Gender Inequality and its Impact on Women&#x27;s Risk of HIV and Access to HIV Services

Gender inequality poses significant barriers to women's ability to prevent and manage HIV infection. Women face higher biological and social vulnerability to HIV due to unequal power dynamics and lack of control over sexual decision making. Violence against women and girls is widespread in many parts of the world, increasing vulnerability. Fear of violence also prevents women from accessing HIV testing, treatment and support services. Addressing gender inequality is critical to effectively respond to the HIV/AIDS epidemic.

Gender inequality and its impact on women’s risk of HIV and access to HIV services Dr Jantine Jacobi Team Leader, Women, Girls and Gender Equality Director, Global Coalition on Women and AIDS UNAIDS [email_address]

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Young women are particular vulnerable to HIV infection young women are particular vulnerable to HIV infection HIV infection rates, by age group in selected countries Women 15-19 (%) Men 15-19 (%) Women 20-24 (%) Men 20-24 (%) Botswana 5.0 2.4 16.0 7.4 Kenya 3.5 1.0 7.4 1.9 South Africa 6.7 2.5 21.1 5.1 HIV infection rates, by age group in selected countries Women 15-19 (%) Men 15-19 (%) Women 20-24 (%) Men 20-24 (%) Botswana 5.0 2.4 16.0 7.4 Kenya 3.5 1.0 7.4 1.9 South Africa 6.7 2.5 21.1 5.1 Source : Global Report, 2008, UNAIDS 5.1 21.1 2.5 6.7 South Africa 1.9 7.4 1.0 3.5 Kenya 7.4 16.0 2.4 5.0 Botswana Men 20-24 (%) Women 20-24 (%) Men 15-19 (%) Women 15-19 (%) HIV infection rates, by age group in selected countries

HIV infections detected in Papua New Guinea, by age, 1987 – 2006 Source : Papua New Guinea National AIDS Council and Department of Health. Figure 29 0 500 1000 1500 2000 2500 3000 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Over 60 Unknown Male Female Sex not Stated Number Age group

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PMTCT increase: 43% in 2008 from 15% in 2005 However, in 2008, only 24% women testing positive for HIV at ante-natal clinics were assessed for their own eligibility for ARVs. Source : UNAIDS, UNICEF & WHO, 2008; data provided by countries. 4.13

Source : UNGASS Country Progress Reports 2008. 83% of countries report having women included as a specific “sector“ in their multisectoral strategic framework Only 53% report having a budget attached to programmes which address women’s issues Caribbean (12) East Asia (3) Eastern Europe and Central Asia (16) Latin America (19) Middle East (4) North America (1) Oceania (7) South and South- East Asia (13) Sub- Saharan Africa (41) Western and Central Europe (14) 0 20 40 60 80 100 Percentage of countries (%) Women are addressed as a specific component of multisectoral HIV strategy (Number of countries reporting) Women are addressed as a specific component of multisectoral HIV strategy with a budget

HIV disproportionately affects women, who make up nearly half of those infected globally. Women are more vulnerable to HIV infection due to physical differences and complications during childbirth. In the US, most new HIV cases among women occur in 10 states, with nearly half in New York, Florida, Texas, California, and New Jersey. The largest age group of infected women is 25-34 years old. While HIV cannot be cured, treatment involves combinations of antiretroviral drugs that suppress the virus and stop disease progression.

Women and HIV

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Global Medical Cures™ | HIV Among Women

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This document discusses women's disparities in access to HIV mitigation in three sub-Saharan African countries - Swaziland, Kenya, and Cameroon. It hypothesizes that women with higher levels of education will have greater access to HIV prevention and treatment services. The analysis found a strong correlation between increased educational attainment and HIV testing and access to test results for women in the three countries. However, overall testing rates remain low, likely due to social stigma rather than lack of accessibility. Women face greater HIV risk due to cultural practices like polygamy, child marriage, and lack of autonomy over sexual and reproductive health decisions.

