New research links high HIV rates in teenage girls to older

Highlights of a new study by UNAIDS were released at the International AIDS conference in Lusaka this week, showing the strongest evidence yet that the high HIV levels in teenage girls is linked to sexual contact with older men. "The study found HIV infection rates of 15-23 percent among girls 15-19 years old, 26-40 percent among men aged 25 or more, and just 3-4 percent among 15-19 year old boys," Peter Piot, Executive Director of UNAIDS said in a press release. Piot added: "The unavoidable conclusion is that girls are getting infected not by of boys their own age, but by older men." The research, conducted between 1997 and 1998 was designed to explore the reasons for the difference in the rate at which the HIV virus was spreading in various parts of the continent. It found that in West Africa for example HIV rates among pregnant women were still under 10 percent, while in many places in Central and East Africa the infection rate exceeded 30 percent. The study showed that in Southern Africa HIV rates had already reached the 30 percent mark despite, according to the study, "the epidemic's relatively recent arrival there." The study compared two towns, Kisumu in Kenya and Ndola in Zambia - which it said could be characterised by high HIV infection rates - with two low prevalence towns, Cotonou in Benin and Yaounde in Cameroon. In general it found that HIV rates were significantly higher among women than men everywhere except in Cotonou. In Kisumu and Ndola, HIV rates were 30-40 percent in women and 20-23 percent in men aged 15-49. In Cotonou and Yaounde the comparable rates were 3-8 percent in women and 3-4 percent in males. It said that the largest female/male differences was found in the 15-19 age group. Teenage girls in Kisumu and Ndola had HIV infection rates of about 15-23 percent, nearly four to six times higher than in boys of the same age group. "Among teenage girls living in Kisumu and Ndola, sex with an older man correlated strongly with a higher risk of HIV," the study said. It added: "In addition to this factor, the study found that early sexual initiation for girls and early marriage for both sexes were associated with a higher risk of being infected." As part of its search in finding reasons for the differing rates of HIV between the different regions, the researches found two factors that were associated with the higher rates of HIV infection. The first was the lack of circumcision in men and evidence of current or previous sexually transmitted disease, especially such as syphilis or genital herpes that could cause genital ulcers. According to Dr Michel Carael head of prevention at UNAIDS, "When almost a quarter of teenage girls have HIV and when close to half of them carry the virus that causes genital herpes, the only possible explanation is that they are becoming infected during their first few exposures to sex - maybe even their very first." "For millions of young African girls in or nearing their early teens, this is an emergency. Prevention just can't wait," said Anne Buve, coordinator of the multi-site study. "Girls have the right to know the facts-they are at high risk of becoming infected quickly even if they have just one partner, especially an older man," she added. Cautioning against misinterpretation of the findings Carael said: "Men reported low condom use and considerable risk behaviour in all cities, and HIV rates as high as 3-8 percent were seen even in the 'low prevalence' sites. So countries should not look at the study and conclude that their AIDS programmes are on the wrong track. On the contrary, the prevention measures now in use - including education for safer sexual behaviour and STD control programmes need to be scaled up."