What Works for Women and Girls

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use was positively associated with disclosure of HIV-positive serostatus and partnerbeing HIV-negative, as well as being married (Allen et al., 2008). (Gray V) (condom use,Caribbean)6. Providing antiretroviral treatment to people living with HIV can increase HIV preventionbehaviors, including condom use. [See Chapter 7C. Treatment: Reducing Transmission]Promising Strategies:7. Cervical cancer screening and treatment can be integrated into HIV care to reduce morbidityand mortality in women living with HIV.A program for cervical cancer for both HIV-positive and negative women in Lusaka,Zambia has screened over 20,000 women in 15 primary care clinics and has linkedcervical cancer prevention services with HIV care and treatment services. Due to lack ofresources to establish a patient recall system, emphasis was on high population coveragerather than frequency of exams. Cervical cancer using visual inspection with acetic acid(VIA) provided on-the-spot results, which was then linked with same visit cryotherapy.Community randomized trials have documented the safety, acceptability and effectivenessof single visit “see and treat” methodology based on VIA and same visit cryotherapyof eligible lesions (Sankaranarayan et al., 2007; Goldie et al., 2005; Denny et al.,2005 cited in Mwanahamuntu et al., 2008). Peer educators as health promotion advocatesand patient navigators reduced loss to follow-up. Community women were trainedon conducting community-based cervical health promotion talk. Women who wantedmore information were directed to the cervical cancer prevention clinics. Women whoattended cervical cancer prevention clinics who had not been tested for HIV were counseledon HPV and HIV testing. HIV-positive women were escorted to nearby HIVcare treatment clinics for further evaluation. To minimize stigma, screening clinicswere co-located in government-operated public health clinics near to but not directlywithin the HIV clinic (Mwanahamuntu et al., 2008). (Gray V) (cervical cancer, treatment,Zambia)A 2007 overview states that cervical cancer screening of HIV-positive women in lowresourcecountries could be integrated with ARV treatments, which have establishedthe regular observation, infrastructure and services to support cervical cancer screenings.The overview explains that a new, rapid HPV test is underway and may be the bestoption considering the difficulties associated with Pap smears, visual inspection andHPV tests in low-resource countries. Pap smears require high standards of implementation,which work in high-resource countries, but may be deficient in low-resourcesettings. Visual inspection relies heavily upon the training of the health provider, thoughit is a low-cost option giving immediate results (Franceschi and Jaffe, 2007). (Gray V)(cervical cancer, treatment, Pap smears)198 CHAPTER 8 MEETING THE SEXUAL AND REPRODUCTIVE HEALTH NEEDS OF WOMEN LIVING WITH HIV
8. Promoting condom use for contraception may make condom use more acceptable andeasier to negotiate. [See Chapter 3A. Prevention for Women: Male and Female Condom Use]9. Early postpartum visits can result in increased condom use, contraceptive use, HIV testingand treatment. [See Chapter 9E. Safe Motherhood and Prevention of Vertical Transmission:Postpartum]Gaps in Programming—Meeting the Sexual and Reproductive Health Needs of WomenLiving with HIV1. Additional efforts are needed to provide information on contraceptive method use towomen living with HIV (or whose serostatus is unknown) who do not desire to havea child or wish to space the next pregnancy.2. Programs must adhere to the longstanding international agreement to voluntarism,informed consent, and ensuring the right of individuals and couples to decide freelyand responsibly the number and spacing of their children.3. Providers need training on contraception, including non-directive counseling andreducing stigma and discrimination for women living with HIV.4. Interventions to increase dual protection and dual method use are needed.5. Women living with HIV need information and access to services for emergencycontraception; safe abortion, where legal; and post-abortion care (PAC) serviceswhere abortion is illegal. Research is also needed on the safest methods of abortionfor HIV-positive women.6. Efforts are needed to address barriers to ensure that women living with HIV canaccess and use contraceptives without the knowledge of their partner, if desired.7. Potential drug interaction between contraceptive options and treatment for TB andHIV co-infection must be considered.8. Efforts are needed to capitalize on opportunities to integrate family planning and HIVservices.9. Policy guidelines need to specify how family planning should be addressed in HIVprevention, treatment and care.10. Additional efforts are needed to reduce the structural barriers, such as gender norms,that influence the behavior or decisions of people living with HIV to engage in unsafesex.WHAT WORKS FOR WOMEN AND GIRLS199
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WHAT WORKSFOR WOMEN AND GIRLSEviden
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Authors:Jill Gay, MAKaren Hardee, P
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Jose Esparza, MD, Ph.D.Senior Advis
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Shyam Kottilil, MD, Ph.D.Staff Clin
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Larry Slutsker, MD, MPHChief, Malar
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Table of ContentsList of Abbreviati
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List of Abbreviations3TCACTAHIANCAP
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PEPPHAPHRPIDPLHAPMTCTPPEPPTPRPTPRBP
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MethodologyMeasuring “what works
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2. Hormonal contraception is safe f
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outcomes has been more difficult to
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2. Promoting contraceptives and fam
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International Political Commitments
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established national action plans o
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Organization of the DocumentThis do
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Table 1.1Countries included in What