2008 Unaids Report Ssa Stats Summary

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Sub-Saharan Africa remains the region most heavily affected by HIV/AIDS, accounting for two-thirds of people living with HIV and three-quarters of AIDS deaths worldwide in 2007. Heterosexual sex is the main driver of the epidemic, though sex work, injection drug use, and sex between men are also significant factors in some countries. While many epidemics appear stable, HIV prevalence continues to grow in southern Africa and Mozambique's central and southern provinces in particular. Some countries like Zimbabwe, South Africa, and Botswana are seeing declines in HIV prevalence among youth.

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INA Māori Women 2009

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Silence no more m. pala

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Marama Pala Ngātiawa ki Kapiti, Kaiwhakahaere/Executive Director (INA), an HIV positive Māori woman, plans to promote the visibility of Indigenous People’s HIV and AIDS issues; to increase the support from local, regional and international Indigenous people. “History shows us that HIV is not openly discussed at Indigenous conferences. It’s an issue that gets left off the agenda.” says Marama Pala, “Even though Indigenous Peoples experience high rates of HIV and AIDS, it needs to be made visible at all Indigenous conferences and gatherings. It’s time that all Indigenous peoples became aware that we are a marginalised community vulnerable to HIV” Indigenous people globally continue to under represented in HIV prevention, research, policy and funding initiatives, and this contributes to ongoing HIV disparities and resource allocation. The stigma within Indigenous communities further marginalises this health issue, making it difficult to discuss. “I hope am able to stress the importance of HIV, speaking openly about HIV and facing the stigma of HIV with my Indigenous and aboriginal brothers and sisters” urges Marama. “Silence No More...for the sake of my HIV negative children; we need to eliminate stigma and discrimination and make our people safe.”

HIV compromises the immune system, leading to AIDS. Early HIV symptoms include fever and swollen glands. Late stage AIDS symptoms include weight loss, fatigue, and infections. HIV is transmitted through contact with infected bodily fluids like during unprotected sex or sharing needles. Prevention methods include condoms, needle exchange programs, and avoiding contact with infected fluids. Currently over 33 million people have HIV/AIDS globally, with most cases in sub-Saharan Africa.

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Scientific Sessions 2015: Global and sri lankan hiv situation among msm

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Reproductive and human rights

Maternal mortality is the death of a woman during or shortly after pregnancy, with major direct causes being hemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labor. In 2008, 358,000 maternal deaths occurred worldwide, with over 99% in developing countries and over half in Sub-Saharan Africa alone. Prevention efforts aim to increase access to family planning and reproductive healthcare services to reduce maternal mortality. HIV/AIDS spreads primarily through unprotected sex, contaminated needles, breastfeeding, and childbirth, with 33.3 million people estimated to be living with HIV/AIDS in 2009. Prevention programs target at-risk groups and aim to change sexual behaviors.

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Social Challenges Facing Low Income Earning Women Living With HIV/AIDS: A Cas...

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Abstract: Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has been in existence for more than twenty years and women account for nearly half the 40 million people living with HIV/AIDS. Women’s rate of new infection surpasses men’s because biological, cultural, and social economic conditions contribute to women’s greater vulnerability to HIV. The challenges that these low-income earning women living with HIV/AIDS face are social, economic, and psychological. When a woman is sick the family’s property, the children’s education, savings and food security are threatened because women provide the majority of labour and managerial services for their household. The purpose of the study was to establish the social challenges that face low-income earning women living with HIV/AIDS. A sample of 248 out of a population of 700 who were receiving Home Based Care within Nakuru Municipality was selected. The study was a survey where Questionnaire and interviews were used to collect data. The data was analyzed using descriptive statistics. The findings of the study revealed that low income women living with HIV/AIDS faced various social challenges such as shame, discrimination, and causing strain in the family among others. The disparities that existed among the singles and the married revealed that one’s marital status determined the extent to which one was ashamed, evoked negative changes in the behaviour of family members and experienced discrimination based on their HIV/AIDS status. The implications of the findings is that the public support for the low-income women living with HIV/AIDS is inadequate and mostly material, and emotional support is also crucial in the management and coping with HIV/AIDS.

