Real progress has been recorded in the global effort against HIV/AIDS, but the defining work still lies with the young, and especially with young women. Women and adolescent girls bear a disproportionate burden of the HIV epidemic compared to men and boys, particularly in sub-Saharan Africa. The pattern is very plain in the disproportionate impact of the pandemic:
Higher Infection Rates: Women make up over 50% of people living with HIV globally and roughly 60% in sub-Saharan Africa according to UNAIDS (year).
Young Women at Risk: Adolescent girls and young women (aged 15–24) are up to 2 to 3 times more likely to acquire HIV than young males of the same age.
Biological Susceptibility: Women face a roughly 2-fold higher biological acquisition risk per unprotected heterosexual act due to larger mucosal surface area and longer exposure to seminal fluids.
HIV Screening: Very many of those who are living with HIV don’t know their status. Improving knowledge on HIV transmission and prevention still requires concerted effort among young persons, with adolescents (ages 10–19 years) facing distinct physiological, psychological, legal, and social factors that make them disproportionately vulnerable to low uptake of HIV testing, according to UNICEF (year).
Patriarchy weighs more heavily on women and girls, and combined with poverty and limited information, it narrows their choices long before they can decide the terms of their own lives. A girl who cannot afford menstrual products, who has dropped out of school, or who depends on others for money, has fewer options, including options about sex. HIV and other sexually transmitted infections (STIs) thrive in exactly those conditions.
The foregoing captures the thinking behind Girls Act, a global, girl-led programme of AIDS Healthcare Foundation (AHF) built on the principle of “For Girls, By Girls”. It began in 2016 in five countries to address high HIV rates among girls and young women and has since grown to nearly 40 countries across Africa, Asia, Europe, Latin America and the Caribbean. It started with adolescent girls living with HIV, then expanded to include other girls and boys who are not necessarily positive. That was deliberate: status is not the emphasis. Its stated aims are to prevent HIV and STI transmission, support girls who are positive to stay on treatment, reduce unplanned pregnancies and keep girls in school. As of 2026, the programme counted more than 4,500 girls in active engagement and had distributed over 1 million sanitary pads.
Girls Act works on four connected fronts:
Health. Girls who are positive are supported to stay on treatment. Girls who are not positive learn the skills to prevent infection and make informed decisions. Free menstrual health products, extended to surrounding communities, meet a basic need that quietly costs many girls their dignity and their days in class. The programme also teaches girls how to make and care for reusable pads, so that access does not depend on supply alone.
Education and livelihoods. Not every girl is in school, and the programme does not write off those who are not. Girls who want to return are supported to do so; those who are out of school are trained in life skills and helped to set up. In Abuja and Benue, members have learned tie-and-dye, bead-making, tote-bag production and snack-making, from chin-chin to doughnuts and egg rolls. These are modest trades with steady demand, and they give young women something precious: their own income. Financial independence is among the strongest protections against the poverty that exposes girls to HIV. The trainings are also taken into communities, so girls who cannot easily travel are not left behind.
Leadership. Through mentorship, advocacy, and resources, AHF Girls Act creates avenues for girls to aspire and to lead. In a society where patriarchy still decides who is heard, a girl who learns to speak up in her clinic, her club and her community is changing more than her own odds. In South Africa, 17 Girls Act members recently completed a four-day public speaking bootcamp, and others have attended a workshop on recognising and preventing human trafficking. Boys are part of the programme too, because protecting girls also means changing what young men know and expect.
Results. Girls are turning up empowered, able to negotiate safe sex and exercise bodily autonomy. Policymakers should pause on that. Negotiating safe sex is the difference between exposure and protection, and bodily autonomy is not a slogan but a public health asset. Ruvarashe, a AHF Girl’s Act member in Zimbabwe, says the support she received taught her to value herself and helped her stay in school, and she hopes other girls in her community will benefit. That is the pattern the programme aims for: a girl who understands her worth makes different choices.
The same model is spreading across Africa. In South Africa, Girls Act has teamed up with the Artisan Development Academy to open STEM and skilled trades to girls, and with a local bakery to run hands-on baking training for 15 adolescent girls. In Uganda, it has worked with the Youth Prevention Program on entrepreneurship training for young people in the Central region. Nigeria is part of this continental network, and with the leadership academy currently being implemented by AHF Nigeria in collaboration with Education as a Vaccine (EVA), what the girls will achieve adds to the evidence that investing in girls works.
A non-governmental organisation cannot carry this alone, and it should not have to. Federal and State governments should domesticate the Girls Act model and fund it, building it into National and State plans for HIV, education and youth development. In practical terms, that means:
dedicated budget lines for menstrual health, so no girl misses’ school for want of a sanitary pad; skills training and start-up support that reach out-of-school girls where they live; support for girls to return to, and stay in, school; leadership platforms for girls in schools and communities; and clear pathways linking young people to HIV testing, treatment and care.
All stakeholders in the HIV response space have a role to play.
Some will say the country has more pressing priorities. They should weigh the cost of inaction: new infections among young people, lifelong treatment, interrupted schooling, and lost productivity. Prevention that also builds livelihoods and leadership is among the smartest investment a government can make.
Our girls have shown what is possible when someone invests in them. They have earned the right to be treated as a key population in the national response, not as an afterthought. Government should adopt the Girls Act, fund it, and scale it up, so that the next generation of Nigerian girls grows up informed, independent, and free of HIV.