By Morenike Oluwatoyin Folayan and David Ita
HIV prevention intervention for any target population requires comprehensive programming. Programmes need to address biomedical, behavioural and structural risk factors. For adolescent girls, there is very little addressing a high HIV risk factor – rape.
The risk of rape is extremely high for girls in Nigeria. A study showed that about 34.1% of sexually active adolescent girls have their first sexual experience through rape. In Nigeria, rape increases the risk of girls to HIV infection just like it does in South Africa.
The mental distress associated with rape is not often managed due to the culture of silence about rape. This culture increases the high risk behavior of rape survivors – unprotected anal and vaginal intercourse, having multiple sex partners and increased engagement in transactional sex.
Rape survivors also suffer depression and low self esteem. In Nigeria, they often use coping strategies that limit their interactions with people and the public further increasing their risk of mental distress.
The risk for HIV infection for adolescent girls is further heightened if they get unwanted pregnancies, and continue to have sex with an infected partner during pregnancy and immediately post delivery.
The risk of engaging in sex during and immediately after delivery is high due to the need to get source for money to support themselves and their child. Pregnancy increases the risk of being a school dropout, having no skills to provide financially for self and a family suddenly trust into her care. Resorting to transactional sex as a way for making income during pregnancy and post delivery is therefore high.
Sadly, the national government does not recognize rape as a risk factor for HIV infection for adolescent girls in Nigeria. Neither does the country have a HIV prevention programme designed to acknowledge that unwanted/unplanned pregnancy is a risk factor for HIV infection for adolescent girls.
The HIV prevention programme in Nigeria should address rape as a structural risk factor for HIV in Nigeria. The risk for rape is high for adolescent girls in Nigeria. Rape increases the risk for pregnancy. Pregnant girls are often forced to marry identified sex partners – rapist or others. They drop out of school, become economically insecured, and are less able to negotiate safe sex.
Not having education beyond secondary school is one of the greatest structural risk factors for HIV infection for women and young girls. Sadly, 49% of females living in rural Nigeria and 22% of those in urban Nigeria have no education.
We need to break the vicious cycle of HIV risk resulting from unwanted adolescents’ pregnancy. Establishing programmes that empower young girls to make decisions about preventing unwanted pregnancy is highly needed in Nigeria.