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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.
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Adequate supply planning and secure funding are needed to avoid ARV stock-outs and use of obsolete medications. "As ART cannot be interrupted without risk of development of drug resistance – and hence worse survival – people on ART need an uninterrupted supply…" (WHO, 2014a: 32). The Coordinated Procurement Planning Initiative, which monitors the supply of ARVs in 22 countries, found that at any point half of these countries were at high risk of stock out (WHO, 2014a). Between 30% and 45% of low- and middle-income countries have annually reported stock outs in recent years (WHO, 2014a). Studies in multiple sub-Saharan African countries report stock shortages and stock outs as major risk factors for treatment interruption. "….Models of supply chain management need to be directly tied to health outcomes to ensure that the priority is improving health rather then reducing costs" (Ying et al., 2014, para 17).
Provision and Access
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Prevention for Women
Male and Female Condom Use
Partner Reduction
Voluntary Medical Male Circumcision
Treating Sexually Transmitted Infections (STIs)
Treatment as Prevention
Prevention for Key Affected Populations
Female Sex Workers
Women Who Use Drugs and Female Partners of Men Who Use Drugs
Women Prisoners and Female Partners of Male Prisoners
Women and Girls in Complex Emergencies
Migrant Women and Female Partners of Male Migrants
Transgender Women and Men
Women Who Have Sex With Women (WSW)
Prevention and Services for Adolescents and Young People
Mitigating Risk
Increasing Access to Services
HIV Testing and Counseling for Women
Treatment
Provision and Access
Adherence and Support
Staying Healthy and Reducing Transmission
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
Safe Motherhood and Prevention of Vertical Transmission
Preventing Unintended Pregnancies
Pre-Conception
Antenatal Care - Testing and Counseling
Antenatal Care - Treatment
Delivery
Postpartum
Preventing, Detecting and Treating Critical Co-Infections
Tuberculosis
Malaria
Hepatitis
Strengthening the Enabling Environment
Transforming Gender Norms
Addressing Violence Against Women
Advancing Human Rights and Access to Justice for Women and Girls
Promoting Women’s Employment, Income and Livelihood Opportunities
Advancing Education
Reducing Stigma and Discrimination
Promoting Women’s Leadership
Care and Support
Women and Girls
Orphans and Vulnerable Children
Structuring Health Services to Meet Women’s Needs