It is estimated that worldwide only three in 10 adolescent girls and young women between the ages of 15 and 24 years have comprehensive and correct knowledge about HIV.

With inadequate knowledge, young people are ill-equipped to make healthy and safe decisions about their sexual health. However, knowledge, while a crucial foundation, is not in itself sufficient to change behaviour and reduce the risk of HIV infection. Knowledge needs to be combined with the right skills and attitudes, which can be taught and developed through high-quality comprehensive sexuality education (CSE).

CSE not only plays an important role in preventing negative sexual and reproductive health outcomes, but also offers a platform to discuss gender issues and human rights and to promote respectful, non-violent relationships. However, gender-responsive and life-skills-based HIV and sexuality education is only covered in the national curriculum by 15% of the 78 countries analysed in the Global education monitoring report, recently launched by the United Nations Educational, Scientific and Cultural Organization.

When CSE programmes focus on gender and power relations, they are much more likely to show positive effects in reducing sexually transmitted infections and unintended pregnancies than programmes ignoring gender and power.

Such a gender-responsive CSE programme have been implemented in Zambia, which is a signatory to the 2013 Ministerial Commitment on comprehensive sexuality education and sexual and reproductive health services for adolescents and young people in eastern and southern Africa.

The curriculum in Zambia focuses on puberty, HIV prevention, gender equality, sexual and reproductive health, relationships and human rights. The overall goal is for adolescents and young people in Zambia to enjoy better sexual and reproductive health and have better health outcomes overall.

Zambia currently has the largest population of young people in its history, with 52.5% aged below 18 years. During their school years, teachers and sexual health specialists have an ideal opportunity to reach students with correct and appropriate health education information. The onset of adolescence brings not only physical change but also vulnerabilities to human rights abuses, particularly in the areas of sexuality, marriage and childbearing.

Harriet Lilanda, aged 13, a student at Twalumba Primary School in Lusaka, Zambia, thinks that the new sexuality education curriculum is important for young people. “Talking openly about sexuality was not an easy thing, as boys would think I am a loose girl. Parents at home were also closed up on us; now I think the knowledge which we are receiving in class will help me,” she said.

Both teachers and students in Zambia welcomed the introduction of CSE in schools and appreciate its contribution to the attitudes of young people.

“I saw the need to get more involved in teaching comprehensive sexuality education because of the way our society hides information on sexuality,” says Agather Shindende, a teacher at Kabulonga Primary School. “I remember growing up and being told that if you sit next to a boy at school you would conceive. I don’t want the current generation to go through what we went through.”

Schools have the potential to contribute to healthy individual behaviour as well as improved social norms around equality and non-violence, but this cannot be realized if, at the same time, they are places of gender inequality and violence. Access to a safe learning environment must be combined with education about gender equality, non-violent behaviour and sexual and reproductive health for everybody.  

“Among the topics that I have learnt, gender stands out as the most interesting one,” says Harriet Lilanda. “I like gender because it teaches us to be equal. Boys and girls can do the same things—mathematics, science, home economics and technical drawing. I have learnt that we must respect each other and that household chores have to be done by girls and boys.”

Gender practices, norms and values influence sexuality, reproduction and relationships: unequal gender relations make it difficult for women and girls to make choices about sex, as well as increasing their vulnerability to violence, early marriage and adverse sexual and reproductive health outcomes.

Ms Shindende appreciates the benefits of CSE and feels that results are slowly being noticed. “The attitude and behaviour among learners regarding gender norms is slowly changing for the better, especially among boys,” she says. “Previously, boys never wanted to take subjects like home economics because they considered it as a subject for girls only, but today, out of 45 learners, 20 are boys and they willingly chose home economics as one of their optional subjects. Therefore, you can see that teaching comprehensive sexuality education from an early age can open up the minds of our young people. We also have many girls taking art and design courses, including technical drawing, which were exclusively for boys.”

When young women and adolescent girls have access to comprehensive age-appropriate sexuality education before becoming sexually active, they are more likely to make informed decisions about their sexuality and approach relationships with more self-confidence. CSE is also known to increase young girls’ condom use, increase voluntary HIV testing among young women and reduce adolescent pregnancy, especially when linked with non-school-based youth-friendly health services provided in a stigma-free environment.

Watch UNESCO video — Being a Young Person: Comprehensive Sexuality Education

GENEVA, 11 October 2016—On this International Day of the Girl Child, UNAIDS strongly supports the call by the United Nations for better age- and sex-specific data that can be used to improve the health and well-being of girls aged 10–19 years old.

