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s we enter the third decade of the HIV pandemic in sub-Saharan Africa, young women—often adolescent girls—are the new face of the disease. In particular, HIV/AIDS is threatening those girls and young women with limited social and economic assets—those who are unable to avoid, manage, or leave unsafe sexual relationships inside and outside of marriage. Out-of-school girls, especially those aged 10–14 living apart from their families, are particularly vulnerable. Those who are newly migrated to urban areas, especially those in domestic service, and girls who are taking care of HIVinfected families or otherwise serving as heads of households, may be under substantial pressure to support themselves, parents, or siblings. Married girls are subject to frequent unprotected sexual relations, often with older partners, and may, therefore, face elevated risk of HIV infection. Girls at risk of sexual exploitation are not a small minority; they are counted in the hundreds of millions. Yet despite their numbers, most are untouched by existing interventions. Indeed, the majority of health, social development, livelihoods, and youth programs are failing to reach the most vulnerable girls living in the path of HIV.

Girls left behind: Redirecting HIV interventions toward the most vulnerable