In the quarter century since the first case of AIDS was diagnosed, few parts of the world have been spared from its toll. Nowhere, however, has been hit harder than Sub-Saharan Africa, where the disease has decimated families and communities, crippled national economies and slowed the pace of efforts to alleviate poverty. Almost two-thirds of HIV-infected individuals live in SubSaharan Africa, where—as in other regions—young people are becoming infected at alarming rates. Worldwide, an estimated 40% of new infections are among those aged 15–24.1(p.4) Addressing the needs of youth, therefore, will be critical to stemming the epidemic. Malawi has been especially hard hit by HIV. Fully 14% of 15–49-year-olds are HIV positive.1 The current population structure is skewed toward the young: About 6.3 million (48%2) of Malawi’s 13 million people are younger than 15;3 91,000 of this group are suspected to be infected with HIV.1 The comparatively low incidence of HIV among this group presents a window of opportunity to reach young people with the information and tools they need in time to help them avoid infection. The same behaviors that expose adolescents to HIV also endanger their health and well-being by putting them at risk for unintended pregnancy. Unintended pregnancy may harm young women if they are not physically or psychologically ready to carry a pregnancy to term, or if they try to terminate the pregnancy by means of an unsafe abortion. In addition, the stigma attached to unwed motherhood can cause young women to drop out of school, endangering their future economic prospects. Controlling the spread of HIV and preventing unintended pregnancy among Malawi’s next generation will depend largely on equipping young people with the knowledge and skills to engage in healthy sexual behavior and increasing their access to sexual and reproductive health services.
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