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Showing 41 - 60 of 92 Results for "India"

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Interventions are needed to bring men and women, youth and parents together to focus on the positive aspects of sexuality. Studies found sexual education focuses on disease, burdening girls with prohibitions, yet neglecting boys.
Mitigating Risk
1 study
Evidence-based interventions are needed for adolescents who inject drugs. "There is a pronounced lack of data on young women who use or inject drugs, a key subpopulation with complex needs" (Larney et al., 2015: S106), despite high rates of HIV. In addition, “it is imperative that interventions not rely on law enforcement, but instead provide low-threshold, voluntary services, shelter and support..." (Conner, 2015: para 1).
Increasing Access to Services
1 study
Interventions to increase the knowledge of people living with HIV — especially women — regarding their rights and provision of resources for them to access and claim these rights need to be scaled up. Studies found that women had insufficient knowledge of their legal rights and no resources to claim their legal rights.
Advancing Human Rights and Access to Justice for Women and Girls
1 study
Interventions are needed to reduce homophobia, which may lead MSM to have partnerships with women. Studies found that homosexuality was heavily stigmatized and that gender norms pressured MSM to marry and have families.
Partner Reduction
1 study
Interventions are needed to provide sex workers with greater control and access over money and resources, which can have a positive impact on HIV-related risk reduction. Studies found that if sex workers had access to resources under their control, women were more likely to negotiate condom use and that female sex workers in debt were less likely to report condom use.
Female Sex Workers
1 study
Well-functioning laboratory systems are needed to measure viral load via PCR to assess effectiveness of treatment. However, adequate clinical results can also be cost-effective and meet patient needs. A study in sub-Saharan Africa found that more than half of test results for viral load were invalid or inaccurate. A review done in low and middle-income countries showed that lack of routine virologic monitoring in resource limited ART programs led to the development of cross-resistance to the NRTI component of second-line treatment. Even where virological monitoring is available and demonstrates virological failure, delayed switching of patients to alternative antiretroviral therapy regimens occurs.
Provision and Access
1 study
Additional efforts are needed to improve information and counseling about HIV during ANC to ensure that pregnant women and their sexual partners have adequate information. Studies found significant numbers of pregnant women received HIV tests with no counseling and reported that HIV testing was a mandatory part of their antenatal care. Studies also found that HIV-positive women feared transmitting HIV to their babies through casual contact. Studies found some providers assured women that treatment guaranteed that there would be no vertical transmission. In addition, studies found that some couples erroneously believed that sex during pregnancy causes miscarriages. Studies have also found that women who have tested HIV-negative at their first antenatal visit had seroconverted to HIV-positive by 12 months following delivery.
Antenatal Care - Testing and Counseling
1 study
Clear policies and legislation supporting access to information and sexuality education are needed to reduce the risk of HIV transmission among young people. Studies found that sex education was lacking, particularly among street children who are at high risk of HIV acquisition.
Mitigating Risk
1 study
Interventions are needed for adolescents to reduce acceptance of gender-based violence and stigma against people living with HIV. A study found high rates of stigma among adolescent girls. A nationally representative survey of youth in Tanzania found high rates of acceptance for a husband to beat his wife if she goes out without telling him; argues with him; burns food; or refuses to have sex with him. In 35% of countries with data available, more than 50% of women and men report discriminatory attitudes toward people living with HIV (UNAIDS, 2015e).
Mitigating Risk
1 study
Enforcement of standard protocols is needed to reduce the risk of provider coercion in HIV testing, particularly in provider-initiated testing and counseling. Studies found that significant numbers of women reported that they could not refuse an HIV test or that HIV testing was mandatory.
HIV Testing and Counseling for Women
1 study
Further interventions are needed to reduce stigma and discrimination against women, specifically, who are at high risk or living with HIV. [See also %{s:45}] Studies found that women and girls are highly stigmatized if they test positive for HIV. Stigma impacts the HIV-positive woman, herself, as well as her children, her siblings and her family. Some providers also discriminate against those living with HIV.
Reducing Stigma and Discrimination
1 study
Further interventions to provide support programs, including counseling, are needed for AIDS-orphaned children and their caregivers to combat depression, social isolation and stigma. Studies found that AIDS orphans reported insufficient food, depression and stigma.
