Abstract
Young women in sub-Saharan Africa are on the front lines in the world’s worst HIV epidemics: in 2017, 14.6% to 20.9% of women aged 20-24 years were HIV-positive in Botswana, eSwatini, Lesotho, and South Africa. Because researchers have rarely traced and tested their sexual partners, the sources of their HIV is unknown. The best available data to estimate young women’s HIV from sex are: their reported sexual behavior; and estimated HIV prevalence and viral suppression in partners. With those data, the estimated percentage of young women aged 15-24 years getting HIV from sex each year in 15 countries (14 in Africa and Haiti) ranges from 0.029% in Haiti to 0.54% in Mozambique (median: 0.17%). This is much less than observed new infections: HIV from sex as a proportion of new infections from all risks ranges from 5% in Namibia to 59% in Tanzania (median: 20%). The message to young women from this exercise is: beware of blood exposures, and reject the stigmatizing belief that an HIV infection is a sign of careless sex.
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