Showing 1 - 18 of 18 Results for "Burkina Faso"

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Further efforts are needed to assess the feasibility of wet-nursing for HIV-positive mothers. A study surveyed 300 women during routine healthcare visits on their knowledge of HIV and breastfeeding, and found that HIV-specific knowledge was poor, but also that the option of using a wet nurse or being a wet nurse was agreeable among 70% and 75% of women, respectively.
Postpartum
1 study
Laws prohibiting discrimination against those who are living with HIV in employment, housing, health and social services and education need to be implemented and more thoroughly evaluated. A study found that women feared losing their homes if found to be living with HIV. [See %{s:67}]
Advancing Human Rights and Access to Justice for Women and Girls
1 study
Efforts are needed to further research and repeal laws that criminalize HIV non-disclosure, exposure or transmission — including vertical transmission of HIV—, which can discourage people from testing for HIV, and undermine the relationship between patients and physicians and other service providers. Because women are more likely to be tested, legal mandates to disclose HIV-positive serostatus may discourage women from accessing needed services and may lead to increased risk of abandonment and violence (see sections on VAW, HTC, etc).
Advancing Human Rights and Access to Justice for Women and Girls
1 study
Increased training is needed for providers to discuss sexuality and pleasure with adolescent youth who need reproductive health services. A analysis of fictional narratives written by young people aged ten to 24 concerning HIV found that young people criticized the lack of skills by providers to discuss issues of sex and pleasure as well as conceptualizing rape as a punishment for girls who do not abstain from sex.
Increasing Access to Services
1 study
Improved integration is needed between maternal, sexual and reproductive health services and HIV treatment services. A study found that even though 11.6% of 1,369 pregnant women were eligible for ARV treatment based on their low CD4 counts prior to delivery and 6 % were eligible postpartum, these women were not integrated into ARV treatment programs; another study found high rates of HIV in STI patients.
Structuring Health Services to Meet Women’s Needs
1 study
Stigma reduction interventions are needed so that women with HIV can choose replacement feeding, breastfeeding and weaning schedules. Studies found that HIV-positive women feared that if they used infant formula or abruptly weaned, they would be stigmatized for their HIV-positive serostatus.
Postpartum
1 study
Efforts are needed to provide HIV prevention and services to children and adolescents aged 10 to 17 who sell sex. [See also Prevention for Young People: %{s:25}] A number of studies show that significant numbers of sex workers selling sex when they are under age 18 and these adolescents are at high risk of acquiring HIV and have numerous legal and policy barriers, such as fear of the police, needing a guardian over age 18 to access HIV testing and counseling, and forced detention, in trying to access services.
Female Sex Workers
1 study
Well-functioning laboratory systems are needed to measure viral load via PCR to assess effectiveness of treatment. However, adequate clinical results can also be cost-effective and meet patient needs. A study in sub-Saharan Africa found that more than half of test results for viral load were invalid or inaccurate. A review done in low and middle-income countries showed that lack of routine virologic monitoring in resource limited ART programs led to the development of cross-resistance to the NRTI component of second-line treatment. Even where virological monitoring is available and demonstrates virological failure, delayed switching of patients to alternative antiretroviral therapy regimens occurs.
Provision and Access
1 study
Interventions are needed to scale up CD4 count screening, especially for pregnant women. A study found that several barriers limited CD4 cell count screening in rural areas, including “availability of laboratories equipped to perform CD4 cell count enumeration, reagent stockouts, and lack of sample transport systems” (Carter et al., 2010: 408). For mothers with CD4 counts above 500, there may be a low risk of HIV transmission through breastfeeding, though further research is necessary.
Postpartum
1 study
HIV-positive mothers, fathers, grandmothers and the larger community need clear, consistent, non-contradictory and nonjudgmental counseling on infant feeding practices. Health care providers need training based on accurate information. Studies found that health care providers gave HIV-positive women conflicting information and that simplified structured counseling tools are needed. Studies found that women reported that providers accused them of killing their infants if they breastfed. Women lack access to infant formula but have been told by providers that it is the only way for their infant to survive. Women were told that breastfeeding is a mode of HIV transmission and exclusive breastfeeding is a mode of prevention. Women fear HIV more than diarrheal disease, even though more deaths occur from diarrheal disease. Women were not given choices. Women did not give providers accurate information on how they were feeding their infant for fear of being denied health care. Women were told to feed their infants formula yet did not have adequate food support, most mothers could not do so with few having an income and most with no access to safe drinking water. Women lacked autonomy to decide infant feeding, which was decided by male partners or grandmothers. "Despite the current WHO recommendations to use extended infant prophylaxis as long as the infant is breastfed, no data are yet available from a clinical trial to confirm effectiveness and safety of this regimen beyond the first six months postpartum" (Taha, 2011: 919).
