Raiza Farnataro lives in the bustling city of Barquisimeto, in the Bolivarian Republic of Venezuela, about five hours away from Caracas. Having lived with HIV for 18 years, she used to access treatment through the public health-care system. However, as the economic situation in the country worsened, medicine became scarce and she began fearing for her life. After two years without treatment, she travelled to the Colombian border, where she could either buy overpriced medicines from pharmacies or access donated medicines from nongovernmental organizations.

Ms Farnataro is just one among an estimated 62 000 people living with HIV in the country who started treatment but lack consistent access to antiretroviral medicines, according to the Venezuelan Network of Positive People. The fallout has been severe. Hospitalization rates among people living with HIV have soared and there are an estimated 20 to 30 AIDS-related deaths every day. By September 2018, an estimated 7700 Venezuelans living with HIV had joined the migrants streaming into neighbouring countries.

“The current humanitarian crisis is leading to a drastic and alarming regression of the national AIDS response that is comparable to, and even worse than, what was experienced at the beginning of the HIV epidemic in the 1980s,” said HIV activist Alberto Nieves of Citizens Action against AIDS (ACCSI). “Deaths, progressive deterioration of health, hunger, denial of access to health-care services and HIV treatment, discrimination, mass migration and xenophobia are the main implications of this crisis for all people with HIV in the country.”

In 2017, UNAIDS-commissioned research by ACCSI generated the first concrete evidence of shortages of antiretroviral medicines, other medicines and HIV reagents.

HIV prevention has also been undermined. Experts are concerned that irregular treatment access could fuel drug resistance in both the Bolivarian Republic of Venezuela and neighbouring countries. Only about a quarter of pregnant women are being screened for HIV and syphilis. Because of food shortages, some mothers living with HIV are opting to breastfeed.

Over the past two years, UNAIDS has coordinated with the Venezuelan Ministry of Health, civil society, the Pan American Health Organization (PAHO) and other United Nations entities and development partners to improve treatment access for adults and children living with HIV in the country, as well as people on the move. UNAIDS joined with civil society and PAHO to support the advocacy that resulted in a Global Fund to Fight AIDS, Tuberculosis and Malaria US$ 5 million allocation to the HIV component of a plan to coordinate support to combat HIV, tuberculosis and malaria in the country. 

UNAIDS, in partnership with Aid for AIDS International, received more than 60 tonnes of antiretroviral medicines, which were distributed to people through state-run dispensing centres. UNAIDS has also coordinated the donation and distribution of testing kits and breast-milk substitutes.

“Thanks to the support of UNAIDS, the Venezuela Network of Positive People and other strategic partners we managed to ensure that treatment was received and distributed in the country in 2018. Our efforts helped to reduce the impact of the crisis, assuring treatment to a significant percentage of people with HIV,” explained Aid for AIDS Executive Director Jesús Aguais. “Otherwise,” he added, “the tragedy would have been greater.”

This action has saved lives. Over the past six months Ms Farnataro has received her antiretroviral medicines through the public health system, thanks to the donation from Aid for AIDS International.

As a member of the Regional Inter-Agency Coordination Platform for Refugees and Migrants from Venezuela, UNAIDS also advocates for the rights and treatment access needs of migrants living with HIV. Priorities include the establishment of a civil society observatory to monitor access to health services and discrimination, distribution of communication materials around prevention, treatment and care and advocacy to address discrimination and xenophobia.

Amid all this, UNAIDS insists on the need to continue strengthening the country’s HIV response. “We need ongoing work with diverse national and international actors for the welfare of all Venezuelans, and to guarantee the health and quality of life of all people living with HIV in the Bolivarian Republic of Venezuela,” said the UNAIDS Country Director, Regina Lopez de Khalek. “We are working so that the country is not left behind in the global effort to end AIDS.”

Palm Springs, in the southern Californian desert in the United States of America, is well known for its hot springs, stylish hotels and golf courses. A playground for the rich and famous, celebrities have flocked to the area since the 1920s.

