What Works for Women and Girls

Within each intervention, studies are listed in order of Gray Scale, with the strongest studiesfirst (Gray I, II, III, etc.) and abstracts last. In some chapters, such as Chapter 11 that discussesthe enabling environment, where structural interventions cannot be linked as directly withimpact on HIV infection, the authors, based on comments from reviewers, exercised judgmenton “what works,” and promising interventions.Where an intervention could have both positive outcomes for women and negative outcomes,this was noted. For example: microcredit can reduce HIV-related risk behaviors (Pronyk et al.,2008), but it could also increase violence against women if the intervention is not carefullydesigned and appropriate to local context (Schuler et al., 1998; Gupta et al., 2008a).In the course of reviewing the literature to generate “what works,” a number of gapsemerged from the literature.Gaps: programs that need to be implemented to meet women’s needs related to the HIV/AIDS pandemic but did not exist with evaluated data.However, no search mechanism was possible to generate gaps. Where gaps emerged in theliterature, these were noted. Evidence of a gap is not exhaustive but illustrative, providing afew examples. Evidence of a problem—such as the prevalence of violence against women—isdescribed in the introduction to each section.No attempt has been made, as is done in the Cochrane Collaboration, to reanalyze the dataon interventions. For some interventions, many large-scale studies including some randomizedcontrolled trials are listed; for other interventions, supporting research is available fromonly one study using a small sample size. With review articles, the original studies are citedas reported in the review. An attempt has been made to use the original studies and primarysources; but where the original could not be located, the authors relied on review articles.Evidence from review articles is noted (e.g., x cited in y).When possible, objective measures such as a decrease in HIV seroconversion rates ora decrease in rates of other STIs are used as evidence. If these measures are not available,evidence is drawn from studies using self-reported behavior changes such as condom use,monogamy, sexual abstinence and a decrease in number of sex partners. This document doesnot address fully the issues of cost, equity, or sustainability.Where possible, we have included sex disaggregated data. Where an interventions is relevantfor both men and women, but does not have sex disaggregated data, it is included. Forthe chapters that are heavily medical interventions, such as those related to treatment andco-infection, only interventions that apply to women are included in the compendium.In all, the evidence for What Works and Promising interventions includes 455 studies.40 CHAPTER 2 METHODOLOGY