Discrimination and disadvantage have held back the potential of girls and women for centuries. This generation of girls—an estimated 1.1 billion globally in 2016, the largest in history—has the power to change the world, but only if they can advance their knowledge, agency and freedom to make their own life-defining choices and reach their full potential.

“Girls count! We need to know what counts for girls, to make sure that they start life HIV-free, stay HIV-free or remain AIDS-free,” said UNAIDS Executive Director, Michel Sidibé.

Globally in 2015:

• Around 120 million girls (aged 15–19 years old) worldwide had experienced rape or other forced sexual acts at some point in their lives.
• In high HIV prevalence areas, women exposed to intimate partner violence were 1.5 times more likely to acquire HIV, with child marriage a risk factor for intimate partner violence.
• Almost 1100 adolescent girls and young women (aged 15–24 years old) were newly infected with HIV every day.
• About 70% of adolescent girls and young women (aged 15–24 years old) did not have comprehensive and correct knowledge of HIV.
• HIV, human papillomavirus (HPV) and cervical cancer are strongly linked. Giving HPV vaccine to all girls aged 9 to 13, regardless of HIV status, will prevent cervical cancer in later life.

The bold targets of the 2016 Political Declaration on Ending AIDS that promote the empowerment of women and girls uphold rights and gender equality as central to achieving the Sustainable Development Goals. They provide our greatest opportunity to guaranteeing that this generation of girls reach their full potential. The collection and analysis of age- and sex-specific data enriched and informed by the experiences and voices of the world’s girls and young women will put them on the Fast-Track to ending AIDS.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

On the International Day of the Girl Child, 11 October, Together for Girls and its partners, including the Government of the United States of America, the Government of Canada, five United Nations agencies, including UNAIDS, and several private sector organizations cohosted an event entitled 72 Hours and Counting: Why Every Hour Matters for Post-Rape Care. Panellists at the event called for increased domestic and global programming to address violence against girls.

Every Hour Matters is a new global advocacy campaign designed to raise awareness of the need to ensure that people have timely access to comprehensive services after rape and of the need for such health services to be made available in all communities. Every Hour Matters was launched in 2016 by Together for Girls, a public–private partnership focused on ending violence against children, particularly sexual violence against girls.

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Human rights experts have called for concerted efforts to end human rights violations based on sexual orientation and gender identity.

A report launched today during the 58th Ordinary Session of the African Commission on Human and Peoples’ Rights, being held in Banjul, Gambia, summarizes a historic dialogue that took place in November 2015 between United Nations human rights experts and representatives of the African Commission on Human and Peoples’ Rights and the Inter-American Commission on Human Rights.

The report, Ending violence and other human rights violations based on sexual orientation and gender identity, highlights grave violations that take place in all regions of the world against lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

The report notes the impact of these abuses on the health of LGBTI people and their access to HIV prevention and care, but also emphasizes positive developments made around the world in protecting the rights of LGBTI people.

In 2014, the African Commission on Human and Peoples’ Rights adopted a resolution calling for the protection of people against violence and other violations on the basis of their real or perceived sexual orientation or gender identity. Commenting on the launch of the report, Pansy Tlakula, Chairperson of the African Commission on Human and Peoples’ Rights, said, “Violence and other human rights violations based on sexual orientation and gender identity constitute universal challenges that require concerted responses by national, regional and United Nations human rights institutions.”

The Inter-American Commission on Human Rights has established a rapporteurship on the rights of LGBTI people. James Cavallaro, President of the Inter-American Commission on Human Rights, highlighted a fundamental element of the work of the Commission. “Bringing the voices of lesbian, gay, bisexual, transgender and intersex people into our work is to challenge the invisibility of the serious human rights violations that they continue to face throughout the Americas and hold States accountable for these violations,” he said.

The United Nations Human Rights Council has passed two resolutions condemning violence and discrimination based on sexual orientation and gender identity. “The dialogue allowed us to share good practices to guide our common struggle to combat impunity and to ensure the protection and realization of the human rights of all individuals, including lesbian, gay, bisexual, transgender and intersex people,” said Christof Heyns, United Nations Special Rapporteur on extrajudicial, summary or arbitrary executions.

