'You are obliged to have a second person': Out-of-school girls and young women 12-19 describe increasing HIV risk behavior as a necessity for many to make ends meet in Cote d'Ivoire

Young women in Cote d'Ivoire are at considerably greater risk for HIV than their male counterparts. Women with more lifetime sex partners and primary level education have higher HIV prevalence. We conducted formative research among out-of-school girls 12-19 to inform the Super Go program of prevention and empowerment for this high risk group. This research included six focus groups in four cities with 49 female participants. While some participants can support themselves through work, others described for themselves and other youth like them a constant search for money to meet daily needs. When possible, these young women and girls obtain money from family and friends. But often family cannot provide and they turn to boyfriends. If one does not provide enough, they will have multiple sex partners, particularly older men with means. Participants generally had some knowledge of HIV and recognized the risk of having multiple partners, but described how many of their peers must constantly look for support. Participants emphasized that the best way to assist those in their situation is to provide assistance to return to school or help them get jobs or start a business. Knowledge is not enough to prevent HIV for young women and girls. In order for HIV prevention programs to be successful for this group, they must include mechanisms to help them stay in school, get job training and work, or provide the means to start businesses enabling them to support themselves without the need to look to sex partners as providers.