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Eliminating Pediatric HIV/AIDS and Caring for Children with HIV

1) The document discusses eliminating pediatric HIV/AIDS through preventing mother-to-child transmission (PMTCT). It outlines the four components of the WHO's PMTCT strategy and improvements in reducing new HIV infections among children from 600,000 in 1990 to 370,000 in 2009. 2) While PMTCT programs have expanded, only about half of pregnant women and infants receive antiretroviral drugs. Early diagnosis and lifelong treatment are critical for infants to survive. 3) Goals for HIV care programs include preventing opportunistic infections, early identification and management of complications, and engaging patients in care, treatment and prevention through education and support. With continued progress, the document argues that virtual elimination of pediatric HIV

Use of Antiretroviral Drigs for Treating Pregnant Women and Preventing HIV In...

The document summarizes the key changes in WHO's 2010 guidelines for preventing mother-to-child transmission of HIV (PMTCT), including recommending lifelong antiretroviral treatment (ART) for all HIV-positive pregnant women and more effective prophylaxis options. It outlines two approaches - Option A focusing on antenatal/intrapartum drugs while Option B continues treatment during breastfeeding. Proper implementation of the new guidelines could reduce transmission rates to below 5% and bring the world closer to virtual elimination of pediatric HIV.

2 egpaf approach and activites who_vienna 2010

This document discusses the 2010 WHO guidelines for preventing mother-to-child transmission of HIV. It summarizes EGPAF's programs in 16 countries that help implement the guidelines. The guidelines represent progress in HIV services and an opportunity to improve care. They will require increased logistical support, long-term follow-up, and integration between programs. If implemented widely, they could virtually eliminate pediatric HIV infections. EGPAF is developing toolkits to help countries adapt and apply the guidelines, and providing technical support for implementation.

Joint ART/PMTCT Guideline Review Process in Kenya

The document summarizes Kenya's process of revising its joint ART/PMTCT guidelines. It discusses that guidelines were revised through a consultative process involving government, donors, partners, and academics. The revisions adopted Option A for PMTCT, increased CD4 thresholds for ART initiation, and updated infant feeding guidelines. Implementation of the new guidelines faced challenges including confusion during transitions and debate over infant feeding policies. Next steps include building health worker capacity, procuring adequate drugs, and implementing revisions by September.

Making it Happen: Revising national policies to reflect changes in WHO recomm...

The document summarizes the process undertaken by Malawi to revise its national PMTCT guidelines in line with recent WHO recommendations. It discusses key changes such as recommending lifelong ART for all HIV-positive pregnant women (Option B+), noting this simple approach could help scale up coverage and reduce maternal mortality. While challenges like cost and adherence exist, the document argues Option B+ outweighs disadvantages and is the most realistic strategy for Malawi given limited CD4 testing availability. It stresses the need for international guidelines and national policies to follow a public health approach that can be implemented at scale.

Towards Virtual Elimination of Pediatric HIV: Adaption of WHO HIV and AIDS Gu...

The document summarizes Zimbabwe's process of revising its national HIV treatment guidelines in accordance with new 2010 WHO guidelines. A committee was formed to work with the National Drug Therapeutics Policy Advisory Committee to review the WHO guidelines and make country-specific recommendations. After extensive stakeholder consultations and situational analysis, the revised guidelines recommend starting ART at CD4 <350 and replacing d4T, and option A for PMTCT. Challenges to implementation include limited infrastructure and resources. Next steps include finalizing costs, addressing gaps, and sensitizing health workers.

Case Study

This case study examines challenges with PMTCT services at Clinic X in Country Z, where HIV prevalence is 32%. The clinic aims to increase male involvement to improve outcomes. Focus groups found that male participation is lacking due to cultural norms where men avoid health issues due to stigma. Men feel clinics are unwelcoming and staff are disrespectful. The top two recommended interventions are improving clinic environments and staff attitudes to create a more supportive experience for men, as greater understanding and involvement of male partners is needed to reduce vertical HIV transmission rates.

