What Works for Women and Girls

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In addition to the authors, a number of people have been involved in compiling the evidencein this document. Carolina Hall, Program Assistant at Population Reference Bureau, contributedto writing the chapters on preventing perinatal transmission and sexual and reproductivehealth. The following people also contributed to research for this compendium of evidence:Martha Wood, MPH, student in Bachelor’s of Midwifery, Flinders University, SouthAustraliaMeher Rehman, Atlas Corps Fellow, Population Action InternationalAlana Hairston, MS, Technical Officer, Global Technical Policy Unit, Elizabeth GlaserPediatric AIDS FoundationBetsy Kidder, MD and Ph.D. student, The George Washington UniversityKathryn Fleming, Senior Project Specialist, Health and Education, American Institutes forResearchTasha Prados, student, University of North Carolina-Chapel HillHolly Greb, Program Coordinator, Population Action International10 ACKNOWLEDGEMENTS
Table of ContentsList of Abbreviations 13Executive Summary 17Chapter 1. Introduction 27Chapter 2. Methodology 35Chapter 3. Prevention for Women 43A. Male and Female Condom Use 50B. Partner Reduction 63C. Male Circumcision 67D. Treating Sexually Transmitted Infections (STIs) 70Chapter 4. Prevention for Key Affected Populations 75A. Female Sex Workers 76B. Women Drug Users and Female Partners of Male IDUs 90C. Women Prisoners and Female Partners of Male Prisoners 100D. Women and Girls in Complex Emergencies 103E. Migrant Women and Female Partners of Male Migrants 106F. Transgender Women and Men 108G. Women Who Have Sex with Women (WSW) 110Chapter 5. Prevention for Young People 113A. Encouraging Behavior Change 114B. Increasing Access to Services 13711
Page 1: WHAT WORKSFOR WOMEN AND GIRLSEviden
Page 4: Authors:Jill Gay, MAKaren Hardee, P
Page 7 and 8: Jose Esparza, MD, Ph.D.Senior Advis
Page 9 and 10: Shyam Kottilil, MD, Ph.D.Staff Clin
Page 11: Larry Slutsker, MD, MPHChief, Malar
Page 15 and 16: List of Abbreviations3TCACTAHIANCAP
Page 17: PEPPHAPHRPIDPLHAPMTCTPPEPPTPRPTPRBP
Page 20 and 21: MethodologyMeasuring “what works
Page 24 and 25: 2. Hormonal contraception is safe f
Page 26 and 27: outcomes has been more difficult to
Page 28 and 29: 2. Promoting contraceptives and fam
Page 30 and 31: International Political Commitments
Page 32 and 33: established national action plans o
Page 34 and 35: Organization of the DocumentThis do
Page 36 and 37: Table 1.1Countries included in What
Page 38 and 39: understanding the epidemic in any g
Page 40 and 41: girls in school, for example. The c
Page 42 and 43: Within each intervention, studies a
Page 45 and 46: Chapter 3.Prevention for WomenA. Ma
Page 47 and 48: Special Risks for WomenStill, despi
Page 49 and 50: AIDS cases reported from 1982 to 20
Page 51 and 52: experience observed in clinical tri
Page 53 and 54: Female Condoms Are the Only Female-
Page 55 and 56: condom if it gives them more pleasu
Page 57 and 58: Correct use of the female condom ha
Page 59 and 60: A two month prospective study from
Page 61 and 62: A study of trends from Demographic
Page 63 and 64:
8. Peer education for women can inc
Page 65 and 66:
3B. Prevention for Women: Partner R
Page 67 and 68:
matic focus on partner reduction, y
Page 69 and 70:
of HIV acquisition, but were either
Page 71 and 72:
four visits, each participant was i
Page 73 and 74:
What Works—Prevention for Women:
Page 75 and 76:
vention immediately following the b
Page 77 and 78:
Chapter 4.Prevention for Key Affect
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2010). Transgender men and women al
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confidentiality—violate human rig
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there were major socio-demographic
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and post-intervention were used to
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tent condom use and 1.5 times more
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to their peers, distribute condoms
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Gaps in Programming—Female Sex Wo
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of a sexual relationship with a pri
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than were naltrexone or placebo. HI
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attributed to …swift introduction
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Promising Strategies:5. Sex-segrega
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9. Programming to prevent initiatio
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D’Ivoire, Cuba, Estonia, Indonesi
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Gaps in Programming—Women Prisone
Page 107 and 108:
EVIDENCEPromising Strategies:1. Vol
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In fact, as of September 2008, 66 o
Page 111 and 112:
Transgender women and men are often
Page 113:
2009). “The invisibility and marg
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especially young women, have their
Page 118 and 119:
negotiation skills and other critic
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to be reached with sex and HIV educ
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What Works—Prevention for Young P
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44% and 100% of participants (Kirby
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tudes, self-efficacy, intentions, a
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as young people in this area had li
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ical validity of the findings that
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study reported having received info
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nancy. Almost 87% of men and 89% of
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last sex, having ever used a condom
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Gap noted, for example, in South Af
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Disaggregated Data Is NeededEffecti
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were also effective in increasing u
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Chapter 6.HIV Testing and Counselin
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Equitable Access to Testing and Cou
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they would come for HIV testing, re
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their jobs (Human Rights Watch, 200
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What Works—HIV Testing and Counse
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women. Of all married HIV-positive
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A study in Ethiopia found that inco
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At a provincial hospital in Mombasa
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Between June and December 2007, mob
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Promising Strategies:6. Encouraging
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10. Counseling may reduce risk beha
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women learned violence prevention s
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Chapter 7.TreatmentA. Provision and
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Treatment Has Been Successfully Adm
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HIV Prevention Is Needed as well as
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Gaps in Programming—Provision and
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These practices and tools are usefu
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Non-judgmental, non-stigmatizing in
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percent among ART-experienced patie
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(Donnell et al., 2010). (Abstract)
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The sexual health of women is an im
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[ for women living with HIV]: impro
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Available GuidelinesA number of sex
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advantages of dual method use, alon
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contraception: 57% used hormonal co
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different; and progression to WHO c
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HIV-related behavioral or biologic
Page 200 and 201:
use was positively associated with
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Gaps in Programming—Meeting the S
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Interactions between ARVs and oral
