Child Marriage and HIV: an ignored relationship

While relatively little is known about the causal relationship between child marriage and HIV, the limited
available research, anecdotal evidence and what we have learned from HIV programming for adolescent girls
suggests that child marriage can increase the risk of girls becoming HIV infected. Given that it can be difficult
for child brides to access HIV prevention and treatment, child marriage can hinder efforts to control the HIV
epidemic. Child marriage is not only a violation of human rights, but is also a public health issue.

It is critical to tackle the relationship between child marriage and HIV because:

• Despite global gains in expanding access to HIV prevention and treatment, AIDS is now the leading
  cause of death among adolescents (aged 10–19) in Africa and the second most common cause of death
  among adolescents globally.
• Adolescent girls and young women are disproportionately affected: of all new HIV infections among
  young people aged 10–24 years, approximately two out of three are girls and young women.iv In 2014,
  more than 5,000 young women and girls were infected by HIV every week, the vast majority in
  southern Africa.
• Child marriage is a global problem: 15 million girls a year are married before the age of 18. If there is
  no reduction in the practice of child marriage, 1.2 billion women alive in 2050 will have married in
  childhood – the equivalent of the entire population of India.vi
  Child marriage and HIV: What do we know?
  The HIV infection rate among married adolescent girls tends to be higher than among their unmarried,
  sexually active peers.

There are a number of factors which make child brides particularly vulnerable:

• Child brides are at a relatively high risk of HIV infection due to their young age and physical
  immaturity, their limited power to negotiate safer sex, the frequency of unprotected sexual activity,
  and the pressure on them to demonstrate their fertility.
• Child brides are more likely to experience gender-based violence, such as intimate partner violence
  and rape. Women exposed to intimate partner violence are one and a half times more likely to acquire
  HIV in regions with HIV prevalence.
• The older husbands of child brides have often had previous sexual partners, which can increase child
  brides’ lifetime risk of HIV infection.
• Girls are more likely to be married or in a union than boys, they often drop out of school before or at
  the time of marriage, and they are far less likely than boys to have comprehensive knowledge of HIV
  and how to protect themselves.