East and Southern Africa Region records rise in new HIV infections among older women

By Michael Gwarisa

While progress has been made regarding improving HIV health outcomes for Adolescent Young Women and Girls (AGYW) in the East, Southern African (ESA) region, a worrying trend shows that more new cases are now being recorded among older women aged between 25 to 34 years.

HIV data shows that women are the face of HIV on the African continent, with 63 percent of all new infections in the continent being recorded in women and is even more pronounced among adolescent girls and young women. HIV infection rates are three times higher among adolescent girls and young women than boys and men of the same age.

Briefing an ICASA panel session on Accelerating HIV prevention through a Continuum lens: Multisectoral approaches for AGWY. Older women of reproductive age, UNFPA ESA Regional Director, Ms Lydia Zigomo said older women were now the neglected face of the HIV pandemic.

Only about 42 percent of districts with very high HIV incidence had dedicated HIV prevention programmes for adolescent girls and young women in 2021. While there has been some progress with AGYW programming, the older women of reproductive age (25-49 years) seem to have been neglected,” said Ms Zigomo.

She added that a review of the recent population-based studies reveals high incidence levels of HIV among older women, especially 25 to 34 years.

“A review by UNFPA Regional Office of ESA noted that a number of older women have an elevated risk of HIV infection, most of whom are still in their peak reproductive years , especially in high-HIV-incidence settings. The review further observed that, while HIV incidence is generally declining for all populations, the trend is slower for older women than for younger cohorts of any gender.

“Older widowed or divorced women, those living in sero-discordant partnerships, engaging in high-risk activity (such as sex work or transactional sex), or living in locations with high HIV prevalence and unsuppressed viral load (particularly among men), have the slowest declines and the most need for tailored, person-centred HIV prevention interventions.”

She said a number of countries on the continent, especially in ESA are increasingly prioritising HIV prevention as an inter-sectoral issue for adolescent girls and young women programming.

“For instance, many countries recommitted to the revised 2021 ESA Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health Services for Adolescents and Young People , pledging to roll out CSE and adolescent/youth-friendly health services among other things,” said Ms Zigomo.

She further noted that the quality and scale of implementation, however, varies widely. Approaches to address adolescent girls and young women, particularly around social protection, have increasingly been developed in the region but remain mainly at project level, with pilot initiatives in many countries contributing to the evidence for what works. The reality of our epidemic especially in ESA, necessitates a life cycle approach to ensure that all women at risk are covered.