Showing 41 - 56 of 56 Results for "Brazil"

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Programs must adhere to the longstanding international agreement to voluntarism, informed consent, and ensuring the right of individuals and couples to decide freely and responsibly the number and spacing of their children. Studies found that women living with HIV had been sterilized against their will, were pressured by providers to terminate a pregnancy, or were stigmatized for becoming pregnant. Studies also found that provision of antiretroviral therapy was conditional on using certain types of contraception. Litigation is currently being undertaken. A study found that HIV-positive women who accessed contraceptive services were not informed of the benefits of PMTCT programs in reducing vertical transmission.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Additional efforts are needed to improve information and counseling about HIV during ANC to ensure that pregnant women and their sexual partners have adequate information. Studies found significant numbers of pregnant women received HIV tests with no counseling and reported that HIV testing was a mandatory part of their antenatal care. Studies also found that HIV-positive women feared transmitting HIV to their babies through casual contact. Studies found some providers assured women that treatment guaranteed that there would be no vertical transmission. In addition, studies found that some couples erroneously believed that sex during pregnancy causes miscarriages. Studies have also found that women who have tested HIV-negative at their first antenatal visit had seroconverted to HIV-positive by 12 months following delivery.
Antenatal Care - Testing and Counseling
1 study
Interventions are needed to sustain viral suppression and reduce loss to follow up once a woman has initiated Option B+, including affordable means of monitoring virological response and effective adherence counseling. Research is needed on how long is optimal to provide care within maternal health systems or when to transfer cART provision outside of maternal health systems. Compared to people who started cART for their own health, a study found that women who started cART while pregnant were 5 times less likely to return to the clinics after the initial visit. Women who started cART while breastfeeding were twice as likely to miss their first follow up appointment. On average, 17% of pregnant women who started ART under Option B+ dropped out of care in the first six months of ART and 22% dropped out within one year (Tenhathi et al., 2014). Systems are rarely in place to track mothers six weeks post-partum (Psaros et al., 2015; Waiswa, 2016). A survey found that ART retention was greatest in those facilities where newly diagnosed pregnant women living with HIV were referred from ANC to the ART clinic in the same facility for initiation and follow up or were referred to facilities serving as ART referral sites that did not provide ANC (van Lettow et al., 2014). A review noted that women found challenges in accessing cART either through maternal care systems, postpartum or through HIV care. Input from pregnant and postpartum women living with HIV is needed
Antenatal Care - Treatment
1 study
Further interventions are needed to provide support (physical, psychological, technological, economic) to patients and caregivers. Studies showed that patients and caregivers have many physical, psychological, and economic unmet needs, with high rates of depression and poverty, and in some cases, rely on their young children or relatives to provide care with no outside support. Some studies show that caregivers suffer from stigma attached to caring for someone HIV-positive. [See also %{s:67}] Some studies showed that women have a lower quality of life than men. A study in a high HIV prevalence area showed that for women, lack of control in sexual decision-making was associated with depression, while for men, intergenerational sex was associated with depression.
Women and Girls
1 study
Adolescents living with HIV need information and services through adolescent-friendly HIV services on a number of topics, including disclosure, safer sex, contraception, safe motherhood and gender-based violence. Studies found that health providers were unprepared to discuss HIV and contraception with adolescents who acquired HIV through perinatal transmission, despite the fact that significant numbers of these adolescents were already sexually active. Another study found that these adolescents need skills to disclose their serostatus to sexual partner. WHO recommends that perinatally infected adolescents be advised of their positive serostatus by age 6 (WHO, 2013) but there is little guidance on disclosure for adolescents. Facilitated disclosure by parents and providers to adolescents living with HIV may lead to higher retention in HIV care (Arrive et al., 2012). Parents living with HIV whose adolescents may be living with HIV also need assistance to disclose to their adolescents, as parents fear rejection from their children. Positive health dignity and prevention interventions can help people living with HIV lead healthy lives and reduce HIV transmission, but tailored interventions for adolescents and their parents have not been evaluated for effectiveness, although a trial is currently ongoing (Cunningham, 2015; Mofeson and Cotton, 2013). One study found that 29% of young women aged 16 to 24 living with HIV reported being forced to have sex. No validated curriculum that was shown to be effective for reducing unsafe sex among adolescents living with HIV was found, although some manuals have been developed (Parker et al., 2013c; UNESCO and GNP+, 2012).
