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Antenatal Care - Testing and Counseling
In 2007, only an estimated 18% of pregnant women were offered HIV tests (ITPC, 2009). "The purpose of antenatal VCT should be to help a woman prepare for a possible positive HIV diagnosis [and] to provide her with information about PMTCT options" (De Bruyn and Paxton, 2005: 145). In developing country settings, between eight and ten percent of women report having received PMTCT interventions (P...
Female Sex Workers
Sex workers, whose work involves sexual relations with multiple partners, are a key group of women who need access to comprehensive sexual health services, including HIV prevention, treatment and care. Programs that enhance sex workers' ability to use condoms are also vitally important (Lafort et al., 2010; Pisani, 2008). Unprotected sex with multiple partners puts sex workers at risk of HIV ac...
Delivery
For women with HIV, there is little evaluated evidence available regarding delivery options, though research has shown that by substantially lowering viral load, HAART can diminish the advantage of a cesarean section in reducing perinatal transmission (Sharma and Spearman, 2008; Rongkavilit and Asmar, 2011; Coovadia and Newell, 2012). Cesarean sections are not always available or safe in many d...
Promoting Women’s Leadership
Strengthening womens rights and health NGOs and supporting women leaders who can mobilize in-country efforts in the interests of women and girls affected by HIV is critical. "...It is not enough for programmes and strategies to be designed on behalf of those living with AIDS; we have much to learn from their experiences, and how they struggle to negotiate being positive and maintaining sex live...
Advancing Human Rights and Access to Justice for Women and Girls
*Respecting, protecting and fulfilling womens rights, particularly the rights of the most marginalized women, is increasingly understood as fundamental to an effective HIV response. Laws reflecting unequal gender norms that discriminate against women may limit their ability to protect themselves from HIV infection. In many countries where women are most at risk for acquiring HIV, laws to protec...
Prevention for Key Affected Populations
Some women are particularly at risk of HIV acquisition due to their occupational exposures, their behavior or that of their sexual partner(s), their sexual identity and/or their sexual orientation. These women live in particularly challenging situations and have high vulnerability to HIV infection and low access to HIV services (Beyrer et al., 2011). UNAIDS defines key populations as those most...
Safe Motherhood and Prevention of Vertical Transmission
Three vital components of AIDS programming for women living with HIV are ensuring safe motherhood through access to health care before, during and after pregnancy and childbirth; ensuring access to treatment; and ensuring access to services to prevent vertical HIV transmission. While much progress has been made in reducing vertical transmission, more could be done. A recent demographic model sh...
Strengthening the Enabling Environment
In order for HIV and/or AIDS interventions for women and girls to succeed, factors beyond the health services need to be addressed through multisectoral interventions. These environmental factors include gender norms that guide how girls and boys grow to be women and men, legal norms that confer or withhold rights for women and girls, access to education, income, levels of tolerance for violenc...
Treatment
Antiretroviral therapy has transformed HIV to a chronic - though still incurable - virus requiring ongoing therapy and strict adherence to treatment. For the most part, virally suppressed people living with HIV today have no difference in life expectancy than demographically similar HIV-negative individuals (Sabin, 2013 cited in Justice and Falutz, 2014; Maman et al. 2012a).
This section does ...
Addressing Violence Against Women
Violence, in addition to being a human rights violation, has been clearly demonstrated as a risk factor for HIV (WHO, 2010f; Stephenson, 2007; Jewkes et al., 2006a; Manfrin-Ledet and Porche, 2003; Dunkle et al., 2004; Quigley et al., 2000b; Silverman et al., 2008). Analysis of DHS data in Rwanda showed that currently married women with few, if any, sexual risk factors for HIV but who have exper...
Adherence and Support
"I'm 18 years, you are telling me drugs for life?" --Woman living with HIV in Uganda (Hsieh, 2013: 11)Treatment adherence is necessary to continually suppress the virus. Adherence to ART leads to better virological outcomes, prevents disease progression and improves survival (Nachega et al., 2010a; Nachega et al., 2010c). Conversely, inadequate adherence leads to drug resistance, which can then...
Antenatal Care - Treatment
Antiretroviral treatment (ART) for women living with HIV is vital to ensuring safe motherhood and reducing vertical transmission. But not all pregnant women access treatment. For women in high-income countries where access to triple therapy during pregnancy has been the standard of care and is near universal, rates of vertical HIV transmission are as low as 0.4%, for example, in Canada (Forbes ...
Reducing Stigma and Discrimination
"...Three decades into the epidemic, stigmatization remains a core feature of the patient experience of HIV/AIDS" (Gilbert and Walker, 2010: 144). Or as one woman living with HIV in Thailand put it: "It does not matter how many thousand people have HIV/AIDS... I would say that only zero percent will accept people living with HIV/AIDS" (Liamputtong et al., 2009: 865). Stigma and discrimination h...
Women Who Use Drugs and Female Partners of Men Who Use Drugs
Despite injecting drug use being a main driver of the HIV epidemic in many parts of the world, evaluated tailored responses for women who use drugs or for female sexual partners of men who use drugs have not matched the needs of this population. Injecting drug use is globally widespread and the main driver of the HIV epidemic in some parts of the world. Approximately 16 million people in 148 co...
Staying Healthy and Reducing Transmission
"Me, I try to tell the man that, 'In this house we have been found with this problem. We should accept it. I should not point a finger at you. You, too, should not point a finger at me. Just buy your protection.' And so, little by little what he does now is different from what he did in the past." --Malawi woman living with HIV (Mkandawire-Valhmu and Stephens, 2010: 691)Successfully treated peo...
Promoting Women’s Employment, Income and Livelihood Opportunities
Women's economic dependence on men and unequal access to resources, including land and income-generating opportunities, increases the likelihood of women and girls engaging in a variety of unsafe sexual behaviors including transactional sex, coerced sex, earlier sexual debut, and multiple sexual partners, and thus increases their risk of becoming infected with HIV (Gillespie and Kadiyala, 2005)...
Provision and Access
Antiretroviral therapy has been successfully administered in a range of situations with adherence, retention, and clinical outcomes similar to those achieved in resource-rich countries. Increasing provision and access, grounded in human rights based approaches, across all populations is critical to continuing that success.
"I cook scones for my children and do not get tired. I do chores, pound...
Mitigating Risk
Young People Need Information
"I want to know if I can have a boyfriend because every time I ask my mum she tells me not to. I would also love to learn about safe sex and safe motherhood (14 year old adolescent girl living with HIV, Zambia cited in Mburu et al., 2013).
A review of the global literature on adolescents found that "there is a significant unmet need for information, education, an...
Hepatitis
Hepatitis is an inflammation of the liver, most often caused by a virus. The most common types of viruses are hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. "Hepatitis A and E are typically caused by ingestion of contaminated food or water and are not known to cause chronic liver disease" (WHO, 2010c). A vaccine exists for hepatitis A and a meta-analysis of eight studies fr...
Orphans and Vulnerable Children
In some countries, three generations have been affected by HIV (Oladokun et al., 2010a). Even as incidence declines, there is a clear need to continue meeting the needs of children orphaned and made vulnerable due to HIV and AIDS.
"Nowadays there is a deadly disease called AIDS. This disease is only treated but not cured. Anyone can be infected -- male, female, young, old, rich, poor, educated...