While HIV is often considered a problem mainly among “high-risk” groups, rising HIV rates in the developing world and new evidence from Africa and Latin America show that young married women are also at risk. In “Protecting Young Women from HIV/AIDS: The Case Against Child and Adolescent Marriage,” Shelley Clark of McGill University et al. analyze data from national surveys from 29 countries and find that:
- Marriage exposes young women to frequent, unprotected sex, especially when the couple wants to have children. In most countries, more than 80% of adolescents who had had unprotected sex in the last week were married.
- Husbands of adolescent wives tend to be much older (by 5-14 years, on average) and more sexually experienced then their wives and are therefore more likely to be HIV-positive. Adolescent brides are also more likely to marry into polygamous unions.
- Adolescent wives are often cut off from formal education as well as other public sources of information such as regular television and radio programs. In all 29 countries, women who married as adults stayed in school longer than young women who married before they turned 18.
- Even when they are aware of HIV risk, most young married women rely on remaining faithful to their husbands—and their husbands remaining faithful to them—as their sole protection from the virus.
HIV/AIDS prevention strategies focused on abstinence until marriage do not fully take into account the health needs of the nearly one in three young women in the developing world who will be married before they are 18 years old. Furthermore, many younger married women want to become pregnant making both condom use and abstinence impractical. Other married women who do not wish to become pregnant often lack the power in a relationship to suggest using a condom or abstaining from sex and therefore have no means of protecting themselves from contracting sexually transmitted infections; they must simply hope that their partners remain faithful to them.
Specific interventions to make sex within marriage safer and, in some countries, to advocate for delaying marriage, are urgently needed to better protect young women from HIV, the authors conclude.
The article appears in the June 2006 issue of International Family Planning Perspectives. Also in this issue:
“Health Care Providers’ Knowledge of, Attitudes Toward and Provision of Emergency Contraceptives In Lagos, Nigeria,” by Olufunke Margaret Ebuehi et al. of the University of Lagos, Nigeria.
“Provider and Health Facility Influences on Contraceptive Adoption in Urban Pakistan,” by Saima Hamid of Health Services Academy, Islamabad, Pakistan and Rob Stephenson of Emory University, Atlanta, GA.
“Partnership Dynamics and Sexual Health Risks Among Male Adolescents in the Favelas of Recife, Brazil,” by Fatima Juarez of El Colegio de Mexico, Mexico City and Teresa Castro Martin of the Consejo Superior de Investigaciones Cientificas, Madrid, Spain.
“Fertility Awareness-Based Methods of Family Planning: Predictors of Correct Use,” by Irit Sinai et al. of Georgetown University.