Bill Gates warns HIV among young Africans could reverse progress

Africa is chronically under-prepared for the looming challenge of the "demographic bulge" and its impact on HIV, philanthropist Bill Gates said at the International AIDS Conference in Durban on yesterday.

He said modelling suggests that if we don't up our game all the gains made in sub-Saharan Africa could be reversed. Gates was referring to sub-Saharan Africa's rapid increase in young people and the high rates of HIV infection among them. In 1990, there were 94-million people between the ages of 15 and 24 [in sub-Saharan Africa]. Today that number has more than doubled. And by 2030, there will be more than 280-million young people in this part of the world. So that highly vulnerable group will be around three times as populous in 2030 as it was it was back in 1990.

According to Gates, of the nearly 2-million people in the world who are newly-infected with HIV each year, almost 1.4-million are in sub-Saharan Africa. He said women and girls are infected at two-and-a-half times the rate of men.

The Human Sciences Research Council's latest household survey shows that almost one in ten South African women are infected with HIV by the time they turn 24.

About 25 percent of new HIV infections in South Africa occur among teenage girls and young women between the ages of 15 and 24. While annual new HIV infections in sub-Saharan Africa have dropped by about a third since the early 2000s, the rate of decline in new HIV infections among adults are stagnating. UNAIDS data show, that since 2010, the rate of new infections has dropped by only 4.5 percent. Gates said that for sub-Saharan Africa, that means, that with stagnating incidence rates, if we are only doing as well as we have been doing, there will be lots more people aged 15-24 living with HIV.

He said "knowledge gaps" about HIV are the greatest when it comes to women and girls, adding that we simply don't have enough data about what directly and indirectly increases their HIV risk: poverty, inequality, forced and early marriage, sexual violence, lack of education. Gates said that there is either no data, and even where data exists, it often ignored women and girls entirely or it misrepresents their unique circumstances. A study released by the Centre for AIDS Programme of Research (Caprisa) in South Africa at the conference this week, showed that about 60 percent of all new HIV infections in young South African women and teenage girls could be linked to older men. Another Caprisa study, conducted among 120 women with HIV in KwaZulu-Natal, revealed that the presence of a bacterium, Prevotella bivia, in the vagina, made young women about 20 times more likely to be HIV-positive.

Mail & Guardian, 21 July 2016