New and bold efforts are needed to reduce the number of new HIV infections amongst young girls and women. This is one of the key focus areas of the new National Strategic Plan on HIV and AIDS, which came into effect last month.
Young South Africans between the ages of 15 - 24 are at great risk of HIV infection. But girls and young women in this age group are more susceptible to HIV infection than men in the same age group.
"The situation in the country is that about 5 million people are living with HIV. We have a high population of young people in our country. About 42 % of our young people are under the age of 20. And young women are vulnerable to HIV infection than their counterparts, which are young men, mainly for physiological reasons", says Rhulani Lehloka, Executive Director of the AIDS Consortium.
As a result, policy makers believe that there is a dire need for the youth, especially girls, to be exposed to sex education to help protect them from HIV infection and other attendant pitfalls of sex.
"There just has to be good, clear educational programmes that talk to young girls about their sexuality and about sex and about the risks that are associated with sex. It's not just the risks of HIV infection, which is, of course, a major risk, but the risks of sexually transmitted infections and the risks of pregnancy. We want every single girl in this country to understand her body and to understand her body in relation to the development of her sexuality", says Mark Heywood, deputy chairperson of the South African National AIDS Council (SANAC), the custodian of the National Strategic Plan (NSP) on HIV and AIDS, TB and STIs.
Heywood says a number of social factors often ensure that girls and young women are not equal partners in their sexual relationships.
"We have to empower young girls in the environments that they go to school in and that they live in. We know that because of poverty, because of inequality many young girls have sexual relationships with older boys or with men and that they feel disempowered in those relationships. We have to give them power, we have to give them the understanding that if they are going to have sex that they must insist on condom use by their male partners. And if their male partner refuses to use a condom, then, we say that young girls and young women should refuse to have sex in those circumstances", he says.
But, he cautions that parents need to come on board to assist programmes that seek to protect girls from the harm that may arise as a consequence of sexual activity.
"Preparing girls for sexuality is a responsibility that every parent has. Preparing girls for both the joys and risks of a developing sexuality is something that parents have to help with. So, we've got to get that discussion going and if we can be successful in that, then, we think that we can begin to cut the rates of HIV infection amongst this important group".
Policy-makers argue that sex education and reproductive health services need to be offered as part of the school system. Until now, the Department of Basic Education has outlawed the provision of condoms in schools. This is largely because parents and school governing bodies have opposed condom provision as they believe that they will promote sexual activity.
But the Health Department says this belief fails to recognise the reality that children have sex at an early age.
"We are still in discussion with the Department of Basic Education whether we can talk about sexual and reproductive health in schools. And if we do, can we render services? Can we give children contraception at schools or do we have to wait for them to come to facilities when they are already pregnant? We can bury our heads in sand and say: 'These kids are nice kids. They don't engage. They just wake up, go to school and come back'. That is actually burying our heads in sand. So, the question is: If parents are not really comfortable with these services in schools, how do we go about addressing this problem? I think this is what we have to deal with", says national Health Department Director-General, Precious Matsoso.
The South African National AIDS Council says although higher rates of HIV infection are evident amongst young girls, HIV prevention efforts should not be limited only to this group of young people. SANAC deputy chairperson, Mark Heywood, says in order to maximise the impact of such programmes, they also need to involve boys.
"These programmes have to talk to young boys as well and we have to bear in mind that if you don't do that, then, young boys grow up, they leave school and they become people who have not been equipped to judge their own behaviours towards people that they may have relationships with at some point in future", he says.