In Central African Republic, C te d'Ivoire, Djibouti and Kenya, at least one in ten adults are HIV-infected. In general, West Africa is less affected by HIV than southern or East Africa. Some countries in central Africa have also seen HIV remain relatively stable, while in neighbouring countries rates have continued to climb. Early and sustained prevention efforts can be credited with these lower rates in some places- Senegal provides a good example. But elsewhere, where far less has been done to encourage safer sex, the reasons for the relative stability remain obscure.
Research is under way to explain differences between epidemics in various countries.
In the worst-affected countries, young people are especially at risk. And yet to date, there is no reproductive health education in schools that would prepare girls to avoid early sex or to adopt safer sexual practices. Many of these births are outside of marriage. Single motherhood was not associated with ignorance or marginalization-over a third of single mothers were educated to secondary level or beyond, compared with just over a quarter of married mothers. Recent HIV surveillance data show how early this exposure can occur and how devastating its consequences can be.