A global war is being waged against girls and young women. From 2005 to 2012, public policy and popular determination resulted in a global dip of 30% in AIDS-related deaths. In that same period, 10- to 19-year-olds suffered a 50% increase in AIDS-related deaths. The epicenter of this is sub-Saharan Africa, and the heart of that epicenter is comprised of girls and young women. How did this happen?

From global agencies (and their donors) to national governments to local practitioners, everyone refused to respect the arc of peoples’ lives. They refused to think of the number of children born HIV+.  Many of those children never received antiretroviral treatment, or ART. Of those who did, few received adequate, or any kind, of follow-up or support. Everyone refused to plan child- and adolescent-friendly services. Children were left to fend for themselves, often without the knowledge or information of their status.

And so the children have died in increasing numbers… especially girls: “Adolescents and young people remain extremely vulnerable to acquiring HIV infection, especially girls who live in settings with a generalized HIV epidemic or who are members of populations at high risk for HIV acquisition or transmission.”

Especially girls. Consider some numbers:

92% of the world’s pregnant women with HIV live in sub-Saharan Africa. 59% of those women received ART or prophylaxis during pregnancy and delivery.

A recent survey indicates that only 15% of young women in sub-Saharan Africa know their status. Put more directly, 85% have no idea.

Young women are three times more likely than young men to become infected.

The situation is actually worse, because there are well-known successful youth-centered programs and projects. They’re out there, and there not difficult to find, from South Africa to Botswana to Mozambique to Jamaica and beyond, successful programs begin with respect for the individual and collective autonomies of children, adolescents, and youth, and they work to better understand the particular operations of genders in their communities.

One study released this week indicates, “Child support grant keeps sugar daddies away.” Or, as the researchers put it, “Our findings provide evidence that government-administered cash transfers are associated with reduced incidence in the past year and lower prevalence of risky sexual behaviours in adolescent girls, but no consistent associations for boys… Child-focused cash transfers target specific—rather than all—risky sexual behaviours, and that a possible mechanism of change might be interruption of risks driven by economic necessity. This finding is especially important because transactional and age-disparate relationships are linked and major vectors of HIV infection, via power inequalities and higher infection rates in older male partners and male partners who provide financial support.”

Do you need a study to tell you that most young girls engaging in sex with older, and wealthier, men are acting “transactionally”? Common sense or conversations with those young girls would suggest as much.

National governments and their international partners have steadfastly refused to have those conversations. They refused to look at girls and young women with anything like a gender lens, with anything like respect. And so the death tolls mount, and the piles of corpses are overwhelmingly women and girls. Girls and young women are not “falling through gaps in HIV services”. They were not forgotten or overlooked. They have been positioned, targeted, by agencies and nation-States that give lip service to women’s rights while colluding in the mass deaths of young women … and especially girls.

(Photo Credit: The Guardian / Elmer Martinez / AFP / Getty Images)