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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 ...
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...
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...
Counseling improves adherence.
Adherence and Support
6 studies
Gray
I, II, IIIa
adherence, and Zambia, community, community health workers, counseling, health care providers, support, treatment
Côte d'Ivoire, Ethiopia, Kenya, Lesotho, Mozambique, Nigeria, Rwanda, South Africa, Sub-Saharan Africa, Tanzania
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...
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...
Voluntary medical male circumcision (VMMC) may be effectively integrated into school programs. [See also %{s:5}]
Mitigating Risk
4 studies
Gray
IIIb, V
adolescents, male circumcision
South Africa
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...
Postpartum
Postpartum care is the most neglected aspect of maternal health, yet a time of high risk for maternal mortality. "The majority of maternal deaths occur during or immediately after childbirth; ...up to half of all newborn deaths occur within the first 24 hours of life" (WHO et al., 2011c). While many women access antenatal care, much fewer women globally have access to postnatal care. For exampl...
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...
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 ...
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...
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...
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...
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 ...
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...