In Malawi, almost a third of new HIV cases occur in women under the age of 30, in part because of traditional coming-of-age ceremonies that introduce young girls to sex, according to AIDS activists.
Malawi's Demographic and Health Survey shows that 20 percent of young girls in the southern African country become sexually active before age 13. Many of them do so with limited knowledge of safe sex.
People working to combat HIV/AIDS infection blame cultural and traditional practices in which girls are sent to special initiation camps. There, the girls sometimes are encouraged to have sex to transition into adulthood.
The practice is rampant in Malawi's southern district of Mangochi, said Chief Chowe, a senior traditional leader. He added that it exposes girls to high risk of HIV infection because they're usually partnered with older men who sleep with several girls in the camp.
The Girls Empowerment Network (GENET), a nonprofit organization in Malawi, works to discourage girls from engaging in sex at a young age. The traditional practice poses a danger of girls becoming addicted to sex, communications adviser Joyce Mkandawire said.
"Once the girls are introduced to the first sexual encounter, they go back and do it on their own because they had done it during the initiation camp," Mkandawire explained.
Many girls become pregnant and drop out of school, she said.
Chowe and Mkandawire said several interventions are addressing the problems associated with early sex among girls.
Chowe said he has been teaching initiation camp counselors about the dangers of encouraging the girls to have early sexual intercourse. With other district leaders, he has developed by-laws that aim to curb sexual activity among girls.
"As traditional leaders in Mangochi, we have designed by-laws which require all school-going age groups should go to school and if they get pregnant, we have imposed a fine on the culprits," Chowe said. "A parent is asked to pay a goat if his or her girl child has been impregnated while in school."
Mkandawire said her organization is pushing to modify the initiation camps' syllabus. "Actually we would like to replace initiation ceremonies with summer camps where girls are told to behave like girls and encourage them to stay in school and not introduce them into womanhood," she said.
The Malawi government's coordinating arm for HIV activities, the National AIDS Commission, says it supports several initiatives aimed at transforming traditional practices that lead to HIV infection among girls.
"We have educational projects where we work with traditional leaders, social leaders and opinion makers in the community to ensure that harmful cultural practices are no longer practiced," said Linje Manyozo, a commission specialist in social and behavioral change intervention.
The government is implementing a five-year national HIV/AIDS strategy it launched in 2012.
The strategy calls for teaching girls life skills so they understand their rights and become empowered.