The UNAIDS Executive Director, Michel Sidibé, and the United Nations High Commissioner for Human Rights, Zeid Ra’ad Al Hussein, said on the launch of the report, “Ending violence, criminalization, discrimination and other human rights violations against lesbian, gay, bisexual, transgender and intersex people are priorities for our organizations and for the entire United Nations system.”

Civil society organizations have also welcomed the report. “Ongoing collaboration and openness to experience-sharing between regional and international human rights systems reinforces the idea of the universality of human rights, and can only help advance the protection of human rights for everyone, including for LGBTI people,” said Sibongile Ndashe, Executive Director of the Initiative for Strategic Litigation in Africa.

Sexual violence is a global problem. An estimated one in three women has experienced physical and/or sexual violence, and 120 million girls worldwide experienced forced sexual intercourse before their 18th birthday. Moreover, in high HIV prevalence settings women who experience intimate partner violence are 50% more likely to acquire HIV than other women.

Access to post-exposure prophylaxis (PEP) in the event of sexual violence, rape or unprotected sexual intercourse within 72 hours can reduce the risk of HIV infection by more than 80%. However, PEP alone is not enough and needs to be part of a package that includes action to address sexually transmitted infections, pregnancy, physical injury, mental illness and access to justice and legal protection.

Supporting people throughout their recovery, including in adhering to the full 28-day course of antiretroviral medicines that needs to be taken for PEP to be effective, is critical. However, people still face many barriers to freely accessing quality services, including stigma and discrimination in health-care settings.

On 16 March, Together for Girls, the World Health Organization and UNAIDS hosted a side event on the margins of the sixtieth session of the Commission on the Status of Women to promote the Every Hour Matters campaign, which will increase awareness of the importance of rapid access to comprehensive post-rape care.

Health-care workers, uniformed services, peacekeepers and others involved in post-rape care must be trained in gender-sensitive methods of relating to people who have experienced sexual violence and to deliver care without judgement and free of discrimination.

Reducing gender-based violence to lessen the risk of acquiring HIV and its impact is at the core of the UNAIDS 2016–2021 Strategy. The United Nations General Assembly High-Level Meeting on Ending AIDS, to be held in June, and the accompanying Political Declaration on AIDS are a critical opportunity to ensure that the sexual and reproductive health and rights of women and girls are promoted and their right to live in a safe environment free from violence is assured.

Together for Girls is a global public–private partnership dedicated to ending violence against children, with a focus on sexual violence. To address this human rights violation and public health problem, Together for Girls brings together the expertise and resources of many organizations working in development, public health and children’s and women’s rights to collaborate with national governments and civil society.

For more information on the campaign, see the Together for Girls website at http://www.togetherforgirls.org/every-hour-matters/.

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As part of the global effort to achieve the Millennium Development Goals (MDGs), countries around the world reported major gains in the health and wellbeing of women and children between 1990 and 2015. The global rate of maternal mortality fell by 47 per cent and child mortality declined by 49 per cent. However, any celebration of progress is tempered by the reality that millions of women, children, newborns, and adolescents continue to die every year; mostly from preventable causes. As the world transitions from the MDGs to the Sustainable Development Goals (SDGs), we must uphold our commitment to keep reproductive, maternal, newborn, child, and adolescent health (RMNCAH) at the heart of the global agenda. Fulfilling this promise is both a practical imperative and a moral obligation.

The UN Secretary-General's Global Strategy for Women's, Children's, and Adolescents' Health sets out a plan to give every woman, child, and adolescent the opportunity to not only survive, but to thrive and transform his or her community. Implementing the Global Strategy and achieving the SDG targets requires an unprecedented level of alignment and coordination amongst each and every one of us working in the field of RMNCAH.

On behalf of the six organizations responsible for promoting and implementing the global health agenda across the UN system, UNAIDS, UNFPA, UNICEF, UN Women, WHO, and the World Bank Group, we, the undersigned, stand united in our commitment to operationalize the Global Strategy.

Building on our tradition of working together to support countries in achieving the MDGs, we, as members of the H6 (previously known as the H4+), will provide coordinated technical support to country-led efforts to implement the Global Strategy and achieve the ambitious targets of the health-related SDGs. At the same time, we will continue to advocate for evidence-based RMNCAH programmes and policies at the global, regional, and national levels.

As the current H6 chair (2016-2018), UNAIDS will lead the partnership in fulfilling its mandate to leverage the strengths and capacities of each of the six member organizations in order to support high-burden countries in their efforts to improve the survival, health, and well-being of every woman, newborn, child, and adolescent.

