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Providing clinic services that are youth-friendly, conveniently located, affordable, confidential and non-judgmental, can increase use of clinic reproductive health services, including HIV testing and counseling and treatment services
Increasing Access to Services
7 studies
Gray
IIIb, IV
HIV testing, STIs, South Africa and Swaziland, Zimbabw, adolescents, health services, mass media, providers, support, treatment, youth
Botswana, Kenya, Madagascar, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zimbabwe
Transforming Gender Norms
Gender norms stand in the way of reducing HIV; indeed, a recent study states that, "The global HIV pandemic in its current form cannot be effectively arrested without fundamental transformation of gender norms" (Dunkle and Jewkes, 2007: 173). As former U.S. Secretary of State Hillary Clinton stated: "Achieving our objectives for global development will demand accelerated efforts to achieve gend...
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) ...
Women Prisoners and Female Partners of Male Prisoners
"... 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...
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 ...
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...
Antenatal Care - Testing and Counseling
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...
Community-based interventions (including media) that provide accurate information about HIV transmission can significantly reduce HIV stigma and discrimination.
Reducing Stigma and Discrimination
7 studies
Gray
IIIa, IIIb, IV
HIV testing, discrimination, education, knowledge, mass media, microfinance, stigma
China, Ghana, Malawi, Nigeria, Thailand, Vietnam
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...
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 ...
When a couple is serodiscordant or both male and female partners are HIV-positive and wish to conceive, having an undetectable viral load and limiting unprotected sex to peak fertility (with the possible use of pre-exposure prophylaxis) may result in the lowest risk of perinatal transmission. [See also %{s:33}]
Pre-Conception
5 studies
Gray
IIIb, V
pre-exposure prophylaxis, pregnancy, serodiscordant, sexual partners, transmission, treatment
Kenya, Saudi Arabia, South Africa, Switzerland, Uganda
Treatment as Prevention
Antiretroviral medication has been successfully used in a number of ways: first and foremost to treat those with high viral load and diminishing CD4 counts; secondly to prevent vertical transmission of HIV from pregnant and breastfeeding women to their infants; third, as a prophylactic for those who have been exposed to HIV occupationally or through sexual assault (post-exposure prophylaxis, PE...
Advancing Education
Increasing girls' access to education is critical to combating the AIDS pandemic. "There is a well-established protective effect of schooling on HIV risk" (Pettifor et al., 2008a; Hargreaves et al., 2008a; Jukes et al., 2008 cited in Pettifor et al., 2012a: 1). Education of girls is associated with delayed marriage and childbearing, lower fertility, healthier babies, and increased earning poten...
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...
Community or school-based HIV education can reduce stigmatizing attitudes towards those living with HIV
Mitigating Risk
6 studies
Gray
IIIa, IIIb, V
Lao PDR, adolescents, communication, education, knowledge, self-perception, sex education, sexual behavior, stigma
China, South Africa, Thailand, Uganda
Treating Sexually Transmitted Infections (STIs)
Worldwide, the burden of sexually transmitted infections in women is more than five times that in men (Sciarra, 2009). Multiple observational studies have found an association between STIs and HIV (Venkatesh et al., 2011b; Cohen and Eron, 2011; Mavedzenge et al., 2010b; Weber et al., 2010). A recent study found that the odds of acquiring HIV were 2.4 times higher in women with prior cervical HP...