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understanding the epidemic in any g
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girls in school, for example. The c
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Within each intervention, studies a
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Chapter 3.Prevention for WomenA. Ma
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Special Risks for WomenStill, despi
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AIDS cases reported from 1982 to 20
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experience observed in clinical tri
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Female Condoms Are the Only Female-
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condom if it gives them more pleasu
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Correct use of the female condom ha
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A two month prospective study from
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A study of trends from Demographic
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8. Peer education for women can inc
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3B. Prevention for Women: Partner R
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matic focus on partner reduction, y
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of HIV acquisition, but were either
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four visits, each participant was i
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What Works—Prevention for Women:
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vention immediately following the b
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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
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EVIDENCEPromising Strategies:1. Vol
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In fact, as of September 2008, 66 o
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Transgender women and men are often
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2009). “The invisibility and marg
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especially young women, have their
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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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Page 151 and 152: their jobs (Human Rights Watch, 200
Page 153 and 154: What Works—HIV Testing and Counse
Page 155 and 156: women. Of all married HIV-positive
Page 157 and 158: A study in Ethiopia found that inco
Page 159 and 160: At a provincial hospital in Mombasa
Page 161 and 162: Between June and December 2007, mob
Page 163 and 164: Promising Strategies:6. Encouraging
Page 165 and 166: 10. Counseling may reduce risk beha
Page 167 and 168: women learned violence prevention s
Page 169 and 170: Chapter 7.TreatmentA. Provision and
Page 171 and 172: Treatment Has Been Successfully Adm
Page 173 and 174: HIV Prevention Is Needed as well as
Page 175 and 176: Gaps in Programming—Provision and
Page 177 and 178: These practices and tools are usefu
Page 179 and 180: Non-judgmental, non-stigmatizing in
Page 181 and 182: percent among ART-experienced patie
Page 183: (Donnell et al., 2010). (Abstract)
Page 186 and 187: The sexual health of women is an im
Page 188 and 189: [ for women living with HIV]: impro
Page 190 and 191: Available GuidelinesA number of sex
Page 192 and 193: advantages of dual method use, alon
Page 194 and 195: contraception: 57% used hormonal co
Page 196 and 197: different; and progression to WHO c
Page 198 and 199: HIV-related behavioral or biologic
Page 202 and 203: Gaps in Programming—Meeting the S
Page 204 and 205: Interactions between ARVs and oral
Page 207 and 208: Chapter 9.Safe Motherhood and Preve
Page 209 and 210: Pillar 1: Preventing Primary HIV In
Page 211 and 212: mission of HIV. HIV testing and cou
Page 213 and 214: EVIDENCE1. Preventing unintended pr
Page 215 and 216: Gaps in Programming—Reducing Unin
Page 217 and 218: 9B. Safe Motherhood and Preventiono
Page 219 and 220: EVIDENCEPromising Strategies:1. Dis
Page 221 and 222: Gaps in Programming—Pre-Conceptio
Page 223 and 224: 9C-1. Safe Motherhood and Preventio
Page 225 and 226: tion (Kershaw et al., 2006). “…
Page 227 and 228: outine tests. Fifty percent of the
Page 229 and 230: An evaluation of UNICEF-funded PMTC
Page 231 and 232: and syphilis (by rapid plasma regai
Page 233 and 234: 2. Additional efforts are needed to
Page 235 and 236: for their own disease” (ITPC, 200
Page 237 and 238: own health needs has never been eva
Page 239 and 240: dine and lamivudine during pregnanc
Page 241 and 242: chose elective cesarean section to
Page 243 and 244: their current pregnancy or a past p
Page 245 and 246: Promising Strategies:5. Integrating
Page 247 and 248: Gaps in Programming—Treatment1. I
Page 249 and 250: 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
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3 times higher for infants who were
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counseling tools are needed. Studie
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Chapter 10.Preventing, Detecting an
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latent infection. Some immunocompro
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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
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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
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used the resource “Understanding
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6. Support groups for people living
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11G. Strengthening the Enabling Env
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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
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Community-based Care is holistic ca
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Microfinance is often defined as fi
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Sexuality is a central aspect of be
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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
Page 403 and 404:
Auvert, B., D. Taljaard, E. Lagarde
Page 405 and 406:
Barker, P., C. McCanno, N. Mehta, C
Page 407 and 408:
Berer, M. 2008b. “Male Circumcisi
Page 409 and 410:
Bong, C-N., S. Chen, Y-J. Jong, T-S
Page 411 and 412:
Brou, H., G. Djohan, R. Becquet, G.
