What Works for Women and Girls

one HIV education program by trained counselors that emphasized negotiation skills;practice using male and female condoms; and education about HIV transmission, andsafer sex. VCT was offered. The intervention provided a booster session after one monthand results were collected after two months. Of the women (aged 17–47, mean age of28), 60% suspected their husbands of having other sexual partners. Initial condomusage was low: only one woman reported using condoms consistently and only 40(10%) reported using condoms at last sex. After two months, consistent condom usagehad increased to 48.5% while 87% of women had used condoms during their last sexualencounter. Overall, feelings of self-efficacy increased: the proportion of women who feltthat they had control over condom usage increased from 47% to 72%, and the proportionwho felt that they could refuse sex without a condom increased from 23% to 57%(Callegari et al., 2008). (Gray III) (condom use, marriage, education, Zimbabwe)6. Promoting acceptability of condom use by both women and men as the norm in sexualintercourse, rather than just for use by sex workers and their clients, can decrease nationalHIV prevalence rates, including for women.In association with to a national multi-year campaign, HIV prevalence in Uganda fellfrom 15% in 1991 to 5% in 2001. Among those who had had sex in the past four weeks,the proportion of women using condoms increased from 0% in 1989 to 8% in 1995;among men, it increased from 1% to 11%. Among unmarried women, the proportionusing the condom increased from 1% to 14% and among unmarried men, it rose from2% to 22%. From 1995–2000, condom use increased from 5% to 25% among womenaged 15–17 and from 3% to 12% for women ages 18–19. Among sexually active men from15 to 17, condom use rose from 16% in 1995 to 55% in 2000, and among those aged18 and 19, it increased from 20% to 33%. Among unmarried sexually active women,condom use increased from almost nothing to 37% by 2000. Condom use rose significantlyamong unmarried sexually active men from 29% in 1995 to 57% in 2000 (Singhet al., 2003a). (Gray III) (condoms, Uganda)A qualitative study conducted from 2001 to 2003 in rural and urban Ethiopia, Tanzania,and Zambia with structured text analysis of more than 650 interviews and 80 focus groupdiscussions and quantitative analysis of 400 survey respondents found that preventivemethods such as condom use are hampered when condom use was considered an indicationof “HIV infection or immoral behaviors and are thus stigmatized” (Nyblade et al.,2003: 2). In all three countries most respondents think that women are to be blamed foracquiring HIV, particularly if this behavior is associated with “immoral sexual behavior.“Gender-based power relationships also play a more direct role in the blame womenface,” (p. 26) as women’s transgressions tend to be more severely regarded than men’s(Nyblade et al., 2003) (Gray III) (condoms, stigma, Ethiopia, Tanzania, Zambia)A survey of 209 women affected by HIV/AIDS and in-depth interviews with 59 womenin Zimbabwe found that women perceived condoms for use only with sex workers. “...Myhusband and I never used condoms. We thought they were only for prostitutes” (Feldmanand Masophere, 2003: 165). (Gray III) (condoms, marriage, sexual partners, Uganda)58 CHAPTER 3 PREVENTION FOR WOMEN