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HIV, pregnancy, violence: The three-pronged crisis stealing the future of Africa's girls
A pregnant schoolgirl in Bungoma County on November 3, 2023. With the rise in teen pregnancies, cases of HIV among young women are also increasing.
Ms Abigael* is not just a statistic. She is a young woman navigating three immediate threats to her life: the risk of HIV, the risk of an unintended pregnancy and the risk of sexual and gender-based violence.
She wakes up before dawn to fetch water, attends school when there is money for the bus fare, and comes home to a house where her grandmother, who took her in after her mother died, has not been well for months. She has no older sibling to ask about her body. No older woman in her life talks about these things openly.
What she knows about sex, pregnancy and HIV, she has pieced together from friends, from whispers, from things she has seen and things she has been told not to ask about and not to do.
She faces all three threats not by choice but by circumstance. She needs information. She needs a system that helps her navigate life rather than one that turns her away at the door. Without either, she will become another entry in the statistics Kenya is already struggling with.
Every year she stays in school, the numbers bend in her favour. Every year she leaves, they bend against her. A pregnancy would force her out of school and close that window permanently, because according to the recently released Kenya Economic Survey 2025, a girl who remains in school reduces her risk of HIV infection by between 11 and 12 percent for every year she stays.
“This is not a tragedy but a pattern that repeats itself 50 times a day in the life of an adolescents in Kenya every time girl acquires HIV. It repeats in the 644 adolescent pregnancies recorded annually. It repeats in the 71 incidents of gender-based violence that occur in this country every single day. And it repeats in every clinic where a girl walks in asking for help and is turned away because she has no guardian to sign the consent form,” Dr Richard Amenyah, UNAIDS Representative and Multi-Country Director for Kenya, Rwanda and South Sudan said.
Shocking statistical surge
Dr Amenyah, during a media briefing held ahead of the 9th RHNK Pan-African Adolescent and Youth Sexual and Reproductive Health and Rights Scientific Conference, said: “The triple threat is not three problems arriving in sequence. It is one trap, and it is sprung the moment a young girl is left without information, without services and without a system that sees her. Let us stop grouping young people as a problem to be managed. Not as a demographic to be studied. But as the architects of the solutions that adults keep trying to build without them.
The conference, convening in Mombasa from June 4 to 6 and organised by the Reproductive Health Network Kenya in partnership with the governments of Kenya and Uganda, is expected to draw more than 1,500 delegates from across the continent. But its central argument is not about numbers or policy briefs but about the adolescent’s health, a generation that is ready, and a system that keeps asking them to wait.
Every week in Kenya, 3,100 young girls acquire HIV. Fifty adolescent girls acquire HIV in Kenya every single day. Seventy-one incidents of sexual and gender-based violence occur in this country every twenty-four hours, according to the recent figures by UNAIDS. “HIV in this country has the face of a young girl. But it is not happening in isolation from everything else.” Dr Amenyah said.
Pregnancies among girls aged 10 to 14 rose by 14.6 percent in 2025, according to the Kenya Economic Survey 2026. "Let us not normalise a 10-year-old having a baby. This should be a sleepless night for a policymaker. This should be a sleepless night for me as a development partner."
"The triple threat is one structural crisis," Dr Amenyah said. "Young girls, adolescent girls, are facing structural challenges that predispose them to getting HIV, that predispose them to having early pregnancy, that predispose them to sexual and gender-based violence. It is one individual facing all three."
Dr Jacqueline Kisia, Director of Sexual Reproductive Health at the Ministry of Health, said, "When a young girl finds out she is pregnant and has no support, she goes through depression. Being diagnosed HIV positive at an early stage definitely affects them mentally. Gender-based violence is also related to defilement, to physical violation. These are not separate conversations."
She said African countries need to invest in Africa's growing youth population by ensuring young people are healthy, educated, informed and supported to fully realise the continent's demographic dividend.
“The argument is not simply a health one. It is an economic one. A young person who cannot access reproductive health services is a young person whose schooling, employment and economic potential is at risk. The triple threat does not just damage health. It disrupts futures,” Dr Kisia said.
Consent barrier
Ms Nelly Munyasia, Executive Director of RHNK, said during the briefing that one of the most consistent findings from the previous RHNK conferences is a barrier that carries life-or-death consequences, the age of consent.
“When adolescents go to health facilities seeking contraception, HIV testing or reproductive health services, healthcare providers frequently ask for consent from a guardian. For many young people across Africa, that guardian does not exist. They are adolescent-headed households. Their grandmothers are bedridden. They are earning money in ways that expose them to sexual relationships and unintended pregnancies, and when they arrive at a clinic seeking help, the system turns them away,” she says.
She adds: “Adolescents have told us over and over that one of the challenges to accessing services has always been the issue around consent. The young woman who cannot access contraception because she has no guardian is the same young woman who becomes pregnant. The young woman who cannot access HIV testing without a guardian is the same young woman whose status goes undetected. The system built to protect her is the very system keeping her from the help she needs.”
Ms Munyasia said, in partnership with other organisations, they have developed a comprehensive document on age of consent that draws together the voices of healthcare providers, the judiciary and young people themselves from across the African continent. The document will be launched at the conference and is intended to travel far beyond Kenya's borders.
"This is a document that will be a point of reference for judges across Africa when they are making rulings involving the age of consent. It will also be a reference document by the Ministry of Health when they are developing policies. And importantly, it will support healthcare providers to ensure that they do not deny adolescent girls the services they need." She said.
Ms Fidelis Ndungu, Deputy Director in charge of Advocacy at the National Council for Population and Development, emphasised the importance of ensuring young people have access to information, services and platforms that empower them to thrive, arguing that investment in youth is not a cost but a foundation for national development.
A young advocate who spoke at the briefing said, "Autonomy for young people, especially when it comes to SRHR, is not just about passing laws that allow access to services. It is about recognising youth as equal partners, key stakeholders and decision-makers. Real accountability comes when young people have ownership over the changes made in their lives."
Dr Claudia Shilumani, IPPF's Regional Director for Africa, said the conference is being held at a moment of acute crisis in the supply chains that sustain adolescent and youth reproductive health services across Africa, describing the impact of the withdrawal of US global health funding as structural and immediate.
“For young people navigating the triple threat, a condom shortage is not an inconvenience. It is an HIV exposure. An empty shelf where contraceptives should be is an unintended pregnancy. The funding withdrawal did not create the triple threat. But it removed the tools that were, imperfectly and partially, helping to contain it,” she said.
Dr Kisia acknowledged the reality from inside the government. "For the last year, when the US cuts came, that affected quite a lot. The government has stepped in, but we have also been experiencing shortages and stockouts. We are doing domestic resource mobilisation and looking for other donors to step in."
At the core of the 9th RHNK Pan-African Adolescent and Youth Sexual and Reproductive Health and Rights Scientific Conference is an attempt to break that pattern. To build the policies, the services, the legal frameworks and the community structures that would mean the next Abigael has somewhere to go, something to hold onto, and a system that says yes instead of no.
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