As representatives of the H6, we renew our commitment to implement this mandate in support of the Global Strategy. We call on RMNCAH activists and advocates worldwide to join us in fulfilling this shared pledge to women, children, and adolescents everywhere.

Michel Sidibé, Executive Director, UNAIDS

Babatunde Osotimehin, Executive Director, UNFPA

Anthony Lake, Executive Director, UNICEF

Phumzile Mlambo-Ngcuka, Executive Director, UN Women

Margaret Chan, Director General, WHO

Tim Evans, Senior Director, Health, Nutrition and Population Global Practice, The World Bank Group

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The Second African Conference on Key Populations in the HIV Epidemic, devoted to key insights, key advances and key partnerships, took place in Dar es Salaam, Tanzania, from 16 to 18 December. 

The conference brought together more than 200 researchers, policymakers, community actors, health service providers and government representatives from across Africa to discuss experiences, lessons learned and research findings regarding HIV and key populations. They include sex workers, transgender people, gay men and other men who have sex with men, people who inject drugs and others.

Key populations are vulnerable to HIV infection and have been left behind by the AIDS response. Punitive laws, stigma and discrimination are serious barriers throughout the continent for all key populations, with gender inequality contributing to the challenges faced by female sex workers. Migration of key populations within and between countries is another factor linked to their vulnerability to HIV.

Conference participants agreed that peer–led and community-based approaches work best and need scaling up. Effective interventions should be developed with close collaboration of key populations, as well. They also noted that data is important in policy dialogue and in facilitating community engagement.

The conference concluded with a call to action to ensure services for key populations are aligned to their needs and experiences and that key populations meaningfully participate in all areas that pertain to their health and well-being. Participants also called on governments to take down punitive legal barriers, to facilitate access to the justice system and to allocate more resources to serving key populations in the AIDS response.

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If the Fast-Track approach to end the AIDS epidemic is to be successful, the rights, roles and responsibilities of men in the AIDS response need to be placed firmly on the global agenda.

It has long been noted that the Fast-Track Strategy cannot be achieved without action on gender equality and human rights. The vulnerability of young women and girls has been an important focus of many programmes and has been debated many times, but more recognition is needed that harmful norms also drive the epidemic among men. Health systems are falling short of addressing the needs of men, which is having a negative impact on the health of both men and women.

“Men play a critical role. When we engage men for their own health and to change harmful gender norms, we improve both men’s and women’s health. This is an essential element of the UNAIDS Fast-Track approach to ending the AIDS epidemic,” said Michel Sidibé, UNAIDS Executive Director.

Reaching men with HIV-related prevention, treatment, care and support services is vital. Men and adolescent boys make up nearly 49% of the global population of 34.3 million adults living with HIV and account for 52% of all new adult HIV infections. Around 60% of the 1.2 million people who died of AIDS-related illness in 2014 were male.

According to UNAIDS, there is a lack of services for men who are at higher risk of HIV infection. Diversity among men, including age, risk behaviour and sexual orientation, needs to be taken into account when planning programmes.

Women under the age of 25 are often vulnerable to HIV, and gender inequality and the structures of society often prevent them from accessing the HIV information and services that can protect them. Men, on the other hand, are affected later in life and are more empowered to access services, but, for many reasons, they don’t.

Men’s access to HIV services is important for their own health but it is also an important way to reduce vulnerability among women. Engaging men in health services for their own health can also provide an entry point for programmes that can also transform harmful gender norms.

UNAIDS calls for more work to be done to explore exactly how harmful gender norms and notions of masculinity may increase men’s vulnerability. For example, stereotypes of male “strength” and invincibility can lead to men not using condoms and avoiding health services, such as HIV testing. It has been shown by research in 12 low- and middle-income countries that men with less equitable attitudes to women are less likely to be tested for HIV.

In addition, studies have reported that men are more likely not to seek out—and stick to—antiretroviral therapy.

UNAIDS contends that health professionals themselves often assume that men do not need, or are not willing to use, HIV-related services. There is a need for such preconceptions to change, with the development of comprehensive policies and programmes that promote men’s access to programmes and address their specific needs. This means changing the perceptions of men in the response to HIV, as they are often referred to as “transmitters” or “vectors”, stereotypes that blame them for infection, stigmatize them and isolate them further from accessing services.

