LUSAKA - The strikingly higher infection rates among adolescent girls compared to boys in Zambia and many other parts of Africa reveal a disturbing trend: the AIDS epidemic is being fueled by the abuse and subordination of young women.
Sexual violence and coercion of girls is widespread, often fueled by intergenerational sex when men choose younger and younger girls because they are assumed to be HIV-negative. The increasing number of orphans created by the AIDS epidemic is contributing to the crisis.
Many girls who are orphaned, or taking care of younger siblings, trade sex to earn a survival income. Such girls are rarely able to negotiate safe sex.
Worse still, the perpetrators of abuses against girls, especially orphans, are sometimes members of their own families, or others charged with looking after them, including teachers.
The State of the Union announcement by President George W. Bush of a new AIDS initiative for Africa and the Caribbean will need to include measures to protect the rights of girls and young women, or it will be impossible to curb the AIDS epidemic.
Interviews conducted recently by Human Rights Watch in Zambia put the gender dimensions of the situation in stark relief. One twelve-year-old orphan described her experience of sexual abuse by relatives.
"My uncle used to beat me with electricity wires," she said. "Before I went to live with my uncle and auntie, I stayed with my big sister's mother, and my brother used to take me in the bush. Then he raped me. I was eight or nine. I was scared. He said 'I'm going to beat you if you ever tell anyone."'
The AIDS crisis makes the subordinate status of women and girls lethal. They are hard-pressed to protect themselves from infection when they are economically and socially dependent, and sometimes subject to threats of violence or abandonment.
When asked by Human Rights Watch why abusers within the family are not reported to the police, many young women stated, in effect, that bringing a complaint against the breadwinner was unthinkable. Even if they do attempt to bring the case to the police, the chance of an effective response from law enforcement agencies is often minimal, furthering the sense of impunity for perpetrators of such crimes. Women and girls often remain silent rather than confront hostile legal and social structures.
Sexual violence and coercion of even very young girls are not unique to Africa, but the AIDS crisis, food shortages, widespread poverty and lack of education makes such abuses more pronounced.
Recent studies by the Joint United Nations Program on AIDS have concluded that about half of all those infected worldwide are women and girls. In the worst affected countries in Africa, many girls are pulled out of school to care for sick relatives in AIDS affected families, or simply because their families can no longer afford to pay school fees.
An integrated response is needed. Social services for women and girls must be expanded to reduce their vulnerability to transmission. Women's property and inheritance rights must be strengthened, and access to education improved. Sexual violence and coercion of females must be investigated and prosecuted.
One of the single most important measures that could be taken to protect girls is to keep their parents alive longer. That means dramatically expanded treatment possibilities.
The remedies required to address some of the key vulnerabilities of women and girls are not very costly compared to many other elements of AIDS programs. By integrating a gender dimension into the Bush administration's new AIDS initiative, the United States can take concrete steps to tackle widespread virus transmission among women and girls by making their protection a priority.
*The writer is Washington director for Africa of Human Rights Watch. She also chairs the Working Group on Women and Girls of the HIV/AIDS Task Force set up by the Center for Strategic and International Studies in Washington