pained a lot,” she lamented.
Later on, Halima said their sexual relationship was strengthened and she started to sleep in his room daily.
“When I asked about his wife, he told me that she had travelled to upcountry, but as days went on, our neighbours became suspicious and disclosed to me that his wife had died of AIDS,” Halima noted bitterly.
Halima was advised to report at KIWOHEDE centre in Manzese branch, whereby after counselling and testing, she was found to be pregnant and living with HIV. Then she was moved to the Ilala-Bungoni centre.
“I had never have sex before meeting him, because soon after completing my primary school education I was taken to Dar es Salaam to work as a house maid in his house,” she said.
Currently, Halima is living with her daughter in Dar es Salaam saying; “I lived at KIWOHEDE centre for a number of months and I got out to establish my own small business to meet my needs and that of my daughter…I have never thought of going back or see that man who infected me with HIV,” she noted.
In sub-Saharan
Findings show that sub-Saharan Africa has the most serious HIV and AIDS epidemic in the world. In 2013, an estimated 24.7 million people were living with HIV, accounting for 71 per cent of the global total.
HIV prevalence for the region was 4.7 but varies greatly between regions within sub-Saharan Africa as well as individual countries.
In Tanzania, for instance, the UNAIDS Gap Report of 2016, shows that 1.4 million people were living with HIV, equating to an estimated prevalence of around five percent.
The severity of the epidemic varies with some regions reporting the highest HIV prevalence, like in Njombe which was 14.8 percent.
Curbing HIV in 2030
While the global community target to end the HIV and AIDS by 2030, Gates says this was purely the concept which do not match with the reality of the situation at the ground.
According to Gates, there were several issues like the trend, number of infections and increasing population which could make 2030 be for getting new tools to slow down the HIV infections and not ending AIDS.
Gates proposes that in order to end AIDS infections, new interventions and new ways of thinking about treatment and prevention were essential.
Amongst the interventions Gates highlighted are the delivery of treatment needs to be more effective and efficient, looking for new innovative ways to reach and treat the 16 million people worldwide who do not know that they are living with HIV.
“We need more creative and effective ideas to make testing and treatment both more accessible and more acceptable,” he urged.
He further noted “This includes initiatives like self-testing, simplified community care models and longer lasting supplies of treatment drugs to cut the number of visits people have to make to the clinic.”
Gates says, every single person living with HIV should be encouraged to seek treatment, enabled to reach viral suppression and empowered to sustain it.
Another intervention is the need for a strong and more rigorous approach to primary prevention to help people protect themselves and others from infection.
Donor funding
Regarding donor funding, Gates is of the view that it was still difficult to think that the donor funding especially on HIV prevention and treatment programmes will increase as many of them are reducing their budgets.
According to Gates, the payoff from expanding the use and efficiency of existing prevention tools is potentially huge.
“But even if we do everything possible with what we have today, it won’t help us achieve the ultimate goal of ending AIDS as a public health threat,” he said.
“Bu if we want to get what we intend, we must develop and deliver new prevention techniques that people want and will use,” he commended.
Citing an example, Gates said that during the International AIDS conference held in Durban, South Africa in 2010, there were few thousand people in Africa who were receiving treatments, but currently the number has increased to more than 12 million.
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