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Chapter 9.Safe Motherhood and Preve
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Pillar 1: Preventing Primary HIV In
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mission of HIV. HIV testing and cou
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EVIDENCE1. Preventing unintended pr
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Gaps in Programming—Reducing Unin
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9B. Safe Motherhood and Preventiono
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EVIDENCEPromising Strategies:1. Dis
Page 221 and 222:
Gaps in Programming—Pre-Conceptio
Page 223 and 224:
9C-1. Safe Motherhood and Preventio
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tion (Kershaw et al., 2006). “…
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outine tests. Fifty percent of the
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An evaluation of UNICEF-funded PMTC
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and syphilis (by rapid plasma regai
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2. Additional efforts are needed to
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for their own disease” (ITPC, 200
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own health needs has never been eva
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dine and lamivudine during pregnanc
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chose elective cesarean section to
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their current pregnancy or a past p
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Promising Strategies:5. Integrating
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Gaps in Programming—Treatment1. I
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cesarean, and 221 were non-elective
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3. Efforts are needed to ensure tha
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“There is no doubt that there are
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formula feeding increases the risk
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of age. For breastfed infants, the
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weeks of gestation and continued un
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A study in Côte d’Ivoire with 54
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during breastfeeding compared with
Page 265 and 266:
3 times higher for infants who were
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counseling tools are needed. Studie
Page 269 and 270:
Chapter 10.Preventing, Detecting an
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latent infection. Some immunocompro
Page 273 and 274:
concurrent active TB and HIV infect
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mortality of HIV-positive people re
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in a 65% decline in mortality and t
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1. Efforts are needed to reduce TB-
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al., 2004 cited in Slutsker and Mar
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stillbirths by 33%. Three cluster-r
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Gaps in Programming—Malaria1. Fur
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dose global coverage was just 27% i
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Chapter 11.Strengthening the Enabli
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combining microfinance and training
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pants meeting once per week for thr
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the men believed that they should n
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in the intervention village were si
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positive impacts. The quasi-experim
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Samoa, Serbia and Montenegro, Thail
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factor associated with sexual assau
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What Works—Strengthening the Enab
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worked with women’s groups, radio
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of school in addressing gender-base
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11C. Strengthening the Enabling Env
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also widely used worldwide and part
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ecognize women’s property rights
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Promising Strategies:2. Community o
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11D. Strengthening the Enabling Env
Page 321 and 322:
Page 323 and 324:
more likely to report having used a
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likely than illiterate women to kno
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of the women surveyed were HIV-posi
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countries extending the fee aboliti
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families and separated from their c
Page 333 and 334:
Page 335 and 336:
used the resource “Understanding
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6. Support groups for people living
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11G. Strengthening the Enabling Env
Page 341 and 342:
EVIDENCEPromising Strategies:1. Inv
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Chapter 12.Care and SupportA. Women
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ical care provided by family member
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dealing with their sorrow, grief, a
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What Works—Care and Support: Wome
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2. Peer support groups can be highl
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discriminated unjustly against them
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6. Home-based antiretroviral therap
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12B. Care and Support: Orphans and
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(Thurman et al., 2007). As of 2008,
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care and services were provided, wh
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for treatment can be safely monitor
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A study done in Kenya (year not giv
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ather than a narrowly defined HIV/A
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7. Further interventions to provide
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ning providers, antenatal care and
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What Works—Structuring Health Ser
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counts available at primary health
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Pregnant women reported feeling out
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Before implementation of the PMTCT
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accessing PMTCT. An evaluation of 3
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A mathematical model based on TB tr
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1. Improved integration is needed b
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15. Additional efforts are needed t
Page 390 and 391:
Community-based Care is holistic ca
Page 392 and 393:
Microfinance is often defined as fi
Page 394 and 395:
Sexuality is a central aspect of be
Page 397 and 398:
References 1Aaron, E. and S. Crinit
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Akabaysh, H. and G. Psacharopoulos.
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Andia, I., A. Kaida, M. Maier, D. G
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Auvert, B., D. Taljaard, E. Lagarde
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Barker, P., C. McCanno, N. Mehta, C
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Berer, M. 2008b. “Male Circumcisi
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Bong, C-N., S. Chen, Y-J. Jong, T-S
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Brou, H., G. Djohan, R. Becquet, G.
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Campbell, L. and M. Lambey. 2002.
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Cluver L. and F. Gardner. 2007. “
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Coovadia, H. 2004. “Antiretrovira
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“What Works compiles a wealth of
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