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Showing 61 - 80 of 226 Results for "providers"

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Further efforts are needed to identify an optimal strategy for safe partner notification. A Cochrane review, including studies from developing countries, found insufficient evidence to determine how partners could or should be notified of their partners HIV status, either by the patient or the provider.
Staying Healthy and Reducing Transmission
1 study
Policy guidelines, including service delivery guidelines, need to specify how contraception should be addressed in HIV prevention, treatment and care. Studies found that many guidelines did not explicitly address family planning in VCT and PMTCT guidelines and that providers and policymakers felt they had insufficient knowledge.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Further interventions providing HIV disclosure support are needed, particularly for women facing abandonment, violence, or other adverse events. [See also %{s:43}, %{c:11} and %{s:67}] Studies found many women faced abuse and abandonment upon disclosing their HIV status.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Criminalization of HIV transmission may lead pregnant women to not seek testing and care. A study in Ukraine with pregnant women found that providers told women who tested HIV-positive that they carry criminal liability and others did not access care. A global review found that in some countries, vertical transmission is criminalized.
Antenatal Care - Testing and Counseling
1 study
Increased efforts are needed to retain women on HAART following birth. Studies found that women who initiated ART during pregnancy were more likely to be lost to follow up than non-pregnant women or that pregnant women who were eligible for HAART according to national guidelines were not provided HAART.
Postpartum
1 study
Interventions are needed to support the autonomous decision-making of HIV-positive women who are caught between the contradictory pressures of family, community and health care providers. Studies found that HIV-positive women and men need information and social support to make decisions that reflect their own preferences in the face of pressure to bear children. A review of the published literature from 1990 to 2008 found that the refusal of health workers to discuss reproductive options in a non-biased way negatively impacts HIV-positive women. Studies also found that HIV-positive men lacked information on pre-conception and felt they could not request this information from health providers.
Pre-Conception
1 study
Establishing comprehensive post-rape care protocols, which include PEP and emergency contraception, can improve services for women.
Addressing Violence Against Women
4 studies Gray IIIb, V counseling, post-exposure prophylaxis, pregnancy, providers, rape, violence Kenya, South Africa
HIV-positive mothers, fathers, grandmothers and the larger community need clear, consistent, non-contradictory and nonjudgmental counseling on infant feeding practices. Health care providers need training based on accurate information. Studies found that health care providers gave HIV-positive women conflicting information and that simplified structured counseling tools are needed. Studies found that women reported that providers accused them of killing their infants if they breastfed. Women lack access to infant formula but have been told by providers that it is the only way for their infant to survive. Women were told that breastfeeding is a mode of HIV transmission and exclusive breastfeeding is a mode of prevention. Women fear HIV more than diarrheal disease, even though more deaths occur from diarrheal disease. Women were not given choices. Women did not give providers accurate information on how they were feeding their infant for fear of being denied health care. Women were told to feed their infants formula yet did not have adequate food support, most mothers could not do so with few having an income and most with no access to safe drinking water. Women lacked autonomy to decide infant feeding, which was decided by male partners or grandmothers. "Despite the current WHO recommendations to use extended infant prophylaxis as long as the infant is breastfed, no data are yet available from a clinical trial to confirm effectiveness and safety of this regimen beyond the first six months postpartum" (Taha, 2011: 919).
Postpartum
1 study
Additional efforts are needed to provide postpartum women with contraception information and methods so they may space or prevent their next pregnancy and use condoms to reduce the likelihood of HIV transmission upon resumption of sexual activity. [See also %{c:15}] Studies found that women were not given contraceptive counseling or contraceptives postpartum and that transport costs restricted their ability to gain access to their contraceptive method of choice. Studies also found an unmet need for postpartum contraception among women living with HIV. Studies found that sexuality and condom use need to be addressed when sexual activity resumes postpartum. Family planning services are most often not provided postpartum in PMTCT programs. Providers and women did not know that clinically well HIV-positive women can use IUDs. Women lacked the full range of available contraception. No study to date has measured pregnancy intention prospectively in an HIV-discordant couple cohort and measured the effect of desired pregnancy on HIV transmission.
