To stem HIV in Africa, prevent transmission to young women

Over the years community-based studies have shown that higher proportions of young women (15-19 years) in Africa are already infected with HIV compared with their male counterparts. This is likely because non-response in HIV surveys is higher in men than women and those who are repeatedly absent or who refuse clinical testing may be more likely to be HIV infected. Moreover HIV is more easily transmitted from men to women than vice versa. Patterns of sexual mixing may also account for differences in the infection levels between men and women evidenced in the frequent sexual relationships between younger women and older men. Men also appear to be less to use condoms with young female partners. In this perspective the success in cutting back the devastation caused by HIV and AIDS in east and southern Africa depends upon the successful prevention of transmission of HIV to young women while focusing on both men and women. Thus prevention programs provided to young women and their older partners in a high-HIV prevalence epidemic should aim to: 1) reduce early exposure to risky sex 2) reduce likelihood of transmission per sexual act and 3) reduce age difference between partners.