What Works for Women and Girls

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Community-based Care is holistic care, treatment, and psychological support for HIV andAIDS patients and their families provided by relatives, friends or community volunteers fromnon-governmental organizations who are in turn supported to a greater or lesser extent byhealth professionals, mostly nurses.Directly Observed Therapy (DOT) is a strategy devised to help clients adhere to Tuberculosis(TB) treatment. A TB case manager or another designated person watches the TB client swalloweach dose of the prescribed drugs. The goal of DOT is to ensure that clients with active tuberculosisreceive and adequately complete their treatment to minimize the risk of spreading thedisease to others and developing drug-resistant TB.Disclosure refers to revealing one’s HIV status after testing positive.Extensively-Drug Resistant Tuberculosis (XDR-TB) occurs when TB becomes resistant to bothfirst- and second-line drugs as result of misuse or mismanagement. XDR-TB is due to bacteriathat are resistant to any fluoroquinolone, and at least one of three injectable second-line drugs(capreomycin, kanamycin and amikacin), in addition to isoniazid and rifampicin .Exclusive Breastfeeding refers to feeding infants only breast milk, without any additional foodor drink, including water, for at least 6 months after birth.Gender-based Violence refers to violence on the basis of one’s gender.Gender Equality means equal treatment of women and men in laws and policies, and equalaccess to resources and services within families, communities and society at large.Gender Equity is the process of being fair to women and men. To ensure fairness, measuresmust often be available to compensate for historical and social disadvantages that preventwomen and men from otherwise operating on a level playing field. Equity leads to equality.Harm Reduction refers to policies, programs and practices that aim to reduce the harms associatedwith the use of psychoactive drugs in people unable or unwilling to stop. The definingfeatures are the focus on the prevention of harm, rather than on the prevention of drug useitself, and the focus on people who continue to use drugs.HIV ELISA Test is a rapid immunochemical test that uses an enzyme to test for HIV antibody.If antibodies to HIV are present (positive), the test is usually repeated to confirm the diagnosis.ELISA stands for “enzyme-linked immunosorbent assay.”Highly Active Antiretroviral Therapy (HAART) is a combination of three or more antiretroviraldrugs consisting of one or more PIs or one NNRTI or the NRTIs—Abacavir or Tenofovir, or anintegrase or an entry inhibitor.388 GLOSSARY OF TERMS
HIV Testing refers to immunologic tests for the identification of HIV antibodies.Home-based Care is the care of persons living with HIV infection and AIDS in their homes. Thisinvolves the provision of comprehensive care by community members, NGOs, Communitybasedorganizations (CBOs), health workers and family members. This type of care is complementaryto the existing health care services.Human rights are the rights to which one is just entitled as a human being.Injecting Drug Users (IDU) refers to those who inject drugs into their bodies. The mostcommonly injected drugs are heroin and other opiates, cocaine and amphetamines.Intermittent Preventive Treatment (IPT) refers to using the anti-malarial drug SulfudoxinePyrimenthamine (SP) as a proactive and effective intervention that prevents and controls theeffects of malaria on mothers and their unborn children.Internally Displaced Persons (IDP) refers to those who are displaced within their own nationalborders and are therefore not covered by international refugee law.Legal Rights are rights that exist under the rules of legal systems.Lesbians are women who are sexually attracted to other women. Lesbians prefer intimate relationshipswith women.LGBT is an acronym for “lesbian, gay, bisexual and transgender. LGBT can refer to individualpeople or a community of people. Lesbian: A homosexual woman. Gay: A homosexual person;can refer to both men and women, but more often to men. Bisexual: A person who is attractedto men and women. Transgender: An umbrella term for people whose gender presentation oridentity is different from their biological sex—for example, a biological male who appears oridentifies at least in some respects as female, or a biological female who appears or identifiesin at least some respects as male.Mass media are instruments or technological means of communication that reach largenumbers of people with a common message; includes radio, television, newspapers, magazines,billboards, banners, posters, store windows and match covers.Men Who Have Sex With Men (MSM) refers to all men who have sex with other men, regardlessof how they identify themselves gay, bisexual, or heterosexual.Microcredit programs extend small loans to very poor people for self-employment projects thatgenerate income, allowing them to care for themselves and their families.WHAT WORKS FOR WOMEN AND GIRLS389
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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
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6. Support groups for people living
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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
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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 388 and 389: 15. Additional efforts are needed t
Page 392 and 393: Microfinance is often defined as fi
Page 394 and 395: Sexuality is a central aspect of be
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Grimes, D., J. Benson, S. Singh, M.
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“What Works compiles a wealth of
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