Palm Springs is also home to a sizable community of people living with HIV, notably gay men, many of whom who are over 50 years old and each with their own very specific health and social needs.

The place many turn to for support is the Desert AIDS Project, a primary health-care centre providing specialized health services for people living with and affected by HIV. Set up by a group of community volunteers in 1984, the Desert AIDS Project has been the Coachella Valley’s primary non-profit health and well-being resource for people from the HIV community for the past 35 years.

“My vision is a comprehensive HIV and primary care health centre with integrative services for all people, regardless of their ability to pay. We believe that addressing the basic humanitarian needs builds the foundation of our holistic approach to care,” said David Morris, the Chief Medical Director of the Desert AIDS Project.

Today, more than 400 volunteers work at the project, which currently has around 4000 clients enrolled in its care, half of whom are affected by HIV. An average of 30–40 additional new clients enrol each month. As well as HIV care, staff and volunteers provide dentistry, behavioural health and social services. They also offer free and confidential HIV testing seven days a week at locations across the region.

“Bringing the Desert AIDS Project and UNAIDS—local and global—together allows us to share strategies, experience and results and also shows how innovative and comprehensive HIV programmes and services in the Coachella Valley can serve as models everywhere,” said Bertil Lindblad, former Director of the UNAIDS New York Office and Director of the Regional Support Team for Eastern Europe and Central Asia, now a member of the Desert AIDS Project’s Board of Directors.

The Desert AIDS Project has become well known and well respected for its policy of providing services to all people in Palm Springs, including the most marginalized. It offers many free or low-cost health services and operates an 80-unit affordable housing community for people in need. A long waiting list for housing has recently prompted an expansion effort to add additional units.

“While many are talking about the end of AIDS, the Desert AIDS Project is innovating, collaborating and working every day to get there,” said Marsha Martin, the North American UNAIDS Programme Coordinating Board delegate for 2017 and 2018.

On 8 February, the Deputy Executive Director, Management and Governance, of UNAIDS, Gunilla Carlsson, was invited to visit the Desert AIDS Project to learn first-hand how the centre meets the health-care needs of the HIV community and people at risk of HIV.

“The Desert AIDS Project is an example of how a holistic health-care approach and community action translates into results. It has evolved from being a group of volunteers providing HIV services to be a health provider. Its success shows what can be done when we put our minds to it,” she said.

The Desert AIDS Project has awarded its prestigious Science and Medicine Award to UNAIDS. The award was presented to the Deputy Executive Director, Management and Governance, of UNAIDS, Gunilla Carlsson, at the 25th Annual Steve Chase Humanitarian Awards in Palm Springs, United States of America, on 9 February.

“UNAIDS is deeply humbled to receive the Science and Medicine Award from an organization like Desert AIDS Project, which has made, and continues to make, such an incredible contribution to the AIDS response. We accept this award on behalf of all people working to ensure that no one is left behind or excluded from life-saving HIV services,” said Ms Carlsson.

Ms Carlsson was joined on stage by Musah Lumumba El-nasoor, the Team Leader of the East and Southern Africa Youth Alliance on Sexual and Reproductive Health and HIV.

“UNAIDS is mobilizing political support, setting the pace and the global agenda, to ensure that science is matched with the necessary resources and tools to deliver results for all people, including those at the margins of society,” Mr El-nasoor said.

Named after one of the Desert AIDS Project’s earliest financial supporters, the designer Steve Chase, the Steve Chase Humanitarian Awards ceremony is the biggest fundraising event of the year for the Desert AIDS Project and an important event on the Palm Springs social calendar.

Steve Chase died of an AIDS-related illness in 1994 at the age of 52 and left an incredible mark on the Desert AIDS Project through his philanthropic work and his ability to bring people together. The first Steve Chase Awards ceremony was held in his honour in 1995.

The Desert AIDS Project provides HIV prevention, treatment and care services to people living with and affected by HIV across the Palm Springs area. Established by a group of volunteers in 1984, the project is today raising funds to expand its Palm Springs campus. With the support of volunteers and donors, it is hoped that the newly raised funds will help meet the health-care needs of 10 000 people, many who are living with HIV.

