Despite recent positive trends among young people (especially females) in some African countries, overall about twice as many young women as men are infected in sub-Saharan Africa. In 2001, an estimated 6–11% of young women aged 15–24 were living with HIV/AIDS, compared to 3–6% of young men. This appears to be due to a combination of factors. Women and girls are commonly discriminated against in terms of access to education, employment, credit, health care, land and inheritance. With the downward trend of many African economies increasing the ranks of people in poverty, relationships with men (casual or formalized through marriage) can serve as vital opportunities for financial and social security, or for satisfying material aspirations. Generally, older men are more likely to be able to offer such security. But, in areas where HIV/AIDS is widespread, they are also more likely to have become infected with HIV.

The combination of dependence and subordination can make it very difficult for girls and women to demand safer sex (even from their husbands) or to end relationships that carry the threat of infection. Studies have shown that young women tend to marry men several years older than themselves, and that their risk of infection increases if a husband is three or more years older than they are. Meanwhile, ignorance about sexual and reproductive health and HIV/AIDS is widespread. In countries with generalized epidemics in Africa, up to 80% of women aged 15–24 have been shown to lack sufficient knowledge about HIV/AIDS. This, combined with the fact that young women and girls are more biologically prone to infection (the cervix being susceptible to lesions), helps explain the large differences in HIV prevalence between girls and boys aged 15–19.

From UNAIDS