Three things you need to know: child marriage and HIV

Here are four important facts you need to know on the links between child marriage and HIV.

1. Adolescent girls are disproportionately affected by child marriage and HIV

Every year, 12 million girls are married before the age of 18. Although boys are sometimes married off, child marriage is driven by gender inequality and disproportionately affects girls.

Young women and girls are also disproportionately affected by the spread of HIV. Globally, young women and girls are twice as likely to acquire HIV as young men and boys.

This is all the more worrying because AIDS-related illnesses are the second leading cause of death among 15-19 -year old girls in sub-Saharan Africa and the third most common cause of death among adolescents globally.

2. Child marriage and HIV have common drivers

Some of the factors that put girls at risk of child marriage also place them at higher risk of HIV infection. These include poverty, low educational attainment and gender inequalities, especially those which limit girls' ability to make decisions about their own health.

Once married, there are a number of factors that can make child brides vulnerable to HIV:

• In many contexts, early sexual debut - including that which takes place within child marriages - is associated with increased lifetime risk of HIV infection.
• Child brides are exposed to frequent unprotected sexual activity, in part because there is pressure on them to prove their fertility.
• Child brides have little say in how they practice their sexuality, because of their young age and limited power in the relationship, leaving them unable to negotiate safer sex or refuse sex.
• They are also more vulnerable to intimate partner violence, a factor that has been shown to increase the likelihood of contracting HIV.
• Girls married before the age of 18 tend to have lower levels of education than their unmarried peers, which further increases their risk of contracting HIV.

3. Child brides are often unable to access HIV information and programmes

Though child brides desperately need sexual health information and services, they are often isolated – both geographically and socially –and unable to access them. Once married, girls are often taken out of schools where they would have had better access to programmes related to sexual health.

Child brides are also often unaware that such information and services are available to them, making it significantly harder to effectively prevent and treat HIV among them.

4. We need to invest in integrated programmes that focus on girls' needs.

There is growing evidence that we need to prioritise the needs of adolescent girls. By placing girls' needs at the heart of solutions, we can work to reduce the structural drivers of both child marriage and HIV.