Wits RHI

Wits RHI is one of the leading multi-disciplinary research institutes in Africa.

Our team’s expertise expands beyond HIV to encompass sexual and reproductive health for adolescents (including prevention of STIs, unintended pregnancy, and gender-based violence), which we can draw on to ensure that HIV pre-exposure prophylaxis (PrEP) is integrated into a comprehensive prevention package for adolescents.

Prevention of HIV in adolescent girls and young women requires a combination approach with strategic and prioritized application of biomedical, behavioural and social/structural prevention activities at different levels to respond to the specific needs of this population. These activities must leverage partnerships and especially engage youth to make efficient use of resources. Adolescent girls and young women infected with HIV either perinatally or behaviorally, require a multi-disciplinary approach to care and treatment encompassing clinical, psychosocial and emotional aspects of care and treatment. This age group is particularly vulnerable to non-adherence to antiretroviral therapy, may have opportunistic infections requiring treatment, previous exposure to multiple ART with associated HIV resistance, sexual and reproductive health needs and require high quality, youth friendly services.

Wits RHI proposed to provide technical assistance to strengthen and standardize multi-sectoral programming for improved HIV prevention, care and treatment outcomes for adolescent girls and young women in South Africa.

In South Africa, HIV prevalence continues to rise. Data from the South African National HIV Prevalence, Incidence and Behaviour Survey, 2012 indicate that Young women 15-24 years are 8 times more likely to be infected with HIV compared to young men. By age 20-24 years, HIV prevalence in young women is 17%, three-fold higher than the men in the same age group, and three-fold higher than in the 15-19 year age group, pointing to high rates of new infection in young women. While HIV-associated mortality has declined with expanding access to ART, concerning behavioral trends in the most recent population-based survey suggest ongoing sexual transmission, particularly in the 15-24 year age group. In 2012, earlier sexual debut and increases in multiple sexual partners (MSP) were observed in this age group. Furthermore more young women reported age-disparate partnerships and sex with a partner five years her senior. While condom use at last sex was reported as 58% of those aged 15-24, this was a decline from previous national surveys.