HIV Risk and Prevention in Adolescent Girls and Young Women

Adolescent girls and young women (AGYW) remain disproportionately affected by HIV, with incidence rates in many settings up to eight times higher than those of their male peers. Their vulnerability is shaped by a confluence of biological factors, such as increased genital inflammation, and structural drivers, including gender inequality, poverty, food insecurity and gender‐based violence. Social dynamics—age‐disparate and transactional partnerships, limited educational attainment and prevailing stigma—further amplify risk by undermining negotiation of condom use and reducing access to testing and care. Prevention efforts now emphasise multi-component packages that combine biomedical tools (for example pre-exposure prophylaxis and voluntary medical male circumcision), behavioural interventions (peer education, stigma reduction) and structural approaches (cash transfers, schooling support). Delivery through schools, community venues and youth-friendly clinics, underpinned by adolescent engagement and leadership, has shown promise. Advances in long-acting formulations and integration of HIV prevention into broader sexual and reproductive health services are critical to scaling up impact. Despite progress in some regions, recent epidemiological data underline the need for intensified, tailored and youth-centred strategies to bend the epidemic curve among AGYW globally.

Research from Nature Portfolio

Qualitative research in South African secondary schools has illuminated how school leadership shapes the success of HIV intervention programmes for AGYW. By interviewing principals across urban and peri-urban districts, investigators identified that strong governance, clear accountability and collaboration with health authorities are essential to effective delivery. The study revealed that leadership commitment directly influences the consistency of peer-education sessions, the availability of condoms and the integration of psychosocial support. Participant-reported insights highlighted the need for capacity building among school managers to overcome logistical barriers and to foster a supportive environment in which girls can learn, seek testing and adhere to prevention messages.

HIV Risk and Prevention in Adolescent Girls and Young Women publication trend

The graph below shows the total number of articles in hiv risk and prevention in adolescent girls and young women across all publications each year (not limited to Nature Index journals).

Technical terms

Age-disparate relationship: A sexual partnership in which there is a significant age gap (commonly ≥5 years) between partners, associated with higher HIV risk. Combination prevention: An integrated strategy that layers biomedical, behavioural and structural interventions to reduce HIV incidence. Antiretroviral therapy (ART): A regimen of drugs that suppresses HIV replication, improves immune function and reduces viral transmission. Viral suppression: The reduction of HIV RNA in blood to undetectable levels, indicating effective ART and lowering transmission risk.

References

1. Principals’ strategies for the effective management and implementation of HIV intervention programmes for adolescent girls in secondary schools. Humanities and Social Sciences Communications (2023).
2. Does self-perceived HIV risk mediate the potential association between HIV-related symbolic stigma and sexual behaviour among young adult women in Cape Town, South Africa?. BMC Public Health (2023).
3. Trends in HIV Prevention, Treatment, and Incidence in a Hyperendemic Area of KwaZulu-Natal, South Africa. JAMA Network Open (2019).
4. Age-disparate relationships and HIV incidence in adolescent girls and young women. AIDS (2017).