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Whilst adolescents have received increasing attention in the global HIV response, the health and well-being of adolescent mothers and their children has been largely overlooked. 1 Adolescent girls, in particular have been and remain central to global HIV prevention efforts, given persistently high rates of HIV incidence among 15-24 year olds, particularly in sub-Saharan Africa. 2 In this region, supporting adolescent parents living in high HIV-risk communities is critical to the elimination of HIV and AIDS, as well as the attainment of several Sustainable Development Goals (SDGs). The scale of vulnerability is significant: there are an estimated 11.4 million adolescent mothers in sub-Saharan Africa, 3 most of whom live in adverse conditions. By the age of 18, 42% of adolescent girls and young women living in urban areas, and more than 50% of those living in rural areas, have been pregnant. 4 Four of every five new HIV infections among 15-19 year olds in sub-Saharan Africa occur among adolescent girls. 5 Late pregnancy and breastfeeding are two high-risk periods for HIV infection, 6, 7 and early unintended pregnancy during adolescence is a risk factor for later HIV infection. 8 Adolescent mothers and their children in sub-Saharan Africa are at greater risk of HIV infection and less likely to receive or stay on treatment. 9 They are also at the epicentre of intersecting vulnerabilities, including those associated with gender inequality, poverty, violence, exclusion, poor education, and early childhood developmental delays that limit generations across a lifetime. 1, 10

This background note outlines the current evidence on the experiences of young mothers …