Child Marriage in the Context of the HIV Epidemic

As the HIV epidemic has matured, in many settings it has become a disease of young women. In sub-Saharan Africa, 75% of the 6.2 million young people aged 15–24 living with HIV are female (UNAIDS 2004). At the same time, child marriage, though on the decline, persists. In parts of Africa, there are large pools of girls at risk of child marriage and many millions of young wives who were married as children. The Population Council has undertaken a multi-level investigation of how to respond to the common presence of these two phenomena - child marriage and the HIV epidemic. One level of investigation examines the impact of child marriage on the epidemic, including on rates of HIV infection among women and girls. A second level of investigation seeks to understand and mitigate the significant risks to girls’ wellbeing and safety that arise from the fact of child marriage alone, and the distinctive risks it brings within the context of the HIV epidemic.

This brief summarises the Council’s work in several areas and presents an overview of the challenges child marriage poses to the rights and health of girls, identifies factors potentially implicated in the epidemiological impact of child marriage on the spread of HIV.

The document outlines two interventions that are aimed at delaying age at marriage and protecting married girls. The strategies include the following: highlighting the neglect and distinct needs of married girls to policymakers and programme managers; advocating for legal reform or better enforcement of existing laws; and addressing the social, cultural, and economic forces that underlie the practice of child marriage.

Fostering a childhood free of marriage in Amhara, Ethiopia

In Amhara, the Council, the Ethiopian Ministry of Youth, UNFPA, and local partners are collaborating on a programme to reduce the incidence of child marriage. The intervention provides girls with a space where they can interact with peers and female mentors. Dialogue with their families strongly discourages child marriage and encourages school registration and attendance. Small amounts of material support are provided to the girls and their families to encourage continuous participation in the program over at least an 18-month cycle. Conscious that a critical mass of participation is required for significant social change, the collaborators have aimed for the intervention to reach at least 30 percent of the eligible girls in each village.

The intervention also includes the creation of meeting spaces for married girls-in effect, married girls’ clubs. These clubs meet at least once a week and provide married girls with social support, appropriate health information, and engagement in community development activities.

Providing support and promoting the safety of married girls in western Kenya

In a district of Nyanza province, Kenya with high levels of early marriage, the Population Council and the Program for Appropriate Technology in Health, together with local partners, are designing and implementing an intervention to support and empower approximately 2,000 newly married adolescent girls and girls considering marriage. The intervention includes three initiatives:

• the dissemination of messages to raise awareness of HIV risks associated with early marriage, conveyed through radio, drama, and community leaders;
• the establishment of clubs for married girls; and
• the promotion of voluntary counselling and testing (VCT) among newly married couples and couples contemplating marriage, through community-level VCT promotion and subsidies for transportation to and from available services