Postpartum
1 study
Efforts are needed to effectively implement Option B+ in non-prejudicial ways. Women who were sex workers reported being denied care until delivery. Women who were not accompanied by husbands were denied any health services during pregnancy. A sign on health centers read: “Notice: all pregnant women are supposed to come with their husbands/partners at their first visit. You will not be given services without implementing this” (Beckham et al., 2015: 66).
Antenatal Care - Treatment
1 study
HIV prevention interventions are needed for methamphetamine, crack, midazolam and/or heroin. People who use various drugs are at high risk of acquiring HIV and amphetamine is often used to enhance and prolong sexual pleasure and to reduce sexual inhibitions. High rates of HIV were found in a group of female crack users and sex workers using amphetamines. There is no effective pharmacotherapy, such as methadone, for cocaine or methamphetamine.
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Interventions in both sending and receiving countries are needed for migrant women and female partners of male migrants who are at high risk of HIV acquisition. Studies found that migrants, and female partners of male migrants, are often at high risk of HIV acquisition yet do not have basic facts concerning HIV transmission nor use condoms.
Migrant Women and Female Partners of Male Migrants
1 study
Greater efforts are needed to help young people personalize HIV risks. Studies found that knowledge about HIV prevention was superficial and that young people believed that they were not personally at risk of HIV acquisition despite risky behaviors and that condoms were not used because of “trust in partners.” Another study found that one adolescent girl reported she did not need to test for HIV as the only people at risk for acquiring HIV were those “who go to beer halls and pubs – prostitutes” (Ferrand et al., 2011). Married adolescent girls who had not become pregnant were significantly less likely to have had HIV testing and counseling (HTC) yet reported high rates of coerced sex within marriage, associated with acquiring HIV. Adolescents in one study suggested visiting hospices or people who were sick with HIV to understand more about HIV.
Mitigating Risk
1 study
Barriers such as cost of medications, stigma, long clinic waits, lack of food, and child-care responsibilities, among others, may discourage women living with HIV from accessing antiretroviral therapy. A study found that patients who were living with HIV but did not access antiretroviral therapy were twice as likely as patients on antiretroviral therapy to report not having enough food to take with treatment as a concern, in addition to concerns about cost barriers. Another study found that cost of ARVs, with direct out of pocket payment at point of care delivery decreased access to ARVs. Another study found transport costs and waiting time a barrier to access to treatment. Increased efforts are needed so that those in pre-ART care understand that HIV can be transmitted prior to ART eligibility.
Provision and Access
1 study
Strategies, including legal strategies, are needed to empower pregnant women living with HIV to ask questions, be properly informed and to challenge stigma, disrespect and abuse. [See also %{s:67}] Consequences for violating patient confidentiality, redress for women with HIV facing discrimination in facilities, and stigma reduction efforts are needed to increase adherence to cART, prior to, during and post pregnancy, including training for providers.
Antenatal Care - Treatment
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
Intensified efforts are needed to increase male and female condom use and reduce multiple partnerships by people who know their HIV-positive status and are not virally suppressed, including young people. Studies found that consistent condom use between discordant couples (or with partners whose serostatus was unknown) was low and, among those on treatment, decreased over time. Lack of condom use was associated with fear of disclosure. People living with HIV as well as couples also believed that treatment with antiretroviral therapy meant that they were either cured of HIV or could no longer transmit the virus and were less likely to disclose their positive serostatus. In some studies, men are more likely to report condom use than women, "given the limited control that women have over the use of the male condom" (Walusaga et al., 2012: 698). Particular attention is also needed to provide condoms to men living with HIV who frequent sex workers, as well as for sex workers themselves to protect themselves (Paz-Bailey et al., 2012). [See %{s:9}]
Staying Healthy and Reducing Transmission
1 study