The event was attended by around 2000 people and made more than US$ 1 million, which will be put towards the US$ 20 million needed for the Desert AIDS Project’s expansion plans. To date, the Desert AIDS Project has raised US$ 13 million towards its goal.

“With leadership provided by the United Nations, and specifically UNAIDS, all of us, including the Desert AIDS Project, working together will achieve what was previously thought of as impossible: the end of AIDS,” said David Brinkman, the Chief Executive Officer of the Desert AIDS Project.

Past award winners of the Science and Medicine Award include Michael Gottlieb, Desmond Tutu and Anthony Fauci. 

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) presented its Sixth Replenishment Investment Case to donors and partners at a meeting held in New Delhi, India, on 8 February. The Investment Case calls for US$ 14 billion to be invested over three years to help save 16 million lives through programmes for HIV, tuberculosis and malaria.

The Global Fund estimates that investing today will cut the mortality rate for the three diseases in half and build stronger health systems by 2023. Full funding would enable the Global Fund to continue playing a critical role in the response to HIV, tuberculosis and malaria, accelerating progress towards universal health coverage and achieving the Sustainable Development Goals.

“Only with a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria can we reach the global targets set for HIV, tuberculosis and malaria,” said Tim Martineau, Deputy Executive Director of UNAIDS, Programme, ai. “UNAIDS is committed to continuing to work with the Global Fund to ensure that it meets its financial targets so that countries can end AIDS as a global health threat and save more lives.”

The Global Fund’s Sixth Replenishment target of US$ 14 billion represents an increase of US$ 1.8 billion, or 15%, more than the US$ 12.2 billion raised during the Fifth Replenishment period.

UNAIDS will continue to strengthen its long-established partnership with the Global Fund to maximize the impact of the investments, accelerate inclusive people-centred responses and end AIDS as public health threat by 2030.

UNAIDS estimates that US$ 26.2 billion will be required for the AIDS response in 2020. In 2017, US$ 21.3 billion was available for the AIDS response in low- and middle-income countries, a shortfall of US$ 5 billion. UNAIDS urges both donors and funding from domestic sources to be scaled up to fill the gaps and end the HIV, tuberculosis and malaria epidemics by 2030 as part of Sustainable Development Goal 3.

Together, UNAIDS and the Global Fund have ensured that millions of people living with HIV have access to treatment and that the people most affected by the epidemic have the health and support services they need.

The United Kingdom of Great Britain and Northern Ireland has announced that it will end the transmission of HIV in the country within 10 years—an announcement that was warmly welcomed by UNAIDS.

In 2016, all United Nations Member States pledged to end AIDS by 2030 in the United Nations Political Declaration on Ending AIDS. This recommitment from the United Kingdom is welcome news that the country remains determined to achieve that goal. 

The United Kingdom has dramatically stepped up its efforts to respond to HIV in recent years, resulting in a 28% decline in new HIV cases in the past two years alone. However, the government says it can do more.

The Secretary of State for Health and Social Care, Matt Hancock, launched the campaign, which is backed by an additional £600 000 from the Public Health England HIV Prevention Innovation Fund, at the AIDSfree Cities Global Forum in London on 30 January. The £600 000 will be used to support 14 volunteer organizations that are spearheading new approaches to HIV prevention and will focus on engaging at-risk or underserved communities.

Also at the event, the Secretary of State for International Development, Penny Mordaunt, made a bold declaration about the country’s commitment to ending AIDS globally. “While the world has made great strides in tackling HIV and AIDS, we need to step up our efforts,” she said. “We passionately believe we can create an AIDS-free future for the whole world. That’s the scale of our ambition.”

The United Kingdom Government has played a leading role in the global response to HIV since the start of the epidemic. It has invested £1.2 billion in the Global Fund to Fight AIDS, Tuberculosis and Malaria and is expanding access to antiretroviral therapy though UK Aid, a five-year, £150 million, programme set up to change the lives of more than 3 million of the world’s poorest people.

