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H.I.V. Risk Greater for Young African Brides
February 29, 2004
By LAWRENCE K. ALTMAN
ATLANTA, Feb. 28 - Teenage brides in some African countries
are becoming infected with the AIDS virus at higher rates
than sexually active unmarried girls of similar ages in the
same areas, the director of Unicef and other United Nations
officials said here on Saturday.
The studies are the first to show such differences among
married and unmarried young women, the officials said at
the closing of a two-day international meeting on women and
infectious diseases. The officials said the findings
pointed to an inadequacy in programs that focus on
abstinence among teenagers as a main means of preventing
H.I.V. infection because they failed to take into account
fully the risk of transmission in marriage.
The young brides are apparently acquiring H.I.V., the AIDS
virus, from their husbands, who tend to be many years older
and were infected before marriage, the officials said.
While many people around the world may conclude that being
married and faithful protects them from exposure to AIDS,
that is not necessarily true, said Dr. Paul DeLay, an
official of the United Nations AIDS program. In many parts
of the world, a married woman who is faithful runs the
highest risk of exposure to the AIDS virus, he said, if she
has "a philandering husband."
Dr. Catherine Hankins, chief scientific adviser to United
Nations AIDS program, said "it's the first time we have
ever seen" differences in H.I.V. infection rates between
married women and sexually active single women ages 15 to
19. She commented from the agency's headquarters in Geneva
on remarks made at the meeting by Dr. DeLay and Carol
Bellamy, the director of Unicef.
Though the findings are from studies in Kisumu, Kenya, and
Ndola, Zambia, they may have applicability elsewhere. The
studies indicated a greater difference in age between the
brides and husbands than among the sexually active teenage
women and their boyfriends.
"Consistently around the world, girls who marry at or after
age 20 have partners closer in age to them than girls who
marry younger than that," Dr. Hankins said.
"We have known for a long time that marriage in and of
itself is not protective for women who have partners who
have been or continue to be at risk," Dr. Hankins said,
referring to the risk of acquiring H.I.V.
"The striking finding here is that among 15-to-19-year-old
girls who are sexually active in these two settings, the
fact of being married carries significantly higher risk -
in part because of the increased age differential between
spouses and in part because condom use in marriage has not
been promoted," she said. "Common H.I.V./AIDS protection
messages are often inappropriate for married adolescents
who seem to have been a forgotten population."
The studies in Africa found that H.I.V. rates in the
husbands were higher than in the boyfriends of sexually
active single teenage women.
AIDS experts have long known that teenage women are more
vulnerable to acquiring H.I.V. infection because cells in
the cervixes of girls are biologically more susceptible to
the virus than those of older women.
Earlier studies of AIDS from the United Nations have shown
that the disease has cut life expectancy to 37 to 40 years
from 60 to 62 in many countries in sub-Saharan Africa.
In addressing the broader dimensions of infections among
women, Ms. Bellamy said that despite the benefits of
globalization, many types of infections were increasingly
affecting a disproportionate number of women, compared with
men. Nearly half of the world's women live on $2 a day or
less, she said.
High illiteracy rates among women in many countries and
cuts in government aid for drugs for malaria, H.I.V. and
tuberculosis "have led to the rampant spread of infectious
diseases that affect the world's poorest communities," she
added.
Citing a World Health Organization report, she said less
money was spent on health care for women and girls
worldwide than for men and boys. She did not provide the
figures.
The world needs to open up educational, economic, social
and political opportunities for women, she said, to "ensure
progress in stabilizing population growth, protecting the
environment and improving health, starting with the health
of young children."
http://www.nytimes.com/2004/02/29/international/africa/29AIDS.html?ex=1079777735&ei=1&en=bb5840350c3c0c6f
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