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Safe Motherhood and Prevention of Vertical Transmission
Three vital components of AIDS programming for women living with HIV are ensuring safe motherhood through access to health care before, during and after pregnancy and childbirth; ensuring access to treatment; and ensuring access to services to prevent vertical HIV transmission. While much progress has been made in reducing vertical transmission, more could be done. A recent demographic model sh...
Malaria
Malaria and HIV co-infection is a critical public health problem that may fuel the spread of both diseases in countries where both diseases are endemic. Malaria seems to be more common for people living with HIV and in areas of unstable malaria transmission, people living with HIV face increased risk of death (Mermin et al., 2006). Men and women living with HIV with CD4 counts below 300 cells p...
Adherence and Support
"I'm 18 years, you are telling me drugs for life?" --Woman living with HIV in Uganda (Hsieh, 2013: 11)Treatment adherence is necessary to continually suppress the virus. Adherence to ART leads to better virological outcomes, prevents disease progression and improves survival (Nachega et al., 2010a; Nachega et al., 2010c). Conversely, inadequate adherence leads to drug resistance, which can then...
Women and Girls in Complex Emergencies
Complex emergencies are situations of disrupted livelihoods and threats to life produced by warfare, civil disturbance and large-scale movements of people, in which any emergency response has to be conducted in a difficult political and security environment (WHO, 2002). Complex emergencies can also be generated from natural disasters. An estimated 200 million people are affected every year by h...
Treatment
Antiretroviral therapy has transformed HIV to a chronic - though still incurable - virus requiring ongoing therapy and strict adherence to treatment. For the most part, virally suppressed people living with HIV today have no difference in life expectancy than demographically similar HIV-negative individuals (Sabin, 2013 cited in Justice and Falutz, 2014; Maman et al. 2012a).
This section does ...
Promoting Women’s Leadership
Strengthening womens rights and health NGOs and supporting women leaders who can mobilize in-country efforts in the interests of women and girls affected by HIV is critical. "...It is not enough for programmes and strategies to be designed on behalf of those living with AIDS; we have much to learn from their experiences, and how they struggle to negotiate being positive and maintaining sex live...
Decriminalization of drug possession and drug use and legalized comprehensive harm reduction services can significantly reduce HIV infections among people who use drugs, compared with persistent or growing rates in countries where such services are restricted or blocked by law. (Global Commission on HIV and the Law, 2012: 29). [See also %{s:11}]
Advancing Human Rights and Access to Justice for Women and Girls
6 studies
Gray
IIIb, V
Czech Republic, Portugal, criminalization, drug use, methadone, needles, opiate substitution therapy
Canada, China, Estonia, Switzerland
Promoting Women’s Employment, Income and Livelihood Opportunities
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)...
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 and Services for Adolescents and Young People
The interventions in this section should also be viewed in conjunction with other topics where young women are included. Studies with adolescent-specific data are also included in the following sections: %{c:5}; %{c:7}; %{c:11}; %{c:13}; %{c:17}; %{c:21}; and %{c:23}.
HIV among adolescents is a growing concern. UNAIDS notes that adolescent girls and young women are a key population in danger o...
Staying Healthy and Reducing Transmission
"Me, I try to tell the man that, 'In this house we have been found with this problem. We should accept it. I should not point a finger at you. You, too, should not point a finger at me. Just buy your protection.' And so, little by little what he does now is different from what he did in the past." --Malawi woman living with HIV (Mkandawire-Valhmu and Stephens, 2010: 691)Successfully treated peo...
Women Who Use Drugs and Female Partners of Men Who Use Drugs
Despite injecting drug use being a main driver of the HIV epidemic in many parts of the world, evaluated tailored responses for women who use drugs or for female sexual partners of men who use drugs have not matched the needs of this population. Injecting drug use is globally widespread and the main driver of the HIV epidemic in some parts of the world. Approximately 16 million people in 148 co...
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 ...
Female Sex Workers
Sex workers, whose work involves sexual relations with multiple partners, are a key group of women who need access to comprehensive sexual health services, including HIV prevention, treatment and care. Programs that enhance sex workers' ability to use condoms are also vitally important (Lafort et al., 2010; Pisani, 2008). Unprotected sex with multiple partners puts sex workers at risk of HIV ac...
Mitigating Risk
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...
Addressing Violence Against Women
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...
Voluntary Medical Male Circumcision
Male circumcision has now been shown in three randomized clinical trials to reduce the risk of HIV acquisition for men by 50-60% (Auvert et al., 2005; Bailey et al., 2007; Gray et al., 2007). Male circumcision at birth as part of postnatal care could result, upon sexual initiation and during his lifetime, in a reduction in the risk of HIV acquisition. Voluntary medical male circumcision (VMMC) ...
Tuberculosis
Tuberculosis is the leading cause of death among people with HIV globally, accounting for almost 25% of all HIV deaths in 2008 (WHO, 2009i). The risk of acquiring TB is 21-34 times greater among people living with HIV than in the general population. In 2010, of 8.8 million incident TB cases worldwide, 1.1 million were among people living with HIV, with an estimated 350,000 deaths (WHO, 2011f). ...
Viral suppression with ARV therapy can minimize the risk of HIV transmission and improve health.
Staying Healthy and Reducing Transmission
12 studies
Gray
II, IIIa, IIIb
CD4 counts, and Zimbabwe, condom use, prevention, seroconversion, serodiscordant, sex behavior, the United States of America, treatment, viral load
Australia, Botswana, Brazil, China, Côte d'Ivoire, India, Italy, Kenya, Malawi, Rwanda, South Africa, Spain, Sub-Saharan Africa, Tanzania, Thailand, Uganda, United States, Zambia, Zimbabwe
Partner Reduction
Multiple sexual partnerships have long been a concern in HIV prevention programming, which has focused on partner reduction. Multiple partnerships bring increased risk of HIV acquisition: A meta-analysis of 68 epidemiological studies from 1986 to 2006 with 17,000 HIV-positive people and 73,000 HIV-negative people found that women who reported three or more sex partners had three times as much l...