“This announcement is a further example of how committed the United Kingdom really is to ending AIDS. Not only in the United Kingdom, but around the world,” said Tim Martineau, Deputy Executive Director of UNAIDS, Programme, a.i. “UNAIDS has worked closely with the United Kingdom since 1996 and we look forward to continuing that partnership to ensure that every penny invested brings us one step closer to ending AIDS.”

The event in London was part of the AIDSfree Appeal, a campaign led by the Elton John AIDS Foundation and the London Evening Standard and Independent newspapers. The money raised from public donations through the appeal will be used to support Elton John AIDS Foundation projects in six key cities around the world—Atlanta, United States of America, Delhi, India, Kyiv, Ukraine, London, Maputo, Mozambique, and Nairobi, Kenya. Through UK Aid Match, the United Kingdom Government has pledged to double public donations up to £2 million, to be spent on projects in Maputo and Nairobi.

The AIDSfree Cities Global Forum welcomed leaders from the six cities, who spoke about their hopes for the future. The event was a prelude to the Fast-Track Cities Global Conference, taking place in London in September 2019, at which representatives of more than 275 Fast-Track cities will convene as the first global gathering of cities accelerating their work to end AIDS as a public health threat.

The Fast-Track cities initiative was launched by UNAIDS in 2014 in partnership with the City of Paris, the International Association of Providers of AIDS Care and UN-Habitat to provide support to cities to Fast-Track their HIV responses and end their AIDS epidemics by 2030.

London signed up to the Fast-Track cities initiative in 2018. New HIV infections in the city have fallen by more than 40% in recent years and London has surpassed the 90–90–90 targets—whereby 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads—having already reached 95–98–97, a remarkable achievement.

“We are eager to take the lessons learned at the forum to a wider gathering of Fast-Track cities later this year in London that will take the measure of progress made and challenges still to be addressed,” said José M. Zuniga, President and Chief Executive Officer of the International Association of Providers of AIDS Care.

In the mining town in northern Myanmar where Hla Hla (not her real name) lives, drugs are easy to come by. Hla Hla started using drugs as a teenager. Some years later, an outreach worker friend accompanied Hla Hla to a health drop-in centre, where she discovered that she was living with HIV. She was initially afraid to tell her husband and family, as she was worried about what other people would think.

Hla Hla’s story is not unique. In Kachin State, Myanmar, where an estimated 21 000 people who inject drugs live, two out of five people who inject drugs are estimated to be living with HIV, according to government statistics.

Kachin State has long been affected by socioeconomic challenges, conflict, opium cultivation and drug use. Migrant workers are drawn from across Myanmar and neighbouring countries to work in its jade and amber mines.

There have been harm reduction programmes, including needle–syringe programmes and opioid substitution therapy, in Myanmar for more than a decade, and the government recently reinforced its commitment and support for harm reduction. However, a recent police crackdown resulted in an increase in arrests of people who use drugs, limiting access to services and increasing stigma and discrimination.

In Kachin State, as well as in Shan North State and the Sagaing Region, the USAID HIV/AIDS Flagship Project focuses its support for harm reduction programmes on delivering HIV prevention and treatment services for people who inject drugs. UNAIDS provides technical guidance for the project, which is implemented by Community Partners International.

One gap being addressed by the project is the lack of female-friendly harm reduction services for women who inject drugs and the sexual partners of men who inject drugs. Women who inject drugs in the region often prefer to remain anonymous and may feel more comfortable working with female health workers. One of the implementing partners, Médecins du Monde, designed an initiative to increase service access for women by setting aside one day per week exclusively for women at its drop-in centre. The women-specific service package includes sexual and reproductive health services, gender-based violence counselling and family planning, in addition to harm reduction services provided by female staff.

Hla Hla attends the drop-in centre and enjoys talking with her peers. Although initially afraid to disclose her status to her husband, she eventually did so when he talked about wanting to have a child with her. Disbelief was followed by acceptance and he took an HIV test.

