In western and central Africa, survey data suggest that HIV prevalence among women aged 20−29 years is higher than that among men of the same age in all countries, and between five and nine times higher in some countries, including Côte d’Ivoire, the Gambia and Ghana. However, by the time they are 40−49 years old, men have similar HIV prevalence; exceptions to this are in the Democratic Republic of the Congo, Ghana and Gabon, where HIV prevalence among women is still almost twice as high in that age range.
The difference in HIV prevalence between men and women in the 20−29-year age group in western and central Africa is greater than that observed in eastern, and some southern, African countries. Possible reasons for this difference include the high rates of voluntary medical male circumcision in western and central Africa, which has been shown to have a 60% protective effect on female-to-male HIV transmission. Other possible reasons for the difference in western and central Africa might be the very low use of condoms and low uptake of antiretroviral therapy among men in the region.