High school learners are at greater risk of contracting HIV in South Africa, with girls being particularly vulnerable.
This is according to public health specialist Marina Rifkin, from HIV management organisation CareWorks, who noted that these teens were not necessarily skilled in negotiating condom use with their partners.
With the sexual debuts of many young people happening before they reached the legal age of consensual sex at 16, she said many would have had their first sexual experience by the age of 14 or even younger.
|Shocking HIV numbers in South Africa|
Statistics for boys in this category are equally chilling, but research shows that the incidence of new HIV infections among young females is more than four times higher than that of their male counterparts.
“Sexually active young women are particularly vulnerable, as they often engage in sexual relationships with older men,” said Rifkin.
Research conducted by the Centre for the Aids Programme Research in SA (Caprisa) showed a trend of girls contracting HIV from older men.
“The study found that both girls and boys, on completion of Grade 7, remained HIV-negative. However, by the time they finished Grade 12, about 7-10% of girls were HIV-positive, yet most of the boys remained HIV-negative. This is because the girls were having sex with older men who were likely to already have been infected by the HIV virus,” she said.
“This age–sex disparity in HIV acquisition continues to sustain unprecedentedly high incidence rates, therefore preventing HIV infection in this age group is a pre-requisite for achieving an Aids-free generation and attaining epidemic control.”
Rifkin pointed out that voluntary HIV counselling and testing, promoting delay of sexual activity and correct and consistent condom use when engaging in sex had shown some success amongst young people.
However, she added that other prevention interventions, such as voluntary medical male circumcision (VMMC), was crucial and shouldn’t be discounted.
Rifkin told Health24 that groundbreaking research in 2015 from Orange Farm demonstrated how HIV could be prevented by medical male circumcision (MMC) when offered as part of a comprehensive HIV prevention strategy.
“This South African study was the first randomised controlled trial (gold standard for clinical trials) to be published that demonstrated that circumcision offered protection against HIV infection, ‘equivalent to what a vaccine of high efficacy would have achieved’.”
Ongoing research in Orange Farm has shown lower HIV infection rates among circumcised men than among uncircumcised men. Models also suggested that VMMC scale-up would reduce HIV incidences in eastern and southern Africa by roughly 30-50% over 10 years.
Rifkin said the risk reduction offered by circumcision was substantial and could reduce the immediate and long-term risk for both young men and women.
“The once-off 20 minute procedure reduces a man’s lifetime risk of HIV by up to 60% and it helps to prevent other STIs,” said Rifkin.
VMMC also reduced the risk of penile cancer, and the risk of acquiring the human papilloma virus (HPV) and, as a result, cervical cancer among the female partners of circumcised males.
However, Rifkin cautioned that as MMC only offers partial protection against a man’s risk of acquiring HIV, correct and consistent condom use was still essential, even after undergoing MMC.
“It is also important to remember that MMC does not protect against all STIs, nor does it prevent pregnancy.”
Young people also need help in preventing HIV, said Rifkin, adding that parents could play an important role in the prevention process.
“While it may be challenging to broach this topic, try to have an open discussion with your teenager about sex and the importance of protecting themselves from both unplanned pregnancy and HIV. Lay down all the options on the table, including the benefits of VMMC and give them the support and guidance they need during this transition period into adulthood.”
Currently, over two million men in SA, aged 15 to 49, have been circumcised. South Africa is about halfway toward the national target of circumcising 4.3 million males, aged 15 to 49, by December 2016.