Global efforts to curb the AIDS epidemic have made remarkable progress in reducing deaths and new HIV infections. However, young women and girls in Africa are still disproportionately affected by HIV as entrenched gender inequalities hinder their ability to safeguard their basic rights and access to health services, said a Zimbabwean expert in women's sexual and reproductive health and rights.

Speaking exclusively to CGTN ahead of World AIDS Day, Edinah Masiyiwa, executive director of Women's Action Group, an organization championing women's sexual and reproductive health and rights in Zimbabwe, called for a holistic approach focusing on the root causes of women and girls' susceptibility to HIV, with prevention programs addressing each country's situation.

The imbalance of power between the sexes predisposes young women and girls to HIV risk, with sexual abuse being a common cause for infections among young women in Africa, said Masiyiwa, who sits on the Global Fund for HIV and AIDS Country Coordinating Mechanism in Zimbabwe.

"It is difficult for women and girls to negotiate safer sex even when they are well-informed about the danger," she said, adding that poverty and fear of violence are fueling risky behaviors that expose women and girls to HIV.

Economic disparities play a major role in young women's exposure to gender-based violence, early marriage, and the likelihood of non-consensual and unprotected sex. For instance, girls who turn to sex work to escape poverty will often accept unprotected sex when offered more money for it, Masiyiwa said.

There were approximately 37.7 million people living with HIV worldwide in 2020, and more than half (53 percent) were women and girls, according to UNAIDS.

The UNAIDS 2019 report on Women and HIV showed that new infections among adolescent girls remained at a high level, particularly in sub-Saharan Africa, posing an obstacle to the global goal of ending AIDS by 2030.

In the worst-hit countries, adolescent girls accounted for more than 80 percent of new HIV infections in their age group, the report said.

Although considerable progress has been made in scaling up antiretroviral therapy, with 66 percent of people with HIV accessing treatment by 2019, declines in HIV incidence have been slower than expected, The Lancet said.

Most programs designed to mitigate the impact of HIV focus on treatment rather than prevention, and services are failing to reach young women and girls who experience gender-based violence and other sexual exploitations, experts say.

Gender norms and harmful cultural practices continue to have a huge impact on the ability of adolescent girls and young women to protect themselves and seek help in cases of rape, Masiyiwa told CGTN, noting that countries that run evidence-based programs targeting specific problems have had more success in their HIV responses.

"Each country knows what their harmful practices are, whether it is polygamy, early marriage, or gender-based violence," she said. "Address that issue."

In sub-Saharan Africa, more than 50 percent of rural and 42 percent of urban young women aged 15-24 have been pregnant before their 18th birthday, according to UNAIDS. Contraceptive use and awareness about HIV among girls below the age of 20 are inadequate, Masiyiwa said.

"It is everyone's responsibility to prevent HIV – to educate the community, to create a friendly policy environment for young people to access health services and treatment, and also to involve men and boys in prevention programs," Masiyiwa said. At the same time, it is important to empower women to say no to non-consensual sex and leave abusive relationships, she added.

Women's sexual and reproductive health and rights have suffered major setbacks in many countries during the COVID-19 pandemic, which threatens to undo decades of progress in gender equality. The ongoing crisis has also aggravated existing inequalities and those socio-economic factors associated with HIV risk, while lockdowns and other restrictions led to steep drops in diagnoses and referrals to HIV treatment.

The theme of World AIDS Day 2021, which fell on Wednesday, is "End inequalities. End AIDS."