Showing 1 - 10 of 10 Results for "Latin America"

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Efforts are needed to educate youth about sexual diversity in order to reduce stigma and discrimination. One study found that in no country in Latin America or the Caribbean was there any school-based sexuality initiatives that discussed sexual diversity. Current efforts are underway by Promundo (Greene, 2012b).
Transgender Women and Men
1 study
Interventions are needed to reduce drug resistance, particularly among those who are treatment naïve. Third line regimens may be needed in some resource limited settings. A systematic review was done on studies published on the spread of drug resistance in resource-limited settings after rollout of ART from 2001 to 2011, which reported on changes in the rate of HIV-1 drug resistance in treatment-naïve HIV-positive patients. The review found that east Africa had the highest rate of increase of drug resistance in treatment-naïve patients at 29% per year since rollout, followed by 14% in southern Africa, and 3% in west and central Africa. No specific analysis was done on gender because many studies did not include sex ratios. In total, 162 reports were included with data from 42 countries and 26,102 patients. In another study of Latin America, it was estimated that at least 6% of patients would need third line regimens within 5 years of ART initiation.
Adherence and Support
1 study
Research is needed on what different factors affect adherence among men and women.
Adherence and Support
1 study
Treatment programs that meet the needs of key populations such as sex workers and trans populations are needed. Recent WHO guidelines (WHO, 2014b) have noted that key populations living with HIV should have the same access to ART and ART management as other populations.
Provision and Access
1 study
Changing the gender norms that can lead to increased risks of HIV such as those dictating multiple sexual partners, the use of violence, or drinking heavily for men and sexual ignorance, submissiveness and dependency for women and girls is a current challenge. Further well-evaluated interventions are needed and existing interventions need to be scaled up. Studies found that women were aware of being at risk for HIV yet felt they had no power to negotiate the terms of sex or to demand condom use. Studies found that both men and women thought multiple sexual partners for men to be an accepted norm in many countries. Media reinforced these gender stereotypes.
Transforming Gender Norms
1 study
Interventions are needed to counter gender norms, such as those which value girls’ sexual ignorance and virginity, which place girls at risk for HIV transmission. [See also %{s:57}] Studies found that gender norms valued sexual ignorance of girls and therefore girls were at risk of HIV acquisition. Some studies found that women did not know anything about HIV until they became HIV-positive. Girls are taught to surrender power to meet cultural expectations of being a good girl or good woman. Boys derive status from having multiple sexual partners.
Mitigating Risk
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
Increased efforts are needed to retain women on HAART following birth. Studies found that women who initiated ART during pregnancy were more likely to be lost to follow up than non-pregnant women or that pregnant women who were eligible for HAART according to national guidelines were not provided HAART.
Postpartum
1 study
Interventions for pregnant women and their partners to stay HIV-negative or reduce HIV transmission are needed. [See also %{c:11} and %{c:13}] Pregnancy is a time of high risk for HIV acquisition. Home-based partner education for couples with no reports of interpersonal violence may be more effective than clinic based interventions, especially when women can opt-out of disclosing their sero-status. A systematic review found that incident infection (i.e. recently acquired during pregnancy) resulted in up to a 15-fold higher risk of vertical transmission.
Antenatal Care - Treatment
1 study
Women and men need accurate information on vertical transmission, treatment adherence strategies, the importance of their viral load and the low risk of vertical transmission if virally suppressed. Adherence has been challenging for women living with HIV postpartum, even for those initiating ART during pregnancy at CD4 counts under 350, with adequate adherence dropping from 75.7% during pregnancy to 53% postpartum globally (Nachega et al., 2012 cited in Coutsoudis et al., 2013). Knowledge of HIV and vertical transmission has shown to be correlated with increased initiation, adherence and retention for pregnant women living with HIV.
Antenatal Care - Treatment
1 study