“The drop-in centre is really helpful for me because now I am healthy and can work, thanks to antiretroviral therapy. Furthermore, I am very happy because my husband is HIV-negative. I have more knowledge about health and can share that with my family and friends,” said Hla Hla.

Aside from providing HIV prevention and treatment services for women who inject drugs, the USAID HIV/AIDS Flagship Project supports initiatives such as the Local AIDS Committees, which provide a platform to raise community awareness about the health risks of drug use and the importance of harm reduction programmes.

Saw Yu Htwe is a mother of three and a Local AIDS Committees member. When one of her children started using drugs, she realized that people who use drugs need understanding and support from their family and community. She is determined to help people who use drugs by creating a better environment for them to address their health and socioeconomic needs.

“People ask us why we are helping people who use drugs, since they think these people are not good. People who use drugs are also human. If we, the community, do not change how we think and our attitudes towards them, our region and our country will not be able to develop,” said Saw Yu Htwe.

Cervical cancer is preventable with the human papillomavirus vaccine. And if detected and treated early, it’s also curable. So why are so many women still developing and dying from cervical cancer?

In 2018, there were an estimated 570 000 new cases of cervical cancer and 311 000 deaths from it worldwide. Much like HIV, cervical cancer is a disease fuelled by social, economic and political inequities. Lower-income countries bear the highest burden, with nearly 80% of all cervical cancers and 90% of deaths.

If cervical cancer prevention, screening and treatment are not urgently scaled up, experts estimate that by 2040 there could be a 50% increase in deaths over 2018 levels.

HIV and cervical cancer are tightly intertwined. Cervical cancer is the most common cancer among women living with HIV. Women living with HIV are up to five times more likely to develop invasive cervical cancer than other women. In sub-Saharan Africa, cervical cancer is the number one cancer killer of women.

Despite the increased risk, many women living with HIV do not have access to regular screening or treatment for cervical cancer. A 2016 study in Malawi showed that only 19% of women aged 30–49 years living with HIV had ever been screened for cervical cancer. In the survey, among the poorest women living with HIV, only 2% had ever been screened for the disease.

“It is unacceptable that women around the world are dying from cervical cancer because they do not have access to life-saving vaccines, screening and treatment,” said Ani Shakarishvili, a Special Adviser at UNAIDS. “We save a woman’s life by ensuring that she has access to antiretroviral therapy for HIV, yet she dies from cervical cancer. Services must be integrated and available to all, without exception.” 

Linking cervical cancer screening and HIV services is cost-effective and saves lives. UNAIDS is working with the United States President’s Emergency Plan for AIDS Relief and the George W. Bush Institute to incorporate cervical cancer screening and care into clinics where women are already accessing HIV services in eight countries across sub-Saharan Africa. The partnership aims to reduce cervical cancer incidence by 95%.

The World Health Organization has recently announced that it will be accelerating global efforts to eliminate cervical cancer as a global public health problem and will continue to take a leading role, including by developing a global strategy towards eliminating cervical cancer, a move warmly welcomed by UNAIDS.  

“As in the global AIDS response, we must approach cancer prevention and treatment as an opportunity to lead a broad coalition demanding health as a fundamental, universal human right,” added Ms Shakarishvili.

On 4 February, World Cancer Awareness Day, UNAIDS is recommitting its support to the global call to action to eliminate cervical cancer and address inequalities by raising awareness and increasing access to prevention, detection and treatment for girls and women at risk, including women and girls living with HIV.

For five weeks in 2018, teams of up to 10 people in each of 120 clinics and hospitals across Lesotho sifted through more than 180 000 records of people diagnosed with HIV and receiving care. The goal: to count the number of people living with HIV who were on treatment in June 2018.

During the long and dusty days, the teams attached green stickers—indicating active on treatment—or other coloured stickers—specifying that a person had defaulted, transferred or died—to nearly 80% of all patient files in the country. Facility by facility, counts of the number of people found to be active on treatment were compared to counts previously reported to the Lesotho Ministry of Health and other partners, including the United States President’s Emergency Plan for AIDS Relief. All of this to confirm that the country’s reporting adds up.

