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Integrating ARV therapy into antenatal care, rather than referring women separately for HIV treatment, can reduce time to treatment and increase adherence for pregnant women living with HIV. [See also %{c:25}] Note: A review found that no one model of care fully addressed all barriers for women, but the most effective models focused on the period of transition between pregnancy and postpartum (Colvin et al., 2014).
Antenatal Care - Treatment
9 studies
Gray
IIIa, IIIb, IV
Zambi, antenatal care, pregnancy, treatment
Kenya, Mozambique, Rwanda, South Africa, Zambia
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...
HIV Testing and Counseling for Women
Knowing ones HIV serostatus is the first step in getting the appropriate treatment and care. According to UNAIDS, fewer than 40% of those living with HIV are aware of their serostatus (UNAIDS, 2010c). In parts of sub-Saharan Africa, more than 80% of people living with HIV do not know their positive serostatus (Anand et al., 2009). Global consensus exists that greater knowledge of HIV status is ...
Antenatal Care - Treatment
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 ...
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...
Increasing Access to Services
While the literature on access to HIV services by adolescents is limited, the literature on access to sexual and reproductive health services more broadly demonstrates that youth-friendly approaches can increase use of reproductive health care services by female adolescents (Gay et al., 2015). Young peoples service needs are frequently overlooked in HIV programming that is not specifically for ...
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 ...
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). ...
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...
Provision and Access
Antiretroviral therapy has been successfully administered in a range of situations with adherence, retention, and clinical outcomes similar to those achieved in resource-rich countries. Increasing provision and access, grounded in human rights based approaches, across all populations is critical to continuing that success.
"I cook scones for my children and do not get tired. I do chores, pound...
Sex and HIV education with certain characteristics (see introduction) prior to the onset of sexual activity may be effective in preventing transmission of HIV by increasing age at first sex and, for those who are sexually active, increasing condom use, testing, and reducing the number of sexual partners.
Mitigating Risk
17 studies
Gray
I, II, IIIa, IIIb, IV
Bahama, adolescents, behavior change, condom use, contraception, low- and middle-income countries, pregnancy, seroconversion, sex behavior, sex education, sexual partners, testing
Africa, Brazil, Kenya, Mexico, South Africa, Sub-Saharan Africa, Tanzania, Thailand, United States
Triple therapy, when used for treatment or prophylaxis through the postpartum period reduces mother-to-child HIV transmission. [See also %{s:45}].
Postpartum
14 studies
Gray
I, II, IIIa, IIIb, IV, V
CD4 counts, HAART, PMTCT, breastfeeding, formula feeding, treatment
Botswana, Burkina Faso, Côte d’Ivoire, Ethiopia, India, Kenya, Malawi, Mozambique, Rwanda, South Africa, Southern Africa, Tanzania, Uganda
Exclusive breastfeeding for the first six months of the infant’s life with a gradual decrease in breastfeeding results in lower rates of HIV transmission to the infant, reduced infant mortality, and improved infant growth compared to mixed feeding or abrupt weaning. Where clean accessible water is not available, breastfeeding after six months reduces infant mortality.
Postpartum
12 studies
Gray
II, IIIa, IIIb
CD4 counts, PMTCT, breastfeeding, breastfeeding PMTCT, formula feeding, infant feeding, mixed feeding, treatment
Côte d’Ivoire, Malawi, Nigeria, South Africa, Uganda, Zambia, Zimbabwe
