What Works for Women and Girls

Gaps in Programming—Meeting the Sexual and Reproductive Health Needs of WomenLiving With HIV (continued)11. Providers need additional skills and resources to provide non-judgmental, confidentialsafer sex counseling to people living with HIV.12. Further interventions providing disclosure support are needed, particularly for womenfacing abandonment, violence, or other adverse events.13. Interventions providing information on sero-sorting as a preventive strategy areneeded.14. Further interventions are needed to ensure that women, especially women living withHIV, are screened and treated for cervical cancer.15. Screening and treating HIV-positive women and their partners for STIs may reduceHIV transmission and will improve health.16. Adolescents who acquired HIV through perinatal transmission need information andtreatment services through adolescent-friendly HIV and family planning services.1. Additional efforts are needed to provide information on contraceptive method use to womenliving with HIV (or whose serostatus is unknown) who do not desire to have a child or wishto space the next pregnancy. Studies found that many women had significant numbers ofunintended pregnancies.Gap noted, for example, in South Africa (Cooper et al., 2009, Laher et al., 2008; Laheret al., 2009a, Rochat et al., 2008); Uganda (Homsy et al, 2009, Heys et al., 2009,Nakayiwa et al., 2009, Bunnell et al., 2008, Bajunirwe et al., 2008); Kenya (Okundi,2009, Imbuki et al., 2009,); Kenya and Malawi (Anand et al., 2009); Argentina (Gognaet al., 2009); India (Suryavanashi et al., 2009); Benin (Gougounon et al., 2008);Botswana (ICW, 2006); Côte d’Ivoire (Desgrées-Du-Loû et al., 2002 cited in de Bruyn,2003); general (Hoffman et al., 2008; Rochat et al., 2006 cited in Reynolds et al., 2008).2. Programs must adhere to the longstanding international agreement to voluntarism,informed consent, and ensuring the right of individuals and couples to decide freely andresponsibly the number and spacing of their children. Studies found that women livingwith HIV had been sterilized against their will, were pressured by providers to terminate apregnancy, or were stigmatized for becoming pregnant.Gap noted, for example, in Namibia (ICW, 2009); Brazil (Oliveira et al., 2007, Nobregaet al., 2007 cited in Oliveira et al., 2007, Knauth et al., 2003); India (Batura et al., 2008);Chile (Araya, 2008); Mexico (Kendall and Perez-Vasquez, 2008); Ukraine (Yaremenko200 CHAPTER 8 MEETING THE SEXUAL AND REPRODUCTIVE HEALTH NEEDS OF WOMEN LIVING WITH HIV