What Works for Women and Girls

Chapter 3.Prevention for WomenA. Male and Female Condom UseB. Partner ReductionC. Male CircumcisionD. Treating Sexually Transmitted InfectionsIn 2008, more than one million people living with HIV had initiated antiretroviral treatmentyet another 2.7 million individuals became HIV-positive (Sepulveda, 2008). More than halfof new infections were among women, with the largest proportion among young women.If the HIV pandemic is to be contained, primary preventionefforts for women and men based on scientifically-derivedevidence must accompany rapid expansion of antiretroviraltreatment (Stover et al., 2007).Unfortunately, “HIV prevention is neither simple norsimplistic. We must achieve radical behavioural changes—both between individuals and across large groups of at-risk“We cannot treat our way outof this pandemic.”(Merson et al., 2008: 485)people—to reduce incidence” (Coates et al., 2008: 670). Prevention efforts need to be tailored tothe epidemiologic and socio-cultural realities of each country and region, and the specific needswomen face. Behavior change (e.g. condom use, partner reduction, use of clean needles) needsto be promoted through a variety of means, including structural changes, such as changes inlegal and gender norms, and promoting girl’s education and employment opportunities. [SeeChapter 11. Strengthening the Enabling Environment] In some countries in sub-Saharan Africa,where 10–30% of the population is living with HIV, everyone must understand the widespreadrisk for HIV transmission and general interventions for women may be warranted. In othercountries, specific key populations of women have much higher levels of HIV prevalence andneed to be the focus of prevention efforts. [See Chapter 4. Prevention for Key Affected Populations]43