What Works for Women and Girls

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15. Additional efforts are needed to provide postpartum women with contraception informationand methods so they may space or prevent their next pregnancy. [See Chapter 9E. SafeMotherhood and Prevention of Vertical Transmission: Postpartum and Chapter 8. Meeting theSexual and Reproductive Health Needs of Women Living With HIV]16. Additional efforts are needed to reduce the risk of TB transmission in high risk, lowresource settings. Studies found that significant TB transmission occurs in health caresettings, particularly among nurses.Gap noted, for example, in a global review (Joshi et al., 2006); Kenya (Galgalo et al.,2008); South Africa (Naidoo and Jinabhai, 2006); Romania (Sotgiu et al., 2008); Russia(Dimitrova et al., 2005); South Korea (Jo et al., 2008).386 CHAPTER 13 STRUCTURING HEALTH SERVICES TO MEET WOMEN’S NEEDS
Glossary of Terms 1Adolescents are individuals who are between puberty and the completion of physical growth,roughly from 11 to 19 years of age.Adolescent/Youth-Friendly Services refers to services that are: Available, accessible andequitable, so that the core interventions for HIV are provided in ways that all young people,including those most at risk of HIV, can use them. Acceptable; with health and related stafftrained to provide services for young people with dignity and respect, also ensuring privacy andconfidentiality; Appropriate and effective, so that the necessary skills, equipment and suppliesare available to provide quality services for HIV prevention, treatment, care and support foryoung people.Antiretroviral Therapy (ARV) consists of the use of at least three antiretroviral (ARV) drugs tomaximally suppress the HIV virus and stop the progression of HIV disease. Huge reductionshave been seen in rates of death and suffering when use is made of a potent ARV regimen.Behavior Change Communication is an interactive process with communities (as integratedwith an overall program) to develop tailored messages and approaches using a varietyof communication channels to develop positive behaviors; promote and sustain individual,community and societal behavior change; and maintain appropriate behaviors.Combination Antiretroviral Treatment (cART) refers to a patient taking two or more antiretroviraldrugs at a time.CD4 Count: CD4 cells are a type of lymphocyte (white blood cell) and are an important part ofthe immune system. HIV most often infects CD4 cells and over time, the number of CD4 cellsdrops, signaling that the immune system is becoming weak.1 For additional SRH-related term defi nitions, please see Center for Communication, 2007.387
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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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“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
Page 337 and 338: 6. Support groups for people living
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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
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Page 351 and 352: 2. Peer support groups can be highl
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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
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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 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
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Gogna, M., M. Pechny, I. Ibarlucia,
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Grimes, D., J. Benson, S. Singh, M.
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Haddock, S., K. Hardee, J. Gay, P.
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Harries, A., R. Chimizi and R. Zach
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Innes, C, S Charalambous, M Felix,
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Islander, F. 2006. Plenary Presenta
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Jewkes, R. 2007. “Comprehensive R
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Kadando, R., J. Lyavala and M. Mulo
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Karnell, A.P., P.K. Cupp, R.S. Zimm
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Luke, N. and K. Kurz. 2002. Cross-g
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Prevent HIV Mother-to-Child Transmi
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“What Works compiles a wealth of
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