What Works for Women and Girls

9. Safe Motherhood and Prevention of Vertical Transmission, and Chapter 11F. Strengtheningthe Enabling Environment: Reducing Stigma and Discrimination] Numerous studies foundthat health workers and the structure of health services, such as services that are only forHIV-positive patients in physically separate parts of hospitals, violate patient confidentiality.In addition, health providers who brought services to women’s homes also violatedtheir confidentiality.Gap noted, for example, in Malawi (Chinkonde et al., 2009); Dominican Republic(CHANGE, 2009); a study in five countries—South Africa, Malawi, Swaziland, Lesothoand Tanzania (Greeff et al., 2008); and a review in Argentina, Mexico, Peru, Poland,Botswana, Kenya, Lesotho, Namibia, Nigeria, South Africa and Swaziland (de Bruyn,2006a).9. Health care settings must address the needs of transgender people and reduce barriers toservices. [See Chapter 4F. Prevention for Key Affected Populations: Transgender Women andMen]10. Where abortion is legal, providers should be trained not to discriminate against HIV-positivewomen who want to terminate their pregnancies. A study found that even where abortionis legal, women living with HIV who wanted an abortion experienced discrimination basedon their HIV-positive serostatus.Gap noted, for example, in Vietnam (Nguyen et al., 2008f).11. Interventions are needed to improve quality of HIV treatment and care within healthservices. Studies found that guidelines for counseling were missing from facilities and thatclients were referred for VCT in geographically distant locations based on donor preference.Gap noted, for example, in India (Sogarwal et al., 2008); Vietnam(Nguyen et al., 2008b);South Africa (Orner et al., 2008); and Zambia (HRW, 2007).12. Interventions are needed to screen and treat both male and female sexual partners for STIs.[See Chapter 3D. Prevention for Women: Treating Sexually Transmitted Infections]13. Efforts are needed to ensure that providing family-focused HIV care within maternal andchild health programs doesn’t discourage men from seeking HIV services. A study foundthat men were excluded from PMTCT programs.Gap noted, for example, in Côte d’Ivoire (Tonwe-Gold et al., 2009).14. Policy guidelines need to specify how contraception should be addressed in HIV prevention,treatment and care. [See Chapter 8. Meeting the Sexual and Reproductive Health Needs ofWomen Living With HIV]WHAT WORKS FOR WOMEN AND GIRLS385