This document discusses reinvigorating condoms as an HIV prevention tool. It begins by noting that while treatment is improving, new infections still outpace those entering treatment, so prevention is still needed. Condoms are effective prevention but face challenges. The document then discusses evidence that condoms work at population levels; barriers like risky behavior, structural barriers, and dual protection; procurement and quality issues; and calls for addressing behavioral disinhibition, criminalization, developing dual protection indicators, building quality control protocols, and strengthening procurement coordination.
AIDSTAR-One Findings Report: Analysis of Services to Address Gender-based Vio...AIDSTAROne
Because gender-based violence (GBV) is widely recognized as both a cause and a consequence of HIV infection, the President's Emergency Plan for AIDS Relief (PEPFAR) has identified reducing GBV as one of its five high-priority gender strategies. As part of this effort, AIDSTAR-One conducted case studies in three countries where GBV services were available: Swaziland, Vietnam, and Ecuador. The case studies and this accompanying findings report aim to identify and share promising programmatic approaches and disseminate key elements of success for replication and scale-up.
www.aidstar-one.com/focus_areas/gender/resources/reports/gbv_series_findings_report
Earning Their Way to Healthier Lives: Women First in MozambiqueAIDSTAROne
A complex matrix of factors, such as low literacy, early sexual initiation, and limited economic opportunities, increases the vulnerability of women to HIV infection in Mozambique. The Women First program addresses the role that poverty and lack of access to health information play in the spread of HIV through legal rights and income-generating activities.
This case study covers one of the 31 programs from the Africa Gender Compendium, an AIDSTAR-One gender and HIV integration resource. A series of five Africa Gender Compendium case studies is accompanied by a findings report, which describes lessons learned, gaps, and common experiences across the programs.
Download this and other gender & HIV resources: http://j.mp/zyjmG7
AIDSTAR-One Issue Paper: The Debilitating Cycle of HIV, Food Insecurity, and ...AIDSTAROne
This document aims to facilitate an understanding of the bi-directional relationship between HIV and food and nutrition security. It illuminates the causes of HIV-related food and nutrition insecurity, and points to a list of programmatic interventions and resources to consider for addressing each cause in detail. http://j.mp/U1L0iV
AIDSTAR-One Outreach to Most-at-Risk Populations through SIDC in LebanonAIDSTAROne
Successful outreach to most-at-risk populations (MARPs) recognizes the sociocultural context and particularly the gendered norms in which MARPs live. This case study (one of nine in a series) documents how outreach workers in Lebanon raise awareness about how gender norms can increase HIV risk; deliver basic information on HIV, hepatitis, and other STIs; offer counseling to support positive behavior change, and distribute free condoms, syringes, and lubricants.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/sidc_lebanon
AIDSTAR-One STIGMA Foundation in IndonesiaAIDSTAROne
Integrating strategies to address gender inequity and change harmful gender norms is an increasingly important component of HIV programs. However, gender integration among programs targeting most-at-risk populations (MARPs) is much less prevalent. In Indonesia, the STIGMA Foundation uses a peer outreach model to help men and women who inject drugs live safer, healthier, more productive lives through community organizing, advocacy, and networking.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/STIGMA_foundation
Utilization of reproductive health services in ghanaAlexander Decker
The document analyzes factors affecting utilization of reproductive health services in Ghana based on a survey of 200 individuals. The results of a probit analysis show that being married and having a higher income positively influence utilization of services, while higher prices negatively affect utilization. Policy should target the unmarried and poor by providing subsidies to increase utilization and enhance reproductive health outcomes.
This document discusses reinvigorating condoms as an HIV prevention tool. It summarizes that condoms are effective at preventing HIV transmission but there are still barriers to their use. Condoms play a key role in HIV prevention strategies alongside other interventions. However, risk compensation behaviors, structural barriers like criminalization of homosexuality, and lack of messaging around dual protection can reduce condom uptake and consistent use. The document calls for addressing these challenges and rigorously evaluating condom programming elements to improve access and effectiveness in different epidemic settings.
AIDSTAR-One Civil Society and Government Unite to Respond to Gender-based Vio...AIDSTAROne
The document summarizes CEPAM's work responding to gender-based violence (GBV) in Ecuador through service provision, advocacy, and awareness campaigns. It describes CEPAM's history of establishing health centers and legal services for GBV survivors. It also discusses Ecuador's National Plan for eradicating GBV, implemented through partnerships between government agencies and civil society organizations like CEPAM. While progress has been made in laws, justice access, and awareness campaigns, more work is still needed to improve health and social services, increase funding, and change underlying social norms accepting GBV.