Page 413 and 414:
Campbell, L. and M. Lambey. 2002.
Page 415 and 416:
Chama, C., W. Gashau and S. Oguche.
Page 417 and 418:
Chimwaza, A., J. Chimango, C. Kapon
Page 419 and 420:
Cluver L. and F. Gardner. 2007. “
Page 421 and 422:
Coovadia, H. 2004. “Antiretrovira
Page 423 and 424:
De Bruyn, M. 2006a. There’s Nothi
Page 425 and 426:
Dharmadhikari, A., J Gupta, M. Deck
Page 427 and 428:
Druce, N. and A. Nolan. 2007. “Se
Page 429 and 430:
Epstein H. 2009. “Universal volun
Page 431 and 432:
Farrell, B. and N. Rajani. 2007.
Page 433 and 434:
Ford, N., D. Wilsono, P. Cawthorne,
Page 435 and 436:
Galvez-Buccollini, J., S. DeLea, P.
Page 437 and 438:
Gillespie, D., H. Bradley, M. Wolde
Page 439 and 440:
Gogna, M., M. Pechny, I. Ibarlucia,
Page 441 and 442:
Grimes, D., J. Benson, S. Singh, M.
Page 443 and 444:
Haddock, S., K. Hardee, J. Gay, P.
Page 445 and 446:
Harries, A., R. Chimizi and R. Zach
Page 447 and 448:
Hillemans, P., T. Ellerbrock, S. Mc
Page 449 and 450:
Hope, R. 2007. Addressing Cross-Gen
Page 451 and 452:
Innes, C, S Charalambous, M Felix,
Page 453 and 454:
Islander, F. 2006. Plenary Presenta
Page 455 and 456:
Jewkes, R. 2007. “Comprehensive R
Page 457 and 458:
Kadando, R., J. Lyavala and M. Mulo
Page 459 and 460:
Karnell, A.P., P.K. Cupp, R.S. Zimm
Page 461 and 462:
Maharashtra, India.” Abstract THP
Page 463 and 464:
Kim, Y., A. Kols, R. Nyakauru, C. M
Page 465 and 466:
Knerr, W., McEachran, J. and Philpo
Page 467 and 468:
Laga, M., M. Alary, N. Nzila, A. Ma
Page 469 and 470:
Leonard, L., I. Ndiaye, A. Kapadia,
Page 471 and 472:
Luke, N. and K. Kurz. 2002. Cross-g
Page 473 and 474:
Mahendra, V., R. Verma, S. Singh, S
Page 475 and 476:
Prevent HIV Mother-to-Child Transmi
Page 477 and 478:
McIntyre, J. and M. Lallemont. 2008
Page 479 and 480:
Minaya, J., A. Owen-Simth and J. He
Page 481 and 482:
Morrison, C. 2009. “Hormonal Cont
Page 483 and 484:
Musaba, E., C. Morrison, M. Sunkutu
Page 485 and 486:
Nelson, K., D. Celentano, S. Euimtr
Page 487 and 488:
Nyamukapa A., S. Gregson, B. Lopman
Page 489 and 490:
Olaleye, A., D. Polsy, D. Atamawanl
Page 491 and 492:
Paiva, V., E. Felipe, N. Santos, T.
Page 493 and 494:
Peacock, D. 2009. “Working with M
Page 495 and 496:
Pillai, S., M. Seshu and M. Shivdas
Page 497 and 498:
Puntos de Encuentro. 2008. Final Ev
Page 499 and 500:
Reniers, G., T. Araya, G.Davey, N.
Page 501 and 502:
Ross, D., J. Changalucha, A. Obasi,
Page 503 and 504:
an Operations Research Study in Zam
Page 505 and 506:
Sekirime, W. and J. Lule. 2009. “
Page 507 and 508:
Shuey, D., B. Baishangire, S. Omiat
Page 509 and 510:
Smith D. 2007. “Modern Marriage,
Page 511 and 512:
Stanwood N., S. Cohn, J. Heiser and
Page 513 and 514:
Stuikyte, R. S. Schonning and S. Me
Page 515 and 516:
Taylor, E. A. Pettifor, B. Mupenda,
Page 517 and 518:
Todd, J., D. Maher, I. Kasamba, E.
Page 519 and 520:
UNAIDS. 2007b. “The Positive Part
Page 521 and 522:
UNIFEM. 2008. http://www.genderanda
Page 523 and 524:
Verhoeff, F. B. Brabin, C. Hart, L.
Page 525 and 526:
Wang, X. and Z. Wu. 2007. “Factor
Page 527 and 528:
Wilcher, R., T. Petruney, H. Reynol
Page 529 and 530:
World Health Organization (WHO). 20
Page 531 and 532:
Yankah, E., J. Ayres, S. Arruda and
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“What Works compiles a wealth of
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