“Together with our team, we reviewed the treatment status of more than 5000 people at the Senkatana Clinic in Maseru, Lesotho, one of the oldest and busiest treatment centres in the country. After two days of reviewing the paper-based files, we found about 30% more people on treatment than the clinic had reported to the Ministry of Health in June 2018,” said Motselisi Lehloma, Ministry of Health Officer. Overall, the exercise found an underreporting to the Ministry of Health of 3% for all the 120 facilities visited.

Since early 2017, UNAIDS and other international partners have supported more than 15 countries, primarily in sub-Saharan Africa, to verify that the number of people reported currently to be on treatment is accurate. This work also supports facilities to improve the accuracy of the data reported through their health information systems by reviewing patient registries and processes for collecting, aggregating and reporting treatment numbers.

“The exercise that Lesotho undertook to audit and validate treatment numbers underscores its commitment to accurately monitor programme impact,” said Kim Marsh, Senior Adviser, Epidemiology and Monitoring, UNAIDS. Thanks to these efforts, and the efforts of many other countries in the region, UNAIDS and stakeholders can be confident in treatment numbers that allow us to monitor progress towards 90–90–90. Through debriefings with clinical staff and written reports, minor deficiencies were addressed on the spot and larger systematic issues were brought to the attention of the ministry and implementing partners in order for them to adopt necessary corrective actions.

Lesotho has one of the highest burdens of HIV in the world. In 2017, 320 000 people were living with HIV in the country, an HIV prevalence of 23.8%.

On the final morning of the 2019 World Youth Day Commemorations in Panama, Pope Francis will visit the Casa Hogar del Buen Samaritano. Named for the Biblical parable of the Good Samaritan, this shelter on the outskirts of Panama City offers comprehensive care to help people living with HIV recover and reintegrate into society.

Their only requirement for entry is need. As a policy, the home welcomes people regardless of sex, age, religion, occupation, sexual orientation, ability or geographical origin.

As volunteers zipped back and forth in feverish preparation for His Holiness yesterday, Buen Samaritano founder and Director, Father Domingo Escobar, took a moment to reflect on the evolution of the home.

It had begun as pastoral work carried out from the Parish of Santa Maria del Camino. People living with HIV—many of them homeless—would look to the church for comfort, counsel and food. The idea began to crystallize that the most marginalized needed more structured support. The Buen Samaritano Foundation and Home were founded 15 years ago with the broader vision of helping build a society free from discrimination, prejudice and stigmatization.

“I believe that it is necessary to highlight the dignity of the human being and to respect the other person, considering that we are all—as the Bible says—the Temple of the Holy Spirit… each one of us,” Father Escobar explained. 

Since its inception, the Buen Samaritano has served more than 300 residents. The combination of spiritual care with medical treatment is key. By bolstering their faith, patients steadily become more optimistic, more “enthusiastic” about taking their medicines and more confident that their treatment will work.   According to the Buen Samaritano Director, the most significant factors undermining people’s treatment adherence are lack of support and fear of prejudice.

“Because of fear of rejection and of discrimination they keep it to themselves and do not share it with family or with others,” he said.

In direct response to this challenge, one branch of the foundation evolved specifically to serve people living with HIV who live with their families but have limited resources. Apart from food and medicines, Buen Samaritano provides sensitization and training for family members, strengthening their ability to provide emotional support for their loved ones.

The foundation has also reached beyond HIV care and treatment to support prevention efforts through seminars and interventions for children, young people including youth at risk, and adults. Last year their prevention programmes reached more than 4500 people. Their Youth Information program promotes “sex education with values” in secondary schools.

UNAIDS has partnered with Buen Samaritano for many years, helping to broker the provision of antiretroviral medicines from the Ministry of Health, as well as partnering around visibility and advocacy.

The work of Father Domingo with underserved people living with HIV in Panama shows the incredible capacity of faith communities to build bridges, not only around treatment and care, but also around eliminating stigma and discrimination and prevention.

