Current inequalities in HIV testing and treatment for children living with HIV and trends in historical coverage of services to prevent vertical (mother-to-child) transmission of HIV are driving year-on-year trends in AIDS-related mortality.

Reductions in AIDS-related deaths among children and adolescents are steepest among children aged 0 to 9 years (a 60% decline since 2010), reflecting both improvement in efforts to prevent new vertical infections and efforts to diagnose and treat children in the months following childbirth and during breastfeeding.

However, among adolescents (aged 10–19 years), progress is slower, with AIDS-related deaths declining just 37% over the same period.

The single biggest paediatric treatment challenge is to rapidly find children living with HIV who were missed at birth or during breastfeeding and link them to care. Scale-up of rights-based index, family and household testing and self-testing, and integrating HIV screening with other child health services, can help close this gap. 

Winnie Byanyima, the UNAIDS Executive Director, recently visited the Hakahana Clinic in Katutura, Windhoek, Namibia, where she saw the Determined, Resilient, Empowered, AIDS-Free, Mentored and Safe (DREAMS) project in action, a project funded by the United States of America. The clinic is a government health facility and a DREAMS participating clinic that has provided health services to 10–24-year-old adolescent girls and young women since September 2020.

Together with the United States Ambassador, Lisa Johnson, and the Executive Director of the Namibian Ministry of Health and Social Services, Ben Nangombe, Ms Byanyima met with DREAMS girls and community care workers at the facility.

“I am very impressed by the confidence and optimism the young women express as a result of the support they receive through the DREAMS programme,” said Ms Johnson.

The DREAMS project seeks to reduce new HIV infections among adolescent girls and young women in Namibia and other countries in sub-Saharan Africa. In 2019, there were 1400 new HIV infections among adolescent girls and young women aged 15–24 years in Namibia—more than double the number of HIV infections among their male peers. It is therefore critical that the HIV response continues to gain momentum.

DREAMS uses a core package of evidence-informed, multisectoral interventions that are proven to reduce new HIV infections among adolescent girls and young women. This includes empowering them with social protection, safe spaces, education and economic skills and with access to family planning and sexual and reproductive health services.

“The knowledge I learnt from DREAMS has taught me about making the right decision. I feel empowered,” said Johanna Shinana, a DREAMS Ambassador.

DREAMS is implemented in five districts in three regions of Namibia and the Hakahana Clinic provides eight safe spaces for young women mostly between the ages of 19 and 24 years.

Ms Byanyima, together with Sheila Roseau, the Country Representative of the United Nations Population Fund (UNFPA), Aina Heita, the United Nations Educational, Scientific and Cultural Organization National Programme Officer for HIV/AIDS, and Thomas Ukola, the Deputy Director at the Directorate of Special Programmes within the Ministry of Health and Social Services, also visited the Namibia Planned Parenthood Association (NAPPA) clinic, which is also in Katutura.

NAPPA is a welfare organization established in 1996 to complement the Ministry of Health and Social Services to provide sexual and reproductive health services and information to young people aged 15‒24 years and lesbian, gay, bisexual, transgender and intersex people from the marginalized and underserved area around Katutura.

“I encourage young people to take advantage of the services that are offered for them and encourage others to take up these services,” said Ms Byanyima while she was at the NAPPA clinic.

Ms Byanyima was introduced to the Condomise Campaign at the clinic. The campaign, supported by UNFPA, is led by young people and provides young people with key messages on sexual and reproductive health and rights, HIV and skills on how to use condoms correctly.  

Klaivert Muandingi, the President of the African Youth and Adolescents Network in Namibia, called on young people to be free in accessing condoms and other commodities. “Condomize, do not compromise. Love smart and play safe,” he said.

8 March 2021

Winnie Byanyima

Executive Director of UNAIDS
Under-Secretary-General of the United Nations

Women leaders have provided a guiding light for the world in responding to the COVID-19 crisis, from heads of government to coordinators of grass-roots social movements. They have reminded the world how crucial it is to have critical numbers of women, in all their diversity, in positions of leadership.

But the COVID-19 crisis has seen progress towards equality pushed back. It has widened the gap between women and men in wealth, in income, in access to services, in the burden of unpaid care, in status and in power.

Up to 20 million more secondary school-aged girls could end up out of school following the crisis. Many may never go back to school or have access to skills and economic opportunities, and will be at greater risk of violence, poor health, poverty and more.

Two and a half million more girls are now at risk of child marriage in the next five years. There has been a dramatic increase in violence against women.