There is a call for a global shift in the discussion on HIV and gender—that it should become more inclusive of men and encourage their greater positive engagement in all aspects of the AIDS response and in advancing gender equality. Sexual and reproductive health is not the responsibility of women alone. Focused, integrated sexual and reproductive health services must be made available to men and adolescent boys. Although much more research needs to be done, there is already a body of data that lays the groundwork for developing and implementing more comprehensive policies and programmes.

To reflect the seriousness of this issue and the need to chart the way forward, a global high-level meeting on men, adolescent boys and AIDS is being held in Geneva on 10 and 11 December. It is co-convened by UNAIDS, Sonke Gender Justice and the International Planned Parenthood Federation. The main objectives are, broadly, to build consensus on what the evidence is saying about men and adolescent boys in the HIV response and what role they have to play in ending the AIDS epidemic. 

10 December 2015

The AIDS movement, led by people living with and affected by HIV, continues to inspire the world and offer a model for a people-centred, rights-based approach to global health and social transformation. And yet, today, amid a swirl of competing and complex global concerns, we confront a serious new obstacle: the oppressive weight of complacency. This is happening when we know that if we focus on the places and people most affected by HIV, the world can end the AIDS epidemic as a public health threat.

This moment is, however, fleeting. We have a fragile window of opportunity in which to scale up. Efforts need to intensify in the locations and among the populations at higher risk of HIV, including women, young people, prisoners, sex workers, gay men and other men who have sex with men, transgender people and people who inject drugs.

Too often, laws, policies and practices undermine equitable access to life-changing HIV services for people most affected by HIV. Punitive laws that hinder effective responses to HIV remain widespread. Some 75 countries criminalize consensual same-sex sexual relations, and the vast majority of countries and territories criminalize drug use and sex work.

Ending AIDS by 2030 as part of the Sustainable Development Goals means breaking down prejudice, exclusion, criminalization and discrimination. This will require progress across the entire spectrum of rights: civil, cultural, economic, political, social, sexual and reproductive.

UNAIDS has launched a bold call to action to leave no one behind through the new UNAIDS 2016–2021 Strategy. It is a call to defend the rights of all people. Through the realization of their rights, people being left behind will move ahead, to the very forefront of the journey to end the AIDS epidemic—informed and empowered, mobilized and engaged.

On International Human Rights Day 2015, let us stand together to ensure that all people, living with or without HIV, are able to live their lives to the fullest, from birth to adulthood and into old age, free from discrimination and with dignity and equality.

Michel Sidibé

Executive Director of UNAIDS

Under-Secretary-General of the United Nations

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The many crises, wars and natural disasters around the globe are leaving women and adolescent girls facing a significantly heightened risk of unwanted pregnancy, maternal death, gender-based violence and HIV, says a new report from the United Nations Population Fund (UNFPA).

The State of world population 2015—Shelter from the storm: a transformative agenda for women and girls in a crisis-prone world is a “call to action” to meet the needs and ensure the rights of tens of millions of women and girls caught up in the turmoil of conflict and disaster. More than 100 million people are now in need of humanitarian assistance, more than at any time since the Second World War.

Although remarkable progress has been made in providing women and girls with humanitarian services in the past 10 years, not enough is yet being done to address their particular vulnerabilities, the report argues. It highlights how, for example, their risk of HIV infection is increased and how this heightened risk should inform programmes and assistance. Women and girls experiencing humanitarian crises often face sexual and gender-based violence, including rape, which is a risk factor for HIV transmission. Other factors experienced include trafficking, transactional sex and sex work.

Access to HIV prevention and life-saving treatment services can also be significantly reduced or disappear completely in times of crisis. The availability of medicines for the prevention of mother-to-child transmission of the virus is often severely disrupted. In addition, women and girls with disabilities face extra vulnerability to HIV in crisis situations, with even more limited access to services and information.

Shelter from the storm sets out concrete ways in which vulnerabilities can be addressed. It refers to an internationally agreed raft of essential reproductive health services and supplies that should be available from the start of any crisis. This basic package includes programmes to prevent sexual violence and manage the consequences of it, reduce HIV transmission, prevent maternal and newborn death and illness, and integrate sexual and reproductive health care into primary health care.   

Opportunities may emerge from crisis too, says the report. The example of HIV is cited, with well-run camps with sufficient resources enabling displaced people to have enhanced access to services.

There is also an emphasis on moving away from simply reacting to crises as they emerge and embracing a pre-emptive approach that promotes prevention, preparedness and resilience. The report argues that people who are healthy, educated and have their human rights protected are likely to have better prospects in the event of a disaster.