Population Council | News Release | The Risks of Early Marriage

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The Risks of Early Marriage

NEW YORK (17 June 2004) — Over the next decade in developing countries, more than 100 million girls under the age of 18, “children” as defined by the Convention on the Rights of the Child, will be married. In countries with HIV epidemics, these girls, most of whom live in Africa and Asia, are at substantial risk for HIV/AIDS infection. Judith Bruce presented findings about early marriage on June 4, 2004, at a special session of the Global Health Council's annual conference. Bruce is the Population Council’s director of Gender, Family, and Development.

Married girls are considerably more likely than sexually active unmarried girls to have unprotected sexual relations. When asked if they had had unprotected sex in the past week, for example, 57 percent of married girls in South and East Africa said they had, compared with 5 percent of unmarried girls. Similarly, in West Africa, 46 percent of married girls had had unprotected sex compared with 5 percent of married girls. In Latin America and the Caribbean, the figures were 62 percent vs. 2 percent, respectively. This dramatic difference in the frequency of unprotected sex is driven by not only the implication of infidelity or distrust associated with certain forms of contraception, such as condoms, but often also by a strong desire to become pregnant.

Despite conventional wisdom, unprotected sex within marriage can raise rather than lower the risk of HIV transmission for adolescent girls. Bruce’s colleague, Shelley Clark of the University of Chicago, calculated that in Kisumu, Kenya, 30 percent of male partners of married adolescent girls were infected with HIV, while only 11.5 percent of the partners of unmarried girls were HIV-positive. Similarly, in Ndola, Zambia, 31.6 percent of married girls’ partners compared to 16.8 percent of unmarried girls’ partners were found to carry HIV. In both of these locations, HIV infection is more prevalent among married girls than among unmarried girls.

Additionally, married adolescents are often extremely isolated, having limited peer networks, restricted mobility, little access to modern media, and few educational options. Social contact and networks are becoming widely recognized as vital to transmitting information and supporting behavior change. Similarly, media and schools are increasingly enlisted to convey HIV prevention messages and support HIV programs. Not only are married adolescent girls often isolated within their new households and from external support, but their needs have not been prioritized or sometimes even considered in current reproductive health initiatives. Indeed, few married adolescents can negotiate the adoption of the currently recommended strategies for reducing HIV/AIDS risk—among them, abstinence, reduced sexual frequency, and condom use.

Bruce suggests four clusters of concern for policy activity and public education related to child marriage.

Raise consciousness about the extensiveness of early marriage and the human rights abuse it constitutes.
Promote later, chosen, legal marriage through several means, including advocacy with leadership groups, enforcement, improving girls’ schooling, the creation of safe spaces for girls to gather and socialize, incentives for girls and parents to delay marriage, increased access to economic skills and resources, and raising awareness of the health and rights implications of large spousal age differences and intergenerational sex.
Support married adolescent girls by decreasing their economic vulnerability, offering schooling, civic participation, and livelihoods opportunities, developing interventions to reduce their social isolation, and explicitly including married adolescent girls in services for adolescent reproductive health and sexual health and for maternal and child health.
Link early marriage, as appropriate, with health risks. Emphasize the situation of the youngest (under 15) mothers with regard to maternal death and disease, including the risk of obstetric fistula (a loss of tissue between the vagina and bladder and/or rectum caused by obstructed labor). Create awareness that marriage is not a sexual safety zone. Evolve appropriate and distinct health policies for sexually active married and unmarried adolescent girls. And develop HIV protection strategies to support married girls, particularly those in their first year of marriage.