The foundation provides a valuable contribution to the community, country and AIDS response. In Panama, an estimated 25 000 people are living with HIV. The country has achieved strong progress related to treatment and reducing mortality. Three-quarters (76%) of diagnosed people in Panama were on treatment by the end of 2017 and there were fewer than 1000 AIDS-related deaths. But with an estimated 1600 new infections that year, the need for strengthened prevention initiatives is clear. For Father Escobar the challenge requires all hands-on deck.

“We must all feel and understand that the task of prevention is a cross-cutting challenge,” the priest explained. “It has to be present in the family, in public policy, in childhood, for the youth and in pastoral work. It is a problem for all, and we can all contribute.”

When she was four years old, Selokela Molamodi’s teacher asked the class what they wanted to be when they grew up. While her classmates volunteered more conventional professions, such as nurses, doctors and lawyers, Ms Molamodi’s answer, given with a fiery determination, was, “I want to be Minister of Education.”

Her love for education, and her characteristic fieriness, has stood 19-year-old Ms Molamodi in good stead. Last year she graduated top of her class, having been head girl in both primary school and high school. Armed with an unshakeable self-confidence and her core principles of transparency, honesty and humility, Ms Molamodi has avoided the fate of many young South African women—HIV infection, unintended pregnancy and an abandoned high school education.

She says she has had to deal with the same harsh realities as other young women—financial difficulties, crime, violence, peer pressure, the temptation of “blessers” [older men] and drug and alcohol abuse. Staying in school kept her focused, she explained.

“There are still a lot of misconceptions about HIV among young people. Sex is not talked about openly. Young people are given knowledge about sexual and reproductive health, but they are not given knowledge on how to make a decision about sex,” she says.

In South Africa, 1500 young women and adolescent girls between the ages of 15 and 24 are infected with HIV every week. They accounted for 29% of all new HIV infections in the country in 2017. Research has shown that older men, generally five to eight years older, are mostly responsible for passing on HIV to younger women; once women reach their mid-twenties, they pass on the virus to men their own age.

“There is a perception among young women that we should have a high number of sexual partners when we are young because that is what it means to be free. Then, when we reach our mid-twenties we will leave that life behind and settle down. But girls don’t understand that they don’t have control over these sexual relationships, that their consent doesn’t count,” she says.

To start a dialogue about these and many other issues facing young women, Ms Molamodi started You for You while she was in her final year of school.

“I call it a movement, not an organization,” says Ms Molamodi. “It is about accepting and loving yourself for you. While we can exist as a community and a collective, we must first love ourselves as individuals,” she says.

Ms Molamodi, along with two friends who started the movement with her, have one-on-one mentoring sessions with other young women on issues such as self-esteem, body positivity, sexual and reproductive health and drug and alcohol abuse. She has also organized two events that focused on empowering young women as leaders “so we can rise as young women and stand up against discrimination, together.”

She looks at DREAMS—the initiative led by the United States President’s Emergency Plan for AIDS Relief—as the matriarch of a family of young women like her. In South Africa, DREAMS works closely with She Conquers, a government-led national campaign aimed at empowering young women and adolescent girls to take responsibility for their health.

“DREAMS/She Conquers has provided us with a space to have natural conversations about things that affect us as young women with other young women. It gives us a voice and brings enlightenment to us. For instance, most of the girls I know have tested for HIV, but none of them ever got to talk about it, until DREAMS/She Conquers came to our school,” she says.

“These are the kinds of initiatives that increase the effectiveness of what UNAIDS is trying to achieve,” says Ms Molamodi. “Yes, give girls access to discrimination-free HIV prevention and treatment services and family planning, but also ask for our feedback. Give us education and information and teach us that actions have consequences which are responsible for our progress or regress.”

She says she would like to see conversations about HIV prevention and sexual and reproductive health being brought together more often with those about careers, empowerment and entrepreneurship.

As for her ambition for You for You, “I want to help grow a continent of young women who are confident enough to speak out; who are able to stand up for each other and empower each other. If I have someone say, “I did not give up” then I know I had a purpose; that I was someone’s reason not to give up.”