What difference has antiretroviral therapy (ART) made in the incidence of HIV among adolescent girls and young women? This study aimed to summarize direct estimates of HIV incidence among adolescent girls and young women since ART and before large investments in targeted prevention for those in sub-Saharan Africa. The findings were derived from a systematic review and meta-analysis of 51 studies that met the study criteria from nine of the ten DREAMS countries.
The researchers found that few sources of direct estimates of HIV incidence exist in high-burden countries–and in particular there is a lack of data disaggregated by age and sex–however the limited data does indicate recent declines among adolescent girls and young women. In some of the highest-risk settings, however, little evidence exists to suggest ART availability and other efforts slowed transmission by 2016. Despite wide geographical diversity in absolute levels of incidence in adolescent girls and young women, risk relative to males persisted in all settings, with the greatest sex differentials in the youngest age groups. The authors suggest that to end new infections among the growing population of adolescents in sub-Saharan Africa, prevention programs must address gender inequalities driving excessive risk among adolescent girls.