As we mark the anniversary of World AIDS Day, we must acknowledge the disproportionately higher HIV infection rates among young women and girls compared with men and boys in high prevalence countries. This is in part an outcome of sexual abuse and violence in many forms -- coercion, exploitation, rape, sexual trafficking.
The World Health Organization (WHO) estimated in 2002 that 150 million girls under age 18 experienced some form of sexual violence. Studies indicate that 36 percent to 62 percent of all sexual assaults are committed against girls ages 15 and younger. The International Save the Children Alliance indicates that only 10 percent to 20 percent of sexual abuse cases receive services or are reported to authorities.
The International Journal of Injury Control and Safety Promotion cites that compared with women, girls face particularly high risk of contracting HIV through rape because their bodies are more vulnerable to tears and lesions that allow the virus to enter the bloodstream. Following incidents of sexual violence, girls also have increased downstream risk of contracting HIV and other diseases, because these human rights violations send girls down a negative life path, increasing the likelihood that they will be engaged in further high risk situations.
Girls who are victims of sexual violence are three times more likely to have an unwanted pregnancy, according to a 2009 Lancet study. Research indicates that HIV-infected mothers, without intervention, have more than a one-third risk of transmitting HIV to their child. Girls under 15 who are pregnant also have a five times higher likelihood of dying in childbirth compared with women 20 and older.
The consequences do not end there. In many countries, perpetrators of sexual violence behave with impunity, while their victims, the girls who are violated, are shamed into silence. If their rape or other manifestation of sexual violence becomes known, the girls are outcast. They are more likely to drop out of school, and their ability to become productive members of their society is fundamentally diminished.
This has ramifications for overall economic development. Madeleine Albright's Women Empowered study indicates that a country will experience 0.3% faster economic growth when an additional 1% of girls are kept in school, while another study cited by The Girl Effect found that girls who are protected and educated return 90% of their earned income to their families and communities, compared with boys who return between 30 and 40%.
At the Clinton Global Initiative Annual Meeting in September 2009, President Clinton announced a new commitment to address sexual violence against girls. Called Together for Girls, partners include four UN agencies -- UNICEF, UNAIDS, UNFPA and UNIFEM -- the Centers for Disease Control and Prevention (CDC), CDC Foundation, Nduna Foundation and Grupo ABC. In 2010, the US Department of State -- through the President's Emergency Plan for AIDS Relief (PEPFAR) and Office of Global Women's Issues -- and BD (Becton, Dickinson and Company) joined as partners.
Together for Girls builds on successful implementation by UNICEF and the CDC of national research in Swaziland to measure the magnitude and health consequences of sexual violence against girls. The results indicated that one out of three girls in Swaziland had experienced sexual violence as a child. Of these, 67% experienced depression, 29% had an unwanted pregnancy, 18% considered suicide, and 5% contracted an infectious disease.
Data from this survey led to critical actions such as introduction of legislation on violence and sexual offenses, establishment of child-friendly courts for testimony on sexual violence, and integration of sexual offenses units trained to work with children into 75% of police stations in the country.
Together for Girls is now working in four countries, in close cooperation with national governments, and many other countries are seeking to engage. The partnership's core methodologies are:
- National research to collect precise data on the extent and causes of sexual violence against girls
- Programmatic and policy actions for prevention, protection, counseling and treatment
- Global advocacy and in-country mobilization to change social norms permissive of sexual violence against girls
The time has come to end sexual violence against girls and put a stop to this source of HIV spread and gross violation of the human rights of children. Some of the world's leading organizations are actively engaged in doing so, and we welcome the support of governments, agencies and like-minded people.
Gary Cohen is executive vice president of BD, board chair of the Centers for Disease Control and Prevention (CDC) Foundation, a board director of the US Fund for UNICEF, Accordia Global Health Foundation and the Perrigo Company, and an adviser to the Clinton Global Initiative. He led the founding of Together for Girls.