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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...
Women and Girls
By all estimates, most care and support is provided in the home and women provide two-thirds or more of that care and support (Ogden et al., 2006; Homan et al., 2005b; Akintola, 2006; UN, 2008b; Nyangara et al., 2009b; Surkan et al., 2010). However, this means that one-third of care and support is provided by men, and some have argued that making this more visible can shift gender norms and inc...
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...
Providing antiretroviral treatment to people living with HIV can increase HIV prevention behaviors, including condom use.
Staying Healthy and Reducing Transmission
9 studies
Gray
IIIa, IIIb, IV
HAART, condom use, condoms, contraception, risk behavior, sex behavior, treatment
Botswana, Brazil, Côte d'Ivoire, Kenya, Rwanda, South Africa, Tanzania, Uganda, Zambia
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...
HIV testing and counseling (HTC) can help women know their HIV status and increase their protective behaviors, particularly among those who test HIV-positive.
HIV Testing and Counseling for Women
14 studies
Gray
I, II, IIIa, IIIb, IV
HIV testing, condom use, condoms, contraception, counseling, couples, disclosure, education, health facilities, sex behavior, sexual partners, sexually transmitted infections
Botswana, Dominican Republic, Kenya, Mozambique, Rwanda, South Africa, Tanzania, Trinidad, Uganda, Zimbabwe
Male and Female Condom Use
The role of condom use in prevention of sexual transmission of HIV is clear. According to the WHO and the U.S. National Institutes of Health, male condoms that are intact are essentially impermeable to even the smallest sexually transmitted virus (UNAIDS, 2004). The effectiveness of male condoms has been shown to be between 8095 percent, depending on how correctly they are used (Weller and Davi...
PMTCT-Plus (family-focused) HIV care can increase the numbers of women and their partners who access treatment and remain adherent. Note: This should not be implemented in any way that prejudices women who do not want to disclose to partners (see overview).
Antenatal Care - Treatment
4 studies
Gray
IIIa, IIIb
PMTCT Plus, PMTCT-Plus, pregnancy, treatment
Africa, Botswana, Côte d’Ivoire, South Africa, Tanzania, Uganda, Zambia
Migrant Women and Female Partners of Male Migrants
Women and men migrate for any number of reasons: lack of food or employment opportunities, war, etc. "In much of South Asia and sub-Saharan Africa, millions of people living in poverty have no viable employment opportunities close to home, forcing individuals to migrate from their communities in search of... a means to provide economic resources for their families. Because of changing market de...
Women Who Have Sex With Women (WSW)
At least seventy-six countries criminalize consensual samesex relations, making access to HIV prevention, treatment and care a challenge for women who have sex with women (UN General Assembly, 2011). According to a report by the International Gay and Lesbian Human Rights Commission, although prevalence rates are lower than heterosexual women, same-sex practicing South African women self-report ...
Antiretroviral therapy has been successfully administered with good adherence, good patient retention, and good clinical outcomes in resource-poor settings, including humanitarian settings, with increased patient survival; results have been similar to those achieved in resource-rich countries.
Provision and Access
15 studies
Gray
I, IIIa, IIIb
CD4 counts, HAART, Jamaica, Mali, South America, conflict, displaced persons, life expectancy, treatment
Africa, Angola, Asia, Botswana, Burkina Faso, Cameroon, Chile, Côte d'Ivoire, Democratic Republic of Congo, Ethiopia, Europe, Ghana, Haiti, India, Kenya, Malawi, Mozambique, Myanmar, Nigeria, North America, Rwanda, Senegal, South Africa, Sudan, Tanzania, Thailand, Uganda, Zambia, Zimbabwe
Reducing Stigma and Discrimination
"...Three decades into the epidemic, stigmatization remains a core feature of the patient experience of HIV/AIDS" (Gilbert and Walker, 2010: 144). Or as one woman living with HIV in Thailand put it: "It does not matter how many thousand people have HIV/AIDS... I would say that only zero percent will accept people living with HIV/AIDS" (Liamputtong et al., 2009: 865). Stigma and discrimination h...
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...
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...
