Report on the Global HIV/AIDS epidemic

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What makes people vulnerable?
knowing it. Moreover, given the very high infection rates now being seen in girls (see
Figure 18), it is unwise to expect young partners to be free of HIV.
Whether sexual initiation is consensual or coerced, it may occur at a very early age
in particularly marginalized communities. In a survey of 1600 children and adolescents in four poor areas of the Zambian capital, Lusaka, over a quarter of children
aged 10 said they had already had sex, and the figure rose to 60% among 14-yearolds. In South Africa, 10% of respondents in a study in six provinces said they had
started having sex at age 11 or younger. The study, commissioned by the South
African Department of Health, recommended that sex education be introduced to
children around the age of 12 if it was to reach most of them before they became
sexually active. Clearly, though, it is important to complement education on AIDS
and life skills with vigorous action against sexual abuse and rape and campaigns to
discourage older men from seeking out young girls for sex.
Box 8. Working with vulnerable girls in Nepal
In Nepal, the Maiti Project has targeted children and young women who are subject
to sexual exploitation and abuse, including girls who are at risk of being sold into
prostitution in India. The project has established camps in high-risk areas, each
camp functioning as a shelter for about 30 girls rescued from traffickers or who are
in danger of being sold. The camps provide education and vocational training, as well
as support and counselling. The project has worked in conjunction with colleges,
local pressure groups, village leaders, medical officers, lawyers and the police. An
evaluation suggested that Maiti Nepal prevents approximately 180 girls from being
sold into brothels in India each year. In addition, 105 people have been imprisoned
as a result of the project's efforts to expose child traffickers. In 1997 alone, 60 girls
were repatriated from India and three-quarters of them were subsequently reunited
with their families. Taking account of the daily challenges faced by vulnerable young
people, the project is remarkable for its integrated approach to their needs for shelter, food, education, health care, legal protection and supportive adult networks.
Violence against women
Violence directed against girls and women - in a sense, the most egregious sign of
male domination - makes them vulnerable to HIV infection in a number of direct and
indirect ways. 7
Violence in the home
Domestic violence reduces women's control over their exposure to HIV. Obviously,
in settings where violence is regarded as a man's right, women are in a poor posi
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