What Works for Women and Girls

women. Of all married HIV-positive persons, 13% reported only one sexual partner intheir life (1% of men and 23% of women). Of the 81% of HIV-positive married personswho did not understand that HIV-discordance was possible within couples, 92% didnot know the HIV status of their spouse (Bunnell et al., 2008). (Gray III) (HIV testing,condom use, contraception, sexual partners, Uganda)Interviews with 127 patients (42% male) in May 2006 in a large public hospital HIVclinic in Santiago, Dominican Republic found that sexually active patients reported usingcondoms significantly more frequently following their HIV diagnosis and were morelikely to use a condom if they believed their partner did not have HIV. Most patients(72.4%) were sexually active. Following their diagnosis, 72.8% of sexually active patientsused condoms more frequently. The most common reason cited for not using a condomafter HIV diagnosis differed by sex: men cited decreased sexual pleasure (70%) andwomen reported that their partner had refused to use a condom (71.8%). Sexually activepatients who believed that their partner did not have HIV were more than 16 times morelikely to report condom use at their last sexual encounter than those who did not knowtheir partner’s HIV status. Those who reported their partner was HIV-positive wereestimated to be more than twice as likely to use a condom as those who were unsure oftheir partners’ HIV status. One-third reported using a condom every time they had sexfollowing their diagnosis. A majority of men had ever paid for sex (80%), while only onewoman (1.4%) had ever paid for sex (Sears et al., 2008). (Gray III) (condom use, HIVtesting, disclosure, Dominican Republic)A longitudinal cohort study in Mozambique from 2002 to 2003 with 450 people whoparticipated in VCT groups and 504 people who were not in VCT groups found thatthose participating in VCT groups increased condom use while those not in VCTgroups did not. Three visits were required for the VCT group, which included bothtesting and counseling components. Those who did not attend VCT attended outpatientANC clinics. Reported condom use always or sometimes was not significantly differentbetween VCT and non-VCT groups at baseline, but was significantly higher at followup.Condom use at most recent sex was the same in both groups at baseline but becamesignificantly more frequent in the VCT group. Condom use during the most recentsexual act increased over time for both HIV-positive and HIV-negative people, but theincrease was greater in those who were HIV-positive. Change was most significant forthose with no literacy skills, showing the importance of interpersonal communication:for those attending VCT an increase from 10% to 64% at the end of the project (Mola etal., 2006). (Gray III) (counseling, HIV testing, condoms, Mozambique)A study of 963 cohabitating heterosexual couples with one HIV-positive and oneHIV-negative partner in Rwanda, found that less than 3% reported condom use priorto VCT. The frequency of sex did not change after joint VCT, but the proportion ofreported contacts with a condom increased to over 80% and remained stable through12 months of follow-up. Couples with regular appointments thorough one year reportedWHAT WORKS FOR WOMEN AND GIRLS153