Pandemics such as COVID-19 and HIV magnify the fissures in society and exacerbate vulnerabilities. Gender-based and intersecting inequalities and violence hold back the lives of women and girls all over the world.

The pandemic has brought into sharp and painful focus that even before COVID-19 an estimated 34 million girls between the ages of 12 and 14 years were out of school, one in three women globally reported having experienced physical or sexual violence and women the world over worked longer hours for less or no pay.

Women who were already stigmatized are among those who are being hardest hit by the impacts of the pandemic. The sudden loss of the livelihoods of sex workers and their lack of access to health care and social protection have intensified their vulnerabilities, especially for those living with HIV. Many female migrants and precarious workers adversely affected by the pandemic are excluded from government relief and protection programmes, as well as health services. Stigma, discrimination and criminalization put transgender women, and women who use drugs, at heightened risk of HIV and other sexually transmitted infections, and hold them back from accessing HIV prevention, treatment and care services.

Recovery strategies cannot be gender-blind or gender-neutral: they must overturn the inequalities that hold women back.

Together, UNAIDS, UN Women, the United Nations Children’s Fund, the United Nations Educational, Scientific and Cultural Organization and the United Nations Population Fund have convened a broad movement, Education Plus, to work with governments to secure the transformative changes that will enable all of Africa’s adolescent girls to be in school, safe and strong. That includes all the girls who have been pushed out of school during the COVID-19 crisis and those who were excluded from school even before the crisis hit.

Overcoming the COVID-19 crisis, and ending new HIV infections and AIDS-related deaths, both require that we close in on the inequalities that drive vulnerabilities. The new global AIDS strategy 2021–2026 puts the rights and multiple and diverse needs of women and girls across their life cycle at the centre of the response: from preventing vertical transmission to providing access to quality education in safe and supportive environments to ensuring comprehensive sexuality education and holistic sexual and reproductive health services.

Gender inequality is not only wrong. It is dangerous. It weakens us all. A more equal world will be better able to respond to pandemics and other shocks; it will leave us healthier and safer and more prosperous.

Progress on gender equality has never been automatic. It has never been given, it has always been won.

We are inspired by the women’s movements leading the struggle for equality. The United Nations stands alongside you to advance a world where women and girls in all their diversity will thrive and take their rightful places as equals.

This International Women’s Day let’s support and celebrate women taking the lead.

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 Network of People Living with HIV in Senegal (RNP+) marked Zero Discrimination Day 2021 by hosting a dialogue on the extent and impacts of the stigma and discrimination faced by women and girls living with HIV in Senegal—a country in which the 2017 People Living with HIV Stigma Index showed one in two people living with HIV experienced stigma and/or discrimination from others.

“Discrimination continues to affect women and girls and this is the reason why they are often excluded from the labour market, are isolated in their communities or experience stigma in health centres. Key populations are also historically the target of discrimination in Senegal,” said Soukèye Ndiaye, the President of RNP+.

Various assessments undertaken in the country have revealed that women living with HIV face obstacles in accessing reproductive health services, that sex workers face high levels of stigma in health-care settings and that the economic and social vulnerability of women living with HIV is not sufficiently taken into account in HIV programmes.

This dialogue served as the spearhead for the advocacy strategy that RNP+ will develop this year on human rights and gender issues in order to better respond to the expectations of its members and communities affected by HIV. This strategy will be accompanied by communication tools such as videos in several local languages and dialogue and sensitization sessions with key actors in the regions most affected by HIV.

During the dialogue, the participants were invited to support the RNP+ in this process. In particular, they were asked to become “champions” committed to making a better use of journalists, community radio and social networks to sensitize the general public to the challenges of discrimination.

Abdoulaye Ka, in charge of human rights issues at the National AIDS Control Council (CNLS), recalled the importance of continued collaboration between the state and non-state sectors. “Community organizations and networks have long been essential in the fight against AIDS because of their central role in raising awareness, informing, dispelling myths and misinformation and providing services to marginalized, vulnerable and discriminated against populations.”

The dialogue, which was supported by UNAIDS, brought together about 30 participants, including people living with HIV, representatives of women’s movements and key populations, human rights advocates, policymakers and health service providers in a meeting held both virtually and physically.

“In Senegal, we know that discrimination against people living with HIV is still a major stumbling block in all aspects of the HIV response. The United Nations Joint Team on AIDS has always placed human rights and gender considerations at the centre of its work and support,” said Demba Kone, the UNAIDS Country Director for Senegal.