Community Male Involvement in PMTCT & Care and Treatment

This document summarizes community efforts in Lesotho to increase male involvement in preventing mother-to-child transmission (PMTCT) of HIV and supporting care and treatment. It outlines the high HIV prevalence in Lesotho, particularly among pregnant women. Male support groups have been established, with over 2,600 members, to educate men and encourage their participation in PMTCT. The groups provide training on positive living, counseling, and distributing condoms. As a result, more men are accompanying partners to clinics and more women are accessing PMTCT services.

HIV Testing for Couples

- The document discusses strategies for HIV testing of couples in sub-Saharan Africa, where most new infections occur within marriages. It highlights examples from Rwanda and Zambia where stand-alone and integrated testing of couples at antenatal clinics identified thousands of discordant couples. - Sustaining couples testing requires addressing both supply of testing services and demand through community promotion to establish it as a social norm. It takes testing 15-20% of target couples to achieve this. Incentives for transport and clinic promoters may be initially needed.

Promoting Male Involvement in PMTCT: Experiences from a rapid syphilis test p...

Male involvement in PMTCT programs was promoted through a pilot program introducing rapid syphilis testing alongside existing HIV testing for pregnant women and their partners in ANC clinics in Zambia. The objectives were to determine feasibility of same-day testing and treatment for syphilis, identify dual infections, and assess effect on male partner uptake. A partner invitation slip was developed and nurses were trained in its use. Preliminary results found successes in same-day treatment reducing missed opportunities and national campaigns encouraging uptake of testing by male partners through invitation slips. Challenges included counseling for discordant results and meeting men's health needs within busy MCH departments.

Working with Men to Improve PMTCT Outcomes - Emerging Approaches

There is solid evidence that interventions can bring about positive gender and HIV-related changes among men and boys. Programs like Stepping Stones, Programme H, and One Man Can Workshop have shown decreases in high-risk behaviors and increases in condom use. A WHO study found that over half of gender-transformative programs were effective or promising. A study in Ethiopia found that after a male engagement intervention, the number of men accompanying their partners to clinics for HIV testing and PMTCT visits increased by 46% and 87.6% respectively. Effective PMTCT requires engaging men, and evidence shows interventions can benefit women, children, and men.

PMTCT Implementation and the Importance of Male Involvement

This document discusses PMTCT (prevention of mother-to-child transmission) of HIV and the importance of male involvement. It notes that over 90% of pediatric HIV infections are from mother-to-child transmission. While PMTCT programs have reduced new pediatric infections from 520,000 in 2001 to 430,000 in 2008, only 55% of pregnant women and 68% of exposed infants received antiretroviral drugs for PMTCT in 2009. The WHO's 4-component PMTCT strategy and EGPAF's expansion of PMTCT programs internationally are also summarized.

Utilizing the District Approach for Scale-Up: The Tanzania Model

The document summarizes the district approach used by EGPAF Tanzania to scale up PMTCT programming. Key aspects of the district approach include working through district health management teams to plan, implement, manage and monitor the PMTCT program, building local capacity, and facilitating integration with existing health structures and systems. Using this approach, EGPAF Tanzania expanded PMTCT services to cover 6 regions of the country between 2003-2009. While the district approach enabled rapid scale up, it also presented challenges related to balancing support and control between EGPAF and districts. Lessons learned highlight the importance of assessing performance by district to improve programming.

Implementing the New WHO Recommendations

The document summarizes key points from the 2010 WHO guidelines for preventing mother-to-child transmission of HIV, treating pediatric HIV, and HIV treatment for adults and adolescents. Major changes included treating all HIV-positive pregnant women and children under 2, simplifying adult regimens, and emphasizing exclusive breastfeeding. Implementing these guidelines could virtually eliminate pediatric HIV but would require increased resources, integration, monitoring, and research to inform future revisions. The Elizabeth Glaser Pediatric AIDS Foundation aims to support countries in adapting and applying the guidelines through toolkits, advocacy, evaluation, and collaboration.

