Liberian President Ellen Johnson Sirleaf, HRH Princess Mathilde of Belgium, and UNAIDS Executive Director Michel Sidibé in Monrovia 18 October, 2010. Credit: UNAIDS

Following a 14-year civil war, Liberia has faced a host of post-conflict challenges that have increased the vulnerability of women and girls to HIV infection, including gender-related violence, poverty, population displacement and limited access to education and health services.

Women and girls represent 58% of the estimated 36 000 people living with HIV in Liberia. HIV prevalence among young women aged 15-24 is about three times higher than that of young men.

Liberian President Ellen Johnson Sirleaf—Africa’s first democratically-elected female head of state—today unveiled a national roadmap for improving the health and well-being of women and girls. Launched in collaboration with HRH Princess Mathilde of Belgium, a Goodwill Ambassador for UNAIDS and UNICEF, Liberia’s new Agenda for accelerating country actions for women, girls, gender equality and HIV aims to:

• Strengthen data collection and analysis to better understand the impact of the HIV epidemic on women and girls in Liberia

• Accelerate access to integrated reproductive and HIV services for women and girls

• Contribute to broader efforts to stop violence against women and girls

Liberia’s national Agenda is based on a global plan developed by UNAIDS and partners to address the gender inequalities and human rights violations that put women and girls at a greater risk of HIV. Speaking at a launch event in Monrovia, President Sirleaf said she was proud that Liberia had been selected as the first country to roll out this national Agenda.

UNAIDS Executive Director Michel Sidibé, who is on an official visit to Liberia with Princess Mathilde and UNICEF, praised Liberian authorities for placing AIDS and sexual and gender-based violence at the heart of the country’s post-war recovery efforts.

“I congratulate President Sirleaf for embracing this Agenda—for recognizing and supporting your most valuable natural resource: women and girls,” said Mr Sidibé. “Women are the solid centre of human life—of families, communities and care.”

Princess Mathilde focused her remarks on the critical importance of education in solving the nation’s ills. “Education is linked to the well-being of children,” she said. “It gives women the possibility to become economically self sufficient. It gives them the opportunity to decide on matters that concern their own lives. It gives them a voice with which to defend their own interests.”

The three-day joint mission to Liberia, which kicked off today, includes meetings with senior government authorities, associations of people living with HIV, and health and medical providers.

“West Africa HIV/AIDS epidemiology and response synthesis”

On the opening day of International Conference on AIDS and STIs in Africa (ICASA), taking place in Senegal under the theme “Africa’s Response: Face the facts,” the World Bank launched a new report exploring the character of the HIV epidemics and responses in countries in West Africa.

The “West Africa HIV/AIDS epidemiology and response synthesis” is a review and analysis of surveillance and research data in 15 West African countries: Benin, Burkina Faso, Côte d’Ivoire, Ghana, Guinea, Mali, Niger, Nigeria, Senegal, Togo, Cape Verde, The Gambia, Guinea Bissau, Liberia, and Sierra Leone.

Aiming to gain an improved understanding of HIV transmission dynamics in this sub-region, the paper focuses on the degree to which epidemics in each country are concentrated or generalized, and the implications that this has for effective prevention strategies. The report argues that more prevention focus is needed on the specific groups in which HIV transmission is concentrated, including female sex workers and men who have sex with men.

The new publication highlights a need for better understanding of the complex nature of transactional sex in West Africa. Many women involved in commercial sex do not self-identify as sex workers and have other occupations as well. The boundaries between commercial and non-commercial sex are blurred and it is difficult to have an idea of the proportion of men having commercial sex due to substantial under-reporting.

The importance of men who have sex with men (MSM) in the HIV epidemic in West Africa is being increasingly recognized. High proportions of MSM are also married and/or have sex with other women with very low rates of condom use, acting as a bridge for HIV between MSM and women.

“Know your epidemic. Know your response”

The paper was written as part of the work programme by the World Bank’s Global AIDS Monitoring and Evaluation Team (GAMET) to support countries to “know your epidemic, know your response” so that interventions are carefully chosen and prioritized based on a careful characterization of each country’s epidemic.

Understanding the behaviors that are giving rise to most new infections is a crucial first step to being able to develop a results-focused, evidence-based response that will be effective in preventing new infections. In turn this will improve resource allocation, all the more appropriate when global economic outlook may impact AIDS response.

The work was carried out in partnership between the World Bank and UNAIDS and with the collaboration of the National AIDS Councils and AIDS programmes of the countries.