Increased Risk of STI and HIV Among Adolescent Girls and Young Women Due to COVID-19: The CACHE 2 Study
How COVID-19 Increased STI and HIV Risk for Adolescent Girls and Young Women
When the COVID-19 pandemic hit, life changed overnight. Schools shut down, families faced financial struggles, and young people—especially adolescent girls and young women (AGYW)—were left vulnerable in ways no one had anticipated.
For many girls, school wasn’t just a place to learn; it was a source of stability, protection, and access to health education and services. But as lockdowns dragged on, a dangerous reality unfolded. With schools closed and support systems weakened, the risk of unintended pregnancies, sexually transmitted infections (STIs), and even HIV increased.
To understand just how deep these impacts run, we launched the CACHE 2 Study.
What is the CACHE 2 Study?
The CACHE 2 Study is a follow-up clinical trial that seeks to measure the lasting effects of COVID-19 on adolescent girls and young women. This research isn’t just about numbers—it’s about real lives, real challenges, and finding real solutions.
Why Does This Study Matter?
Before the pandemic, a group of 436 adolescent girls and young women were part of an earlier study on vaginal health. Some received menstrual cups, while others did not. Now, years later, researchers are following up to see how COVID-19-related hardships—such as school closures, economic stress, and limited healthcare access—have influenced their risk for HIV, STIs, and bacterial vaginosis (BV).
How Does It Work?
The study brings participants back for check-ins every six months at UNIM Research and Training Centre, whether they’re still in school or have since left. During each visit:
- Girls fill out a confidential survey on an Android tablet about their experiences, challenges, and behaviors.
- They receive HIV testing through a simple blood draw.
- Researchers measure height, weight, and other physical health indicators.
- Girls provide self-collected vaginal swabs for BV and STI testing.
- Study staff provide education on safe sexual practices and STI prevention in a private and supportive setting.
For those using menstrual cups, the study also offers ongoing support and training on safe use.
What is the Study Trying to Find?
The CACHE 2 Study is driven by three key questions:
- How did COVID-19 restrictions affect young women economically, socially, and behaviorally?
- Did stress and uncertainty from the pandemic increase their risk for HIV and STIs?
- Can biological factors, such as stress, play a role in making girls more vulnerable to infections?
What Have We Learned So Far?
So far, researchers have completed follow-ups through month 72 and are preparing for the month 78 follow-ups. The study is uncovering critical links between pandemic-related stress and long-term health risks for girls. This research could inform future policies and programs to better protect young women in times of crisis.
The Bigger Picture
The findings from CACHE 2 could shape public health responses for years to come. If we understand how crises like COVID-19 impact young women’s health, we can build stronger, more resilient systems to support them, keep them safe, and empower them—no matter what challenges the world throws their way.
This isn’t just about one study—it’s about ensuring that no girl is left behind.