Showing 1 - 20 of 33 Results for "Botswana"

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Increased detection of acute infection, along with immediate, effective counseling and support is needed. A trial is underway in Botswana to identify those with high viral loads to initiate treatment (Novitsky et al., 2010 cited in Delva and Abdool Karim, 2014).
Staying Healthy and Reducing Transmission
1 study
Efforts are needed to mobilize transgender women and men at a community level to support prevention and safety. One study found that in order to assure prevention and safety, community mobilization of transgender people is needed.
Transgender Women and Men
1 study
Increased financial and other support is needed for adults, especially grandparents, caring for orphans, including those who are HIV-positive. Studies found families caring for orphans lacked adequate food and nutrition and reported financial difficulties in meeting basic needs.
Orphans and Vulnerable Children
1 study
Women, especially married women, ongoing education about the role of condoms in preventing HIV acquisition and transmission, along with condom negotiation skills. A study found that women did not believe that condoms reduce the risk of HIV transmission. Another study found that married women of alcoholic men are aware of risks of contracting HIV from their husbands but reported difficulty in negotiating condom use as well as violence.
Male and Female Condom Use
1 study
Increased efforts are needed to reduce stigma against adolescents living with HIV, particularly young key populations. A study found that adolescents living with HIV kept silent about their HIV status to schools, friends and family so as to not experience stigma and discrimination.
Increasing Access to Services
1 study
Further efforts are needed to determine the optimal frequency of testing in order to minimize HIV transmission in a cost-effective way. In some settings, testing for acute infection is warranted which would require testing every three to six months. A study found that 12% of women and 10% of women who had reported testing HIV-negative were found to be seropositive one to two years later. Modeling studies have found that screening one time, annually, can be cost-effective and that yearly testing in a high incidence area found that potential high-risk transmission with high viral load could be reduced by yearly HIV testing.
HIV Testing and Counseling for Women
1 study
Interventions are needed to foster the involvement of HIV-positive women and promote cooperation between people living with HIV and AIDS and health care facilities, government and other agencies creating HIV-related programs and policies. Studies found that little cooperation existed between HIV-positive women and health facilities but that efforts have been underway to educate parliamentarians concerning HIV-positive women’s issues.
Promoting Women’s Leadership
1 study
Health service providers must make additional efforts to ensure confidentiality regarding patient’s serostatus. [See also %{c:11}, %{c:15}, %{c:17}, and %{s:67}] Numerous studies found that health workers and the structure of health services, such as services that are only for HIV-positive patients in physically separate parts of hospitals, violate patient confidentiality. In addition, health providers who brought services to women’s homes also violated their confidentiality.
Structuring Health Services to Meet Women’s Needs
1 study
Interventions are needed to reduce homophobia, which may lead MSM to have partnerships with women. Studies found that homosexuality was heavily stigmatized and that gender norms pressured MSM to marry and have families.
Partner Reduction
1 study
Health care provider training is needed to increase confidentiality and decrease discrimination against sex workers seeking health services. Studies found that significant proportions of female and transgender sex workers did not visit health facilities because of lack of confidentiality, discrimination, and lack of counseling when accessing HIV testing.
Female Sex Workers
1 study
Interventions are needed to provide sex workers with greater control and access over money and resources, which can have a positive impact on HIV-related risk reduction. Studies found that if sex workers had access to resources under their control, women were more likely to negotiate condom use and that female sex workers in debt were less likely to report condom use.
Female Sex Workers
1 study
Health care settings need to offer appropriate, non-discriminatory services—and be attentive to HIV risk behaviors—to meet the sexual and reproductive health needs of WSW. Studies found that a number of WSW also have sexual relationships with men yet did not get tested for HIV.
Women Who Have Sex With Women (WSW)
1 study
Improved support systems for lay or basic health workers are needed to facilitate effective care in areas where lay health care workers provide a significant proportion of HIV care. Systems need to be developed specifically for remuneration, retention, and adequate supervision.
Provision and Access
1 study
Interventions are needed to enhance counseling to successfully prepare patients for lifelong therapy. Studies have found that patients were not well prepared for life-long therapy; that adherence rates decreased over time and hospital costs increased for those who were less adherent. A study found that patients believed that ART killed other patients, not understanding that initiating ART at high viral loads and low CD4 counts reduces the likelihood of survival.
Adherence and Support
1 study
Interventions, including community based distribution of cART and/or funds for transport, are needed to reach pregnant women living with HIV who do not access ANC, postpartum care or cART. “Restrictions on women’s mobility and lack of access to transportation and financial resources may limit their ability to seek PMTCT services” (Ghanotakis et al., 2012: table 2).
Antenatal Care - Treatment
1 study
Enforcement of standard protocols is needed to reduce the risk of provider coercion in HIV testing, particularly in provider-initiated testing and counseling. Studies found that significant numbers of women reported that they could not refuse an HIV test or that HIV testing was mandatory.
HIV Testing and Counseling for Women
1 study
Additional outreach programs are needed for patients who miss ART clinic visits or fail to initiate treatment. A study showed that issues such as provider to patient ratios; adherence support programs; and needing transport from rural areas were associated with lower CD4 counts at initiation of ART. Other studies showed that patients were lost between initiation and maintenance sites. Another study found that one in five treatment-eligible HIV-positive individuals refused to initiate ART (Katz et al., 2011). Others who dropped out of treatment were using unproven remedies.
Provision and Access
1 study
Interventions are needed to reduce cross-generational sex and marriage. Studies found that young women relied on older men to pay their school fees in exchange for sex. Numerous studies found significant numbers of young girls having sexual relationships with older men, who are more likely to be HIV-positive and seek sexual partnerships with younger women. Studies also found that due to poverty, parents encouraged transactional sex and that efforts are needed to address parental pressures.
Mitigating Risk
1 study
Laws and practices that obstruct adolescents’ access to services, such as parental consent requirements, age, and marital status requirements, must be aligned with the actual behavior of adolescents. Studies found that legal requirements restricted adolescents from getting tested for HIV even if they were sexually active and at risk for HIV. "There is a strong evidence base that the stigma, discrimination and criminalization affecting adolescent key populations aged 10 to 17 is intensified due to domestic and international legal constructs that rely on law-enforcement based interventions dependent upon arrests, pre-trial detention, incarceration and compulsory ‘rehabilitation’ in institutional placements," particularly among adolescents who sell sex or inject drugs (Conner, 2015: para 1).
Increasing Access to Services
1 study
Women living with HIV need information and access to services for emergency contraception and post-abortion care (PAC) services. Studies found that women did not have adequate knowledge of emergency contraception, nor access to services for post-abortion care.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study