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Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
Given that most HIV transmission occurs through sexual intercourse, it is critical to include a sexual and reproductive health lens in HIV programming. In fact, several European governments have recently revised their international policies, recognizing that HIV/AIDS is a sexual and reproductive health issue (Germain et al., 2009).
All women have the right to decide freely and responsibly on t...
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...
Comprehensive prevention programs that include components such as peer education, medical services, and support groups, can be effective in enabling sex workers to adopt safer sex practices.
Female Sex Workers
5 studies
Gray
II, IIIa, IIIb
HIV testing, STIs, community organizing, community outreach, condom use, condoms, peer education, risk reduction, sex workers
China, India
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...
Prevention and Services for Adolescents and Young People
The interventions in this section should also be viewed in conjunction with other topics where young women are included. Studies with adolescent-specific data are also included in the following sections: %{c:5}; %{c:7}; %{c:11}; %{c:13}; %{c:17}; %{c:21}; and %{c:23}.
HIV among adolescents is a growing concern. UNAIDS notes that adolescent girls and young women are a key population in danger o...
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...
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...
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...
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...
Integrating legal education and services into health care settings can help ensure that women are able to secure their rights.
Advancing Human Rights and Access to Justice for Women and Girls
6 studies
Gray
IIIa, IV, V
HIV-related discrimination, legal assistance, people who use drugs, post-exposure prophylaxis, property rights, rape, violence against women, wills
Kenya, Ukraine, Zambia
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...
Peer support groups can be highly beneficial to women living with HIV.
Women and Girls
11 studies
Gray
IIIa, IIIb, IV, V
PLHA, PMTCT, care, counseling, disclosure, mothers, stigma, support grops, support groups, treatment
Australia, Botswana, India, Kenya, South Africa, Thailand, Uganda, Vietnam, Zambia, Zimbabwe
Providing antiretroviral treatment to people living with HIV can increase HIV prevention behaviors, including condom use.
Staying Healthy and Reducing Transmission
9 studies
Gray
IIIa, IIIb, IV
HAART, condom use, condoms, contraception, risk behavior, sex behavior, treatment
Botswana, Brazil, Côte d'Ivoire, Kenya, Rwanda, South Africa, Tanzania, Uganda, Zambia
Promoting family planning counseling and voluntary contraceptive use as part of routine HIV services (and vice versa) can increase contraceptive use, including dual method use, thus averting unintended pregnancies and transmission of infection among women living with HIV. [See also %{s:75}]
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
8 studies
Gray
I, II, IIIa, IIIb, IV, V
HAART, HIV testing, STIs, condom use, condoms, contraception, counseling, family planning, treatment
Africa, China, Haiti, India, Kenya, South Africa, Thailand, UK, Uganda, Zambia
Early postpartum visits, especially with on-site contraceptive services, can result in increased condom use, contraceptive use, HIV testing and treatment.
Postpartum
6 studies
Gray
IIIa, IIIb
DMPA, HIV testing, PMTCT, condom use, contraception, counseling, family planning, pregnancy
Côte d’Ivoire, Kenya, Russia, Rwanda, Swaziland
Tuberculosis
Tuberculosis is the leading cause of death among people with HIV globally, accounting for almost 25% of all HIV deaths in 2008 (WHO, 2009i). The risk of acquiring TB is 21-34 times greater among people living with HIV than in the general population. In 2010, of 8.8 million incident TB cases worldwide, 1.1 million were among people living with HIV, with an estimated 350,000 deaths (WHO, 2011f). ...
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...
Structuring Health Services to Meet Women’s Needs
The manner in which health services are structured has an impact on HIV prevention, treatment and care services for women and girls. Women often need multiple reproductive health services such as family planning in addition to HIV prevention, treatment and care, but most health care facilities are not structured to provide integrated services. Integration can be defined broadly as 1) co-locatio...
Malaria
Malaria and HIV co-infection is a critical public health problem that may fuel the spread of both diseases in countries where both diseases are endemic. Malaria seems to be more common for people living with HIV and in areas of unstable malaria transmission, people living with HIV face increased risk of death (Mermin et al., 2006). Men and women living with HIV with CD4 counts below 300 cells p...