Increasing Coverage & Quality of PMTCT Services Beyond 2010

This document discusses strategies for improving prevention of mother-to-child transmission (PMTCT) of HIV programs beyond 2010. It notes that while progress has been made, many challenges remain as only 55% of pregnant women receive PMTCT drugs and 68% of exposed infants receive them. Improving completion of the PMTCT "cascade" from testing to treatment is critical to reduce transmission rates. The document calls for global action including expanding programs, strengthening health systems, and integrating PMTCT with other maternal and child health services to work towards eliminating pediatric HIV.

WHO Guidelines: 2010 and Beyond

Following Mother-Infant Pairs: A Best Practice Experience from Zimbabwe

The document discusses modifications made to Zimbabwe's Child Health Card (CHC) to better support the identification, follow-up, and care of HIV-exposed mother-baby pairs in the country's PMTCT (Prevention of Mother-to-Child Transmission) program. Key changes included adding panels to record infant feeding, follow-up care, ARV prophylaxis, and growth. Testing showed the revised CHC was generally accepted. The participatory revision process helped ensure support and the CHC is now used across health facilities to strengthen integration of HIV services for mothers and babies.

Training & Mentoring of Health Providers: Malawi's Approach

Malawi has made progress in scaling up its PMTCT program and increasing access to HIV/AIDS services, but faces ongoing challenges. The zonal mentorship program was established to improve quality of PMTCT implementation through regular supportive supervision of sites. It has increased coordination between districts and built capacity of coordinators. However, challenges remain around inadequate funding, staffing, and resources to fully support and sustain the mentorship program.

Providing HIV Care & Treatment Services for Women & Families

1) Integrating antiretroviral treatment (ART) services into maternal and child health clinics improves access to HIV care and treatment for pregnant women. A study in Swaziland found more pregnant women eligible for ART initiated treatment when services were provided on-site rather than through referral. 2) Similarly, a study in Zambia found integrating ART into antenatal care clinics resulted in more HIV-positive pregnant women initiating ART during their pregnancy compared to the standard referral approach. Provision of on-site ART may be more effective than referral for linking infected women to treatment. 3) Challenges to fast-tracking pregnant women into treatment include weak referral systems between vertical HIV and maternal programs. Integr

Early Infant Diagnosis & Treatment: The Swaziland Experience

Dr. Sujit Chatterjee CEO Hiranandani Hospital

The document summarizes Swaziland's experience with early infant diagnosis (EID) and treatment of HIV-infected children. It discusses how establishing in-country DNA PCR testing significantly reduced turnaround time for EID results. It also describes how focused follow-up of results led to more than doubling the number of infants initiating antiretroviral treatment, from 18 to 44. The document concludes that successful EID programs require investments in both laboratory infrastructure and programming to ensure test results are effectively communicated and used to start life-saving treatment for HIV-positive infants.

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Eliminating Pediatric HIV/AIDS and Caring for Children with HIV

Use of Antiretroviral Drigs for Treating Pregnant Women and Preventing HIV In...

2 egpaf approach and activites who_vienna 2010

Joint ART/PMTCT Guideline Review Process in Kenya

Making it Happen: Revising national policies to reflect changes in WHO recomm...

Towards Virtual Elimination of Pediatric HIV: Adaption of WHO HIV and AIDS Gu...

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Community Male Involvement in PMTCT & Care and Treatment

HIV Testing for Couples

Promoting Male Involvement in PMTCT: Experiences from a rapid syphilis test p...

Working with Men to Improve PMTCT Outcomes - Emerging Approaches

PMTCT Implementation and the Importance of Male Involvement

Utilizing the District Approach for Scale-Up: The Tanzania Model

Implementing the New WHO Recommendations

Increasing Coverage & Quality of PMTCT Services Beyond 2010

WHO Guidelines: 2010 and Beyond

Following Mother-Infant Pairs: A Best Practice Experience from Zimbabwe

Training & Mentoring of Health Providers: Malawi's Approach

Providing HIV Care & Treatment Services for Women & Families

Early Infant Diagnosis & Treatment: The Swaziland Experience

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