In South Africa, adolescent girls and young women are the first victims of HIV contamination

In South Africa, adolescent girls and young women are the first victims of HIV contamination

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Abigail, 22 years old, beneficiary of the Childline association.  In Soshanguve, Pretoria, South Africa, on July 1, 2022.

Abigail was madly in love. When she got pregnant, her boyfriend became increasingly jealous. She Punch. Abigail stayed. Her brother tried to warn her: “This guy sees other girls. » She didn’t want to hear anything. Then she caught him with a woman. she forgave she had a child with another. Abigail never pressed charges for the beatings, but she eventually left. “I understood that if this continued, I was going to get sick”says the 22-year-old.

Shortly after leaving her boyfriend, she pushed open the door of Childline, an association that supports adolescents in the municipality of Soshanguve, north of the South African capital, Pretoria. Abigail took a moment to decide. “I was afraid of being judged but here we don’t judge you, because we know that most girls go through the same thing”she says as proof. South Africa is one of the most violent countries in the world towards women. In 2017, the country had a femicide rate five times higher than the world average, according to the United Nations.

A year later, Abigail has regained her confidence and is now the one who advises the girls in the neighborhood to end toxic relationships. But the young she knows that she was lucky. Months after warning her about the risks of sexually transmitted diseases, her sister confided in her that she was HIV positive. “That’s when I realized how easy it was to catch him. My sister is a shy person, she would not have thought that this could happen to her. »

fear of judgment

Like many young people living with HIV, Abigail’s sister has not told anyone about her status for fear of being judged. However, it is far from being an isolated case. Each week, more than 1,600 new infections are detected in adolescent girls and young women, or a third of all new infections in South Africa. Between the ages of 15 and 24, they are three times more likely to contract HIV than men of the same age.

Staff members of the Childline Association, a support association for adolescents, hold a briefing on the year's goals, in Soshanguve, Pretoria, South Africa, on July 1, 2022.
Specialized in child protection, Childline teams combine HIV prevention with the fight against violence against women.  Adolescent girls and young women exposed to violence are the most susceptible to contracting the virus.

“Many young women become infected after experiencing sexual violence or some form of coercion. And it is they who suffer the damage, not the aggressors who contaminated them., analyzes Dr. Nataly Woollett. A trauma psychologist, she conducted a study on the perception of health services by seropositive youth and currently works with young pregnant victims of violence. “The nurses do not respect them, the girls are accused of being frivolous, undisciplined or lacking in morals”she says.

“In clinics, they usually tell you that you can only blame yourself, because you have had several partners. What did you expect? Sometimes people make fun of you when they see the treatment you came in for, and within an hour the whole neighborhood knows it.”adds Abigail. If South Africa is the first focus of the HIV epidemic in the world -7.8 million people live with the virus-, the disease remains taboo, and the harshness of the public care system, saturated, hits adolescents even more than to adults.

“Most of the time, guys send their girlfriends to get tested. If it’s negative, it means they’re negative too,” says Melokhule.

Consequence: in a study published in 2019 in the journal The HIV lancet, researchers estimate that less than half of young people who test positive for HIV receive antiretroviral treatment in South Africa. However, the country has the largest antiretroviral program in the world. Within the general population, 93% of infected people know their status and three quarters of them are receiving treatment.

Fear of stigma also discourages young people from sharing their status with their partners. “When they try to talk, the other usually ends the relationship by accusing him of infidelity or blaming him for his past sexual activity”, continues Dr. Nataly Woollett. For their part, several young women recount the difficulty of getting men to accept condoms: “We have to convince them, they imply that we do not trust them”Melokhule says. As for detection, “Most of the time, guys send their girlfriends. If it’s negative, that means they are too.”the young woman continues.

“No means no”

Melokhule realized that she, too, was in a toxic relationship thanks to Childline’s ‘No Means No’ program, which educates young women about abuse. “I understand that some things that you think are acceptable are not. When your boyfriend tells you: “Stop drinking, you’re drinking my money” or that he thinks you belong to him because he gives you money to go out, it’s not normal “says today. At 20, after three years of relationship, she left her partner of seven years.

Melokuhle, 20, received support from the Childline association.  The toxic relationship that her boyfriend had with her ended.  In Soshanguve, Pretoria (South Africa), July 1, 2022.

“Many girls don’t understand that they are in a forced relationship; for them, it is normal. Even in the case of a transactional relationship with an older man. Families accept, because it puts bread on the table. Often, it’s not about buying nail polish or going to the hairdresser, it’s much more dramatic. Everyone knows, but nobody says anything, silence marks a form of acceptance»details Nataly Woollett, who underlines the impossibility of talking about sex within families.

Long on the sidelines of the fight against sexually transmitted diseases, the prevention of violence against women is now at the center of the fight against HIV in South Africa. Specializing in child protection since the late 1990s, Childline is one of the frontline associations. Since 2019, it has sensitized or supported more than 13,000 young women, through workshops ranging from professional support to learning self-defense, through budget management and psychological support. In total, Nacosa, the network of associations of which it is a member, hopes to reach 200,000 young people in the next three years.

Summary of our dossier AIDS in Africa: the time of hope

This article is part of a dossier produced as part of a partnership with the Global Fund.

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