Postpartum
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
Efforts are needed to further research and repeal laws that criminalize HIV non-disclosure, exposure or transmission — including vertical transmission of HIV—, which can discourage people from testing for HIV, and undermine the relationship between patients and physicians and other service providers. Because women are more likely to be tested, legal mandates to disclose HIV-positive serostatus may discourage women from accessing needed services and may lead to increased risk of abandonment and violence (see sections on VAW, HTC, etc).
Advancing Human Rights and Access to Justice for Women and Girls
1 study
Further interventions are needed to reduce stigma and discrimination against women, specifically, who are at high risk or living with HIV. [See also %{s:45}] Studies found that women and girls are highly stigmatized if they test positive for HIV. Stigma impacts the HIV-positive woman, herself, as well as her children, her siblings and her family. Some providers also discriminate against those living with HIV.
Reducing Stigma and Discrimination
1 study
Tailored interventions are urgently needed to provide greater availability and access to female condoms, along with education and training regarding their use as an additional option to male condoms. Studies found that women, including female sex workers, felt that they could avoid conflict and enhance their safe sex bargaining power by using a female condom when their sexual partner refused to use a male condom.
Male and Female Condom Use
1 study
Efforts are needed to provide HIV prevention and services to children and adolescents aged 10 to 17 who sell sex. [See also Prevention for Young People: %{s:25}] A number of studies show that significant numbers of sex workers selling sex when they are under age 18 and these adolescents are at high risk of acquiring HIV and have numerous legal and policy barriers, such as fear of the police, needing a guardian over age 18 to access HIV testing and counseling, and forced detention, in trying to access services.
Female Sex Workers
1 study
Interventions are needed to provide sex workers with greater control and access over money and resources, which can have a positive impact on HIV-related risk reduction. Studies found that if sex workers had access to resources under their control, women were more likely to negotiate condom use and that female sex workers in debt were less likely to report condom use.
Female Sex Workers
1 study
Evidence-based interventions are needed for adolescents who inject drugs. "There is a pronounced lack of data on young women who use or inject drugs, a key subpopulation with complex needs" (Larney et al., 2015: S106), despite high rates of HIV. In addition, “it is imperative that interventions not rely on law enforcement, but instead provide low-threshold, voluntary services, shelter and support..." (Conner, 2015: para 1).
Increasing Access to Services
1 study
Further interventions are needed that support women safely through the disclosure process. [See also %{s:43}] Studies found that women in some settings experienced increased violence and abandonment following disclosure or feared violence as a result of disclosure. Some HIV-positive women wish to disclose their serostatus but want trained health providers to help them do so.
HIV Testing and Counseling for Women
1 study
Further efforts are needed to ensure optimal counseling strategies and topics, with detailed information about accessing treatment and risk reduction. Studies found that women who went for an HIV test prior to marriage felt they did not need another HIV test for the duration of the marriage and that pre-test counseling was important. Providers do not feel comfortable asking about sexual practices. Studies have found that those who test HIV-negative engage in a high frequency of sexual risk behaviors.
HIV Testing and Counseling for Women
1 study
Further operations research is needed on the optimal collaboration between HIV treatment facilities and community-based organizations, including cost-effectiveness data. A review of the global evidence found that more information is needed on which interventions are most effectively provided in communities as compared to HIV treatment facilities, and how a patient's integrated needs can be best met as a continuum of care.
Adherence and Support
1 study
Further interventions are needed to provide couples counseling and testing to reduce seroconversion during pregnancy. Studies found that inadequate numbers of couples are counseled on safer sex during pregnancy and that despite national guidelines, repeat testing during pregnancy is not routinely done. Studies also found that inadequate spaces for men in antenatal care as well as gender norms that discouraged men from accompanying women to antenatal care discouraged couples testing.
Antenatal Care - Testing and Counseling
1 study