Orphans and Vulnerable Children
1 study
Interventions are needed to scale up and increase access to methadone and buprenorphine—effective agonist therapy for the treatment of drug dependence, as well as needle exchange/distribution programs. Studies found only tiny fractions of those who need maintenance medication had access. A study found that user fees for methadone maintenance programs presented a barrier to access to care. In places where no needle exchange programs are operating, high rates of borrowing of used syringes occur, placing IDUs at high risk of acquiring HIV.
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Interventions are needed to provide women and their partners with a better understanding of the risk of acquiring HIV through sexual practices as well as through injecting drug use (IOM, 2007). Studies found low rates of condom use despite sexual relationships with IDUs, lack of knowledge by IDUs on sexual and reproductive health and lack of access to clean needles. A study also found that many MSM and male intravenous drug users avoid disclosure of their sexual and drug risk behavior along with their HIV status due to stigma and gender norms and that most wives reported violence and little or no condom use. HIV-positive male IDUs want help with disclosure to their wives. Most wives of IDUs reported only a single lifetime sexual partner and only a tiny proportion reported injecting drug use.
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Laws and practices that obstruct adolescents’ access to services, such as parental consent requirements, age, and marital status requirements, must be aligned with the actual behavior of adolescents. Studies found that legal requirements restricted adolescents from getting tested for HIV even if they were sexually active and at risk for HIV. "There is a strong evidence base that the stigma, discrimination and criminalization affecting adolescent key populations aged 10 to 17 is intensified due to domestic and international legal constructs that rely on law-enforcement based interventions dependent upon arrests, pre-trial detention, incarceration and compulsory ‘rehabilitation’ in institutional placements," particularly among adolescents who sell sex or inject drugs (Conner, 2015: para 1).
Increasing Access to Services
1 study
Barriers such as cost of medications, stigma, long clinic waits, lack of food, and child-care responsibilities, among others, may discourage women living with HIV from accessing antiretroviral therapy. A study found that patients who were living with HIV but did not access antiretroviral therapy were twice as likely as patients on antiretroviral therapy to report not having enough food to take with treatment as a concern, in addition to concerns about cost barriers. Another study found that cost of ARVs, with direct out of pocket payment at point of care delivery decreased access to ARVs. Another study found transport costs and waiting time a barrier to access to treatment. Increased efforts are needed so that those in pre-ART care understand that HIV can be transmitted prior to ART eligibility.
Provision and Access
1 study
Ongoing surveillance is needed to assess the impact of cART on infants (both HIV-negative and HIV-positive) exposed in utero and during breastfeeding. A recent US study had encouraging results that among ARV-exposed uninfected children, no learning issues were noted (Nozyce et al., 2014) and another US-based study found no increased risk for infants exposed to ART (Phiri et al., 2014). A pilot ART registry in Africa has been launched
Antenatal Care - Treatment
1 study
Strategies, including legal strategies, are needed to empower pregnant women living with HIV to ask questions, be properly informed and to challenge stigma, disrespect and abuse. [See also %{s:67}] Consequences for violating patient confidentiality, redress for women with HIV facing discrimination in facilities, and stigma reduction efforts are needed to increase adherence to cART, prior to, during and post pregnancy, including training for providers.
Antenatal Care - Treatment
1 study
Further interventions are needed to provide support (physical, psychological, technological, economic) to patients and caregivers. Studies showed that patients and caregivers have many physical, psychological, and economic unmet needs, with high rates of depression and poverty, and in some cases, rely on their young children or relatives to provide care with no outside support. Some studies show that caregivers suffer from stigma attached to caring for someone HIV-positive. [See also %{s:67}] Some studies showed that women have a lower quality of life than men. A study in a high HIV prevalence area showed that for women, lack of control in sexual decision-making was associated with depression, while for men, intergenerational sex was associated with depression.
Women and Girls
1 study
Efforts are needed to reform laws that criminalize drug use and/or drug possession for personal use and to eliminate compulsory drug detention and instead, provide people who use drugs with access to HIV and health services, including harm reduction, and voluntary, effective evidence-based drug dependency treatment. Detention centers are administered by police, military or other national government public security authorities and operate outside the formal criminal justice system with detainees held without trial or right of appeal; those detained are not allowed to leave voluntarily (Wolfe, 2012). Studies found that female IDU were not given reproductive health services, including PMTCT services in compulsory detention and/or prison settings. Detoxification programs were substandard and ineffective. Despite high rates of HIV, antiretroviral treatment is largely unavailable in compulsory drug detention centers. IDUs who have started antiretroviral treatment should be able to continue treatment in prison with access to medical supervision. [See also %{s:11}]
Advancing Human Rights and Access to Justice for Women and Girls
1 study