What Works for Women and Girls

More documents

Recommendations

Info

International Political Commitments on Women,Girls and HIV/AIDSSince the 1994 International Conference on Population and Development, governments haverecognized that action must be taken to prevent HIV infections among women and girls,provide care and support, and address the “social, economic, gender and racial inequities”that increase vulnerability (ICPD Programme of Action, 1994). At the United Nations GeneralAssembly Special Session in 2001, governments noted that “women and girls are disproportionatelyaffected by HIV/AIDS” and committed to develop national strategies to “promotethe advancement of women and women’s full enjoyment of all human rights; promote sharedresponsibility of men and women to ensure safe sex; empower women to have control overand decide freely and responsibly on matters related to their sexuality to increase their abilityto protect themselves from HIV infection” (United Nations Declaration on HIV/AIDS. 2001).In 2006, member states of the United Nations General Assembly went further in thePolitical Declaration on HIV/AIDS, committing themselves to, among other things:Promote responsible sexual behavior among youth and adolescents (including the use ofcondoms);Provide evidence- and skills-based, youth-specific HIV education and mass media interventions;andProvide youth-friendly health services;Eliminate gender inequalities, gender-based abuse and violence;Provide health care and services, including for sexual and reproductive health, as well ascomprehensive information and education to increase the capacity of women and adolescentgirls to protect themselves from the risk of HIV infection;Ensure that women can exercise their right to have control over, and decide freely andresponsibly on, matters related to their sexuality in order to increase their ability to protectthemselves from HIV infection;Take all necessary measures to create an enabling environment for the empowerment ofwomen and strengthen their economic independence;Strengthen legal, policy, administrative and other measures for the promotion and protectionof women’s full enjoyment of all human rights;Ensure that pregnant women have access to antenatal care, information, counseling andother HIV services;Increase the availability of and access to effective treatment to women living with HIV andinfants in order to reduce mother-to-child transmission of HIV;Ensure effective interventions for women living with HIV, including voluntary and confidentialcounseling and testing, with informed consent; access to treatment, especially lifelongantiretroviral therapy; and the provision of a continuum of care.28 CHAPTER 1 INTRODUCTION
Global Initiatives on Women, Girls and HIV/AIDSA number of multilateral and bilateral donors have developed gender policies or strategies,including the two largest donors for AIDS, the Global Fund to Fight AIDS, Tuberculosis andMalaria and the U.S. President’s Initiative for AIDS Relief.The Global Fund’s Gender Equality Strategy, approved in late 2008 (The Global Fund toFight AIDS, TB and Malaria, 2009), is aligned with the principles underpinning the GlobalFund’s approach: country-led initiatives; evidence-based practices; subject to independentreview; and able to be monitored. Based on the Gender Equality Strategy, the Global Fundpromotes programs and seeks proposals that:Scale up services and interventions that reduce gender-related risks and vulnerabilities toinfection;Decrease the burden of disease for those most at-risk;Mitigate the impact of the three diseases; andAddress structural inequalities and discrimination.The legislation authorizing PEPFAR in 2003 contained strong language related to genderand the need to address the vulnerability of women and girls with strong programming toreduce gender inequity (Ashburn et al., 2009: USAID/AIDSTAR-One, 2009). The Officeof the Global AIDS Coordinator (OGAC) defined five strategies to address gender inequity,including:Increasing gender equity in HIV/AIDS activities and services;Reducing violence and coercion;Addressing male norms and behaviors;Increasing women’s legal protection; andIncreasing women’s access to income and productive resources.National Strategies Have Been DevelopedBut Implementation Is LaggingSome countries have also created agendas that address gender issues within the AIDSpandemic. For example, Brazil brought together government agencies, the Ministry of Healthand the Special Secretary for Women’s Policies, along with leaders in women’s rights andhealth promotion to develop an intersectoral policy to address women’s needs in the AIDSpandemic: access to health services; sexual and reproductive health care; social service needs,etc. (Guimaraes de Andrade et al., 2008). Similarly, seven Southern African countries haveWHAT WORKS FOR WOMEN AND GIRLS29
