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Previously, it was thought that the presence of the lactobacillus bacteria was the biggest factor.This research provides evidence that microbial diversity is a key factor alongside the concentrations of key bacteria such as lactobacillus.Explore this page to find out more about why women and girls are at risk of HIV, HIV testing and counselling, treatment for women and girls living with HIV, reducing mother to child transmission, HIV prevention programmes and the way forward.Since the start of the global HIV epidemic, women in many regions have been disproportionately affected by HIV.This is a far higher rate than new infections among young men, with young women twice as likely to acquire HIV as their male peers.3 In sub-Saharan Africa, despite making up just 10% of the population, one out of every five new HIV infections happens among adolescent girls and young women.In the worse-affected countries, 80% of new HIV infections among adolescents are among girls, who are up to eight times more likely to be living with HIV than adolescent boys.4 5 It is estimated that around 50 adolescent girls die every day from AIDS-related illnesses.6 In East and Southern Africa young women will acquire HIV five to seven years earlier than their male peers.7 In the region, seven young women become newly infected with HIV for every three young men.

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Procedures relating to a women’s sexual and reproductive health (SRH), performed without consent, including forced sterilisation, forced virginity examinations and forced abortion also deter women from accessing services.15 16 In some cases, healthcare providers do not fully understand laws around childbirth and HIV.The study found that adolescent girls tended to endorse these stigmatising attitudes, and also observed or experienced SRH-related stigma regularly.29 Adolescent girls and young women belonging to groups most affected by HIV (sometimes known as ‘key populations’) are also negatively affected by laws that criminalise injecting drug use, sex work and homosexuality.30 31 Adolescent girls’ and young women’s vulnerability to human rights violations and HIV is further amplified by age.32 Despite this, even where programmes for key populations exist, the presence of ‘youth-friendly’ services to address the specific needs of young people from these groups are normally lacking.33 34 Studies have shown that increasing educational achievement among women and girls is linked to better SRH outcomes, including delayed childbearing, safer births and safer abortions, lower rates of sexually transmitted infections (STIs) and unintended pregnancies.35 Women with more education tend to marry later, bear children later and exercise greater control over their fertility. (2015) ‘Length of secondary schooling and risk of HIV infection in Botswana: evidence from a natural experiment’, Lancet Glob Health, Volume 3, No.8, p.e470–e477 It has also been shown to be linked to reduced risk of partner violence, another factor that makes women and girls vulnerable to HIV.37 Despite this, in the least developed countries in the world, 60% of girls do not attend secondary school.38 Research has shown a direct correlation between girls’ educational attainment and HIV risk: uneducated girls are twice as likely to acquire HIV as those who have attended school.39 In Botswana, UNAIDS reports that every additional year of school a girl completes reduces her risk of acquiring HIV by 11.6%.40 However, many young people who are in school do not receive adequate education on HIV, sex and sexuality.