What Works for Women and Girls

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What Works—Strengthening the Enabling Environment: Addressing Violence AgainstWomen1. Community-based participatory learning approaches involving men and women cancreate more gender-equitable relationships, thereby decreasing violence.2. Establishing comprehensive post-rape care protocols, which include PEP, can improveservices for women.3. Microfinance programs can lead to reduction in gender-based violence whenintegrated with participatory training on HIV, gender, and violence.Promising Strategies:4. Training teachers about gender-based violence can change norms about acceptanceof gender-based violence.5. Multi-media health promotion can increase awareness of violence against women.6. Integrating HIV prevention into services for abused women may increase condomuse.EVIDENCE1. Community-based participatory learning approaches involving men and women can createmore gender-equitable relationships, thereby decreasing violence. [See also 11A. TransformingGender Norms]An evaluation of the Stepping Stones program for young people in the Eastern CapeProvince of South Africa found that the program was effective in reducing sexual risktaking and violence perpetuation among young, rural African men. The evaluation wasa random controlled trial. Men reporting fewer partners, higher condom use, and lesstransactional sex, perpetration of intimate partner violence and substance use (Jewkeset al., 2008). Stepping Stones is a gender transformative approach designed to improvesexual health through building stronger and more gender-equitable relationships amongpartners, including better communication. Stepping Stones uses participatory learningapproaches to increase knowledge of sexual health, and build awareness of risks and theconsequences of risk taking. The program included a 50-hour intervention/workshop(with a comparison group receiving a 3-hour intervention on HIV and safer sex) (Jewkeset al., 2006b). (Gray II) (violence, condom use, sex behavior, South Africa)WHAT WORKS FOR WOMEN AND GIRLS303
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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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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
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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
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Gaps in Programming—Pre-Conceptio
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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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Page 255 and 256: formula feeding increases the risk
Page 257 and 258: of age. For breastfed infants, the
Page 259 and 260: weeks of gestation and continued un
Page 261 and 262: A study in Côte d’Ivoire with 54
Page 263 and 264: during breastfeeding compared with
Page 265 and 266: 3 times higher for infants who were
Page 267 and 268: counseling tools are needed. Studie
Page 269 and 270: Chapter 10.Preventing, Detecting an
Page 271 and 272: latent infection. Some immunocompro
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Page 279 and 280: 1. Efforts are needed to reduce TB-
Page 281 and 282: al., 2004 cited in Slutsker and Mar
Page 283 and 284: stillbirths by 33%. Three cluster-r
Page 285 and 286: Gaps in Programming—Malaria1. Fur
Page 287 and 288: dose global coverage was just 27% i
Page 289 and 290: Chapter 11.Strengthening the Enabli
Page 291 and 292: combining microfinance and training
Page 293 and 294: pants meeting once per week for thr
Page 295 and 296: the men believed that they should n
Page 297 and 298: in the intervention village were si
Page 299 and 300: positive impacts. The quasi-experim
Page 301 and 302: Samoa, Serbia and Montenegro, Thail
Page 303: factor associated with sexual assau
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Page 309 and 310: of school in addressing gender-base
Page 311 and 312: 11C. Strengthening the Enabling Env
Page 313 and 314: also widely used worldwide and part
Page 315 and 316: ecognize women’s property rights
Page 317 and 318: Promising Strategies:2. Community o
Page 319 and 320: 11D. Strengthening the Enabling Env
Page 321 and 322: What Works—Strengthening the Enab
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Page 325 and 326: likely than illiterate women to kno
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Page 329 and 330: countries extending the fee aboliti
Page 331 and 332: families and separated from their c
Page 333 and 334: What Works—Strengthening the Enab
Page 335 and 336: used the resource “Understanding
Page 337 and 338: 6. Support groups for people living
Page 339 and 340: 11G. Strengthening the Enabling Env
Page 341 and 342: EVIDENCEPromising Strategies:1. Inv
Page 343 and 344: Chapter 12.Care and SupportA. Women
Page 345 and 346: ical care provided by family member
Page 347 and 348: dealing with their sorrow, grief, a
Page 349 and 350: What Works—Care and Support: Wome
Page 351 and 352: 2. Peer support groups can be highl
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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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“What Works compiles a wealth of
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