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 and 12: Larry Slutsker, MD, MPHChief, Malar
Page 13 and 14: Table of ContentsList of Abbreviati
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 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
Page 79 and 80: 2010). Transgender men and women al
Page 81 and 82:
confidentiality—violate human rig
Page 83 and 84:
there were major socio-demographic
Page 85 and 86:
and post-intervention were used to
Page 87 and 88:
tent condom use and 1.5 times more
Page 89 and 90:
to their peers, distribute condoms
Page 91 and 92:
Gaps in Programming—Female Sex Wo
Page 93 and 94:
of a sexual relationship with a pri
Page 95 and 96:
than were naltrexone or placebo. HI
Page 97 and 98:
attributed to …swift introduction
Page 99 and 100:
Promising Strategies:5. Sex-segrega
Page 101 and 102:
9. Programming to prevent initiatio
Page 103 and 104:
D’Ivoire, Cuba, Estonia, Indonesi
Page 105 and 106:
Gaps in Programming—Women Prisone
Page 107 and 108:
EVIDENCEPromising Strategies:1. Vol
Page 109 and 110:
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
Page 116 and 117:
especially young women, have their
Page 118 and 119:
negotiation skills and other critic
Page 120 and 121:
to be reached with sex and HIV educ
Page 122 and 123:
What Works—Prevention for Young P
Page 124 and 125:
44% and 100% of participants (Kirby
Page 126 and 127:
tudes, self-efficacy, intentions, a
Page 128 and 129:
as young people in this area had li
Page 130 and 131:
ical validity of the findings that
Page 132 and 133:
study reported having received info
Page 134 and 135:
nancy. Almost 87% of men and 89% of
Page 136 and 137:
last sex, having ever used a condom
Page 138 and 139:
Gap noted, for example, in South Af
Page 140 and 141:
Disaggregated Data Is NeededEffecti
Page 142 and 143:
were also effective in increasing u
Page 145 and 146:
Chapter 6.HIV Testing and Counselin
Page 147 and 148:
Equitable Access to Testing and Cou
Page 149 and 150:
they would come for HIV testing, re
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 200 and 201:
use was positively associated with
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
Page 251 and 252:
3. Efforts are needed to ensure tha
Page 253 and 254:
“There is no doubt that there are
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
Page 273 and 274:
concurrent active TB and HIV infect
Page 275 and 276:
mortality of HIV-positive people re
Page 277 and 278:
in a 65% decline in mortality and t
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 and 304:
factor associated with sexual assau
Page 305 and 306:
What Works—Strengthening the Enab
Page 307 and 308:
worked with women’s groups, radio
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:
Page 323 and 324:
more likely to report having used a
Page 325 and 326:
likely than illiterate women to kno
Page 327 and 328:
of the women surveyed were HIV-posi
Page 329 and 330:
countries extending the fee aboliti
Page 331 and 332:
families and separated from their c
Page 333 and 334:
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
Page 353 and 354:
discriminated unjustly against them
Page 355 and 356:
6. Home-based antiretroviral therap
Page 357 and 358:
12B. Care and Support: Orphans and
Page 359 and 360:
(Thurman et al., 2007). As of 2008,
Page 361 and 362:
care and services were provided, wh
Page 363 and 364:
for treatment can be safely monitor
Page 365 and 366:
A study done in Kenya (year not giv
Page 367 and 368:
ather than a narrowly defined HIV/A
Page 369:
7. Further interventions to provide
Page 372 and 373:
ning providers, antenatal care and
Page 374 and 375:
What Works—Structuring Health Ser
Page 376 and 377:
counts available at primary health
Page 378 and 379:
Pregnant women reported feeling out
Page 380 and 381:
Before implementation of the PMTCT
Page 382 and 383:
accessing PMTCT. An evaluation of 3
Page 384 and 385:
A mathematical model based on TB tr
Page 386 and 387:
1. Improved integration is needed b
Page 388 and 389:
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
Page 399 and 400:
Akabaysh, H. and G. Psacharopoulos.
Page 401 and 402:
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
Page 534:
“What Works compiles a wealth of
show all

What Works for Women and Girls

Create successful ePaper yourself

Delete template?

Save as template?