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Showing 81 - 100 of 160 Results for "Kenya"

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HIV prevention interventions and treatment programs are needed for transgender people. Studies found that despite high rates of HIV, few prevention interventions are for transgender people. Studies showed that providers refused transgender people any services.
Transgender Women and Men
1 study
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
Interventions are needed to increase community involvement and investment in programs that promote the introduction and utilization of youth-friendly services. A literature review found that in order to increase utilization of youth friendly services, efforts to change community attitudes on adolescent sexuality were needed
Increasing Access to Services
1 study
Further efforts are needed to determine the optimal frequency of testing in order to minimize HIV transmission in a cost-effective way. In some settings, testing for acute infection is warranted which would require testing every three to six months. A study found that 12% of women and 10% of women who had reported testing HIV-negative were found to be seropositive one to two years later. Modeling studies have found that screening one time, annually, can be cost-effective and that yearly testing in a high incidence area found that potential high-risk transmission with high viral load could be reduced by yearly HIV testing.
HIV Testing and Counseling for Women
1 study
Interventions to increase dual protection and dual method use are needed. Studies found that couples are reluctant to use condoms in addition to other contraceptive methods because it may symbolize distrust of a partner, particularly among adolescents.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Concerted efforts are needed to enable adolescents at risk to test confidentially for HIV and be immediately linked to services, with information on where and how to access services. Access to and update of HIV testing and counseling (HTC) by adolescents is significantly lower than for adults. One study found that adolescents who were tested through provider-initiated testing (the WHO standard) had higher loss to follow up if they tested HIV-positive than adolescents who were tested through voluntary testing and counseling (Lamb et al., 2014). HTC must, according to WHO, include consent, confidentiality, counseling, correct test results and connections to treatment, care and prevention services. A recent report found that no data exists for HTC among ages 10 to 14 (All in to End Adolescent AIDS, 2015c). Access to HTC for adolescents who inject drugs is particularly challenging. HTC clients also need counseling on contraception and referral to services.
Increasing Access to Services
1 study
Additional efforts are needed to provide postpartum women with contraception information and methods so they may space or prevent their next pregnancy and use condoms to reduce the likelihood of HIV transmission upon resumption of sexual activity. [See also %{c:15}] Studies found that women were not given contraceptive counseling or contraceptives postpartum and that transport costs restricted their ability to gain access to their contraceptive method of choice. Studies also found an unmet need for postpartum contraception among women living with HIV. Studies found that sexuality and condom use need to be addressed when sexual activity resumes postpartum. Family planning services are most often not provided postpartum in PMTCT programs. Providers and women did not know that clinically well HIV-positive women can use IUDs. Women lacked the full range of available contraception. No study to date has measured pregnancy intention prospectively in an HIV-discordant couple cohort and measured the effect of desired pregnancy on HIV transmission.
Postpartum
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
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 research is needed on infant transmission risks of malaria and/or HIV in pregnant women who have malaria-HIV co-infection.
Malaria
1 study
Women’s right and access to, and control over, an equitable share of marital property and inheritance, including land, needs to be recognized and protected in law and practice.
Advancing Human Rights and Access to Justice for Women and Girls
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 foster the involvement of HIV-positive women and promote cooperation between people living with HIV and AIDS and health care facilities, government and other agencies creating HIV-related programs and policies. Studies found that little cooperation existed between HIV-positive women and health facilities but that efforts have been underway to educate parliamentarians concerning HIV-positive women’s issues.
Promoting Women’s Leadership
1 study
Research is needed on treating anemia, malnutrition and other dietary conditions as well as on optimum micronutrients for patients accessing HAART and for patients prior to accessing treatment. [See also %{c:13}] Increased clarity is needed for providers, caregivers and patients on nutritional needs in settings of marked food insecurity. A Cochrane review which included 16 studies with weak methodologies found that “the evidence-base for the specific effect of micronutrient supplements in children and adults with HIV is limited, but sufficient to make some recommendations for practice. In the absence of population-specific adverse effects, there is no reason to decline similar recommendations for HIV-infected populations” (Irlam et al., 2010: 16).
Women and Girls
1 study
Health service providers must make additional efforts to ensure confidentiality regarding patient’s serostatus. [See also %{c:11}, %{c:15}, %{c:17}, and %{s:67}] Numerous studies found that health workers and the structure of health services, such as services that are only for HIV-positive patients in physically separate parts of hospitals, violate patient confidentiality. In addition, health providers who brought services to women’s homes also violated their confidentiality.
Structuring Health Services to Meet Women’s Needs
1 study
Additional efforts are needed to reduce the risk of TB transmission in high risk, low resource settings. Studies found that significant TB transmission occurs in health care settings, particularly among nurses.
Structuring Health Services to Meet Women’s Needs
1 study
Health care provider training is needed to increase confidentiality and decrease discrimination against sex workers seeking health services. Studies found that significant proportions of female and transgender sex workers did not visit health facilities because of lack of confidentiality, discrimination, and lack of counseling when accessing HIV testing.
Female Sex Workers
1 study
Women who use drugs need access to services for violence against women, dual method use, effective contraception and reproductive health. Studies found high rates of violence, including rape, and lack of access to reproductive health services among women who use drugs. One study found high rates of unintended pregnancies.
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Sex and age disaggregated data is critical to assess which ages are falling through the cracks in data collection. Current HIV data collection masks critically needed data on adolescents ages 10 to 19. For example, a study that disaggregated ages found that loss to follow up for patients aged 10 to 24 was twice as high for ages 15 to 19 than for ages 10 to 14 (Koech et al., 2014).
Increasing Access to Services
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