Increasing Access to Services
1 study
Additional efforts are needed to provide information and more contraceptive options for women living with HIV (or whose serostatus is unknown) who do not desire to have a child or wish to space the next pregnancy. The 2012 WHO guidelines on hormonal contraceptives and HIV should be widely disseminated to programs and providers. Studies found that many HIV-positive women had significant numbers of unintended pregnancies and that preferred contraceptive methods were not available.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Women Prisoners and Female Partners of Male Prisoners
Prevention for Key Affected Populations
"... Prisons have been largely neglected in the global response to the HIV pandemic" (Angora et al., 2011: 1244). Comprehensive HIV prevention, voluntary testing, care and treatment are often not provided in pretrial detention, even where these services exist in the community (Csete, 2011). "Many prison systems limit access to antiretroviral therapy, according to country reports to UNAIDS" (UNA...
Hepatitis
Preventing, Detecting and Treating Critical Co-Infections
Hepatitis is an inflammation of the liver, most often caused by a virus. The most common types of viruses are hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. "Hepatitis A and E are typically caused by ingestion of contaminated food or water and are not known to cause chronic liver disease" (WHO, 2010c). A vaccine exists for hepatitis A and a meta-analysis of eight studies fr...
Promoting Women’s Employment, Income and Livelihood Opportunities
Strengthening the Enabling Environment
Women's economic dependence on men and unequal access to resources, including land and income-generating opportunities, increases the likelihood of women and girls engaging in a variety of unsafe sexual behaviors including transactional sex, coerced sex, earlier sexual debut, and multiple sexual partners, and thus increases their risk of becoming infected with HIV (Gillespie and Kadiyala, 2005)...
Addressing Violence Against Women
Strengthening the Enabling Environment
Violence, in addition to being a human rights violation, has been clearly demonstrated as a risk factor for HIV (WHO, 2010f; Stephenson, 2007; Jewkes et al., 2006a; Manfrin-Ledet and Porche, 2003; Dunkle et al., 2004; Quigley et al., 2000b; Silverman et al., 2008). Analysis of DHS data in Rwanda showed that currently married women with few, if any, sexual risk factors for HIV but who have exper...
Mitigating Risk
Prevention and Services for Adolescents and Young People
Young People Need Information "I want to know if I can have a boyfriend because every time I ask my mum she tells me not to. I would also love to learn about safe sex and safe motherhood (14 year old adolescent girl living with HIV, Zambia cited in Mburu et al., 2013). A review of the global literature on adolescents found that "there is a significant unmet need for information, education, an...
Antenatal Care - Testing and Counseling
Safe Motherhood and Prevention of Vertical Transmission
In 2007, only an estimated 18% of pregnant women were offered HIV tests (ITPC, 2009). "The purpose of antenatal VCT should be to help a woman prepare for a possible positive HIV diagnosis [and] to provide her with information about PMTCT options" (De Bruyn and Paxton, 2005: 145). In developing country settings, between eight and ten percent of women report having received PMTCT interventions (P...
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
Given that most HIV transmission occurs through sexual intercourse, it is critical to include a sexual and reproductive health lens in HIV programming. In fact, several European governments have recently revised their international policies, recognizing that HIV/AIDS is a sexual and reproductive health issue (Germain et al., 2009). All women have the right to decide freely and responsibly on t...
Prevention for Women
In this era of great strides forward in treatment, it is important not to lose sight of the continued need to undertake a range of interventions to prevent HIV transmission. An estimated 2.7 million people newly acquired HIV infection in 2010, as they did for each of the years 2009, 2008 and 2007, down from 3.1 million people in 2002 (WHO et al., 2011b). However, even with all this encouraging ...
Advancing Human Rights and Access to Justice for Women and Girls
Strengthening the Enabling Environment
*Respecting, protecting and fulfilling womens rights, particularly the rights of the most marginalized women, is increasingly understood as fundamental to an effective HIV response. Laws reflecting unequal gender norms that discriminate against women may limit their ability to protect themselves from HIV infection. In many countries where women are most at risk for acquiring HIV, laws to protec...
Antenatal Care - Treatment
Safe Motherhood and Prevention of Vertical Transmission
Antiretroviral treatment (ART) for women living with HIV is vital to ensuring safe motherhood and reducing vertical transmission. But not all pregnant women access treatment. For women in high-income countries where access to triple therapy during pregnancy has been the standard of care and is near universal, rates of vertical HIV transmission are as low as 0.4%, for example, in Canada (Forbes ...