AIDSTAR-One Findings Report: Analysis of Services to Address Gender-based Vio...AIDSTAROne
Because gender-based violence (GBV) is widely recognized as both a cause and a consequence of HIV infection, the President's Emergency Plan for AIDS Relief (PEPFAR) has identified reducing GBV as one of its five high-priority gender strategies. As part of this effort, AIDSTAR-One conducted case studies in three countries where GBV services were available: Swaziland, Vietnam, and Ecuador. The case studies and this accompanying findings report aim to identify and share promising programmatic approaches and disseminate key elements of success for replication and scale-up.
www.aidstar-one.com/focus_areas/gender/resources/reports/gbv_series_findings_report
Earning Their Way to Healthier Lives: Women First in MozambiqueAIDSTAROne
A complex matrix of factors, such as low literacy, early sexual initiation, and limited economic opportunities, increases the vulnerability of women to HIV infection in Mozambique. The Women First program addresses the role that poverty and lack of access to health information play in the spread of HIV through legal rights and income-generating activities.
This case study covers one of the 31 programs from the Africa Gender Compendium, an AIDSTAR-One gender and HIV integration resource. A series of five Africa Gender Compendium case studies is accompanied by a findings report, which describes lessons learned, gaps, and common experiences across the programs.
Download this and other gender & HIV resources: http://j.mp/zyjmG7
AIDSTAR-One Issue Paper: The Debilitating Cycle of HIV, Food Insecurity, and ...AIDSTAROne
This document aims to facilitate an understanding of the bi-directional relationship between HIV and food and nutrition security. It illuminates the causes of HIV-related food and nutrition insecurity, and points to a list of programmatic interventions and resources to consider for addressing each cause in detail. http://j.mp/U1L0iV
AIDSTAR-One Outreach to Most-at-Risk Populations through SIDC in LebanonAIDSTAROne
Successful outreach to most-at-risk populations (MARPs) recognizes the sociocultural context and particularly the gendered norms in which MARPs live. This case study (one of nine in a series) documents how outreach workers in Lebanon raise awareness about how gender norms can increase HIV risk; deliver basic information on HIV, hepatitis, and other STIs; offer counseling to support positive behavior change, and distribute free condoms, syringes, and lubricants.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/sidc_lebanon
AIDSTAR-One STIGMA Foundation in IndonesiaAIDSTAROne
Integrating strategies to address gender inequity and change harmful gender norms is an increasingly important component of HIV programs. However, gender integration among programs targeting most-at-risk populations (MARPs) is much less prevalent. In Indonesia, the STIGMA Foundation uses a peer outreach model to help men and women who inject drugs live safer, healthier, more productive lives through community organizing, advocacy, and networking.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/STIGMA_foundation
Utilization of reproductive health services in ghanaAlexander Decker
The document analyzes factors affecting utilization of reproductive health services in Ghana based on a survey of 200 individuals. The results of a probit analysis show that being married and having a higher income positively influence utilization of services, while higher prices negatively affect utilization. Policy should target the unmarried and poor by providing subsidies to increase utilization and enhance reproductive health outcomes.
This document discusses reinvigorating condoms as an HIV prevention tool. It summarizes that condoms are effective at preventing HIV transmission but there are still barriers to their use. Condoms play a key role in HIV prevention strategies alongside other interventions. However, risk compensation behaviors, structural barriers like criminalization of homosexuality, and lack of messaging around dual protection can reduce condom uptake and consistent use. The document calls for addressing these challenges and rigorously evaluating condom programming elements to improve access and effectiveness in different epidemic settings.
AIDSTAR-One Civil Society and Government Unite to Respond to Gender-based Vio...AIDSTAROne
The document summarizes CEPAM's work responding to gender-based violence (GBV) in Ecuador through service provision, advocacy, and awareness campaigns. It describes CEPAM's history of establishing health centers and legal services for GBV survivors. It also discusses Ecuador's National Plan for eradicating GBV, implemented through partnerships between government agencies and civil society organizations like CEPAM. While progress has been made in laws, justice access, and awareness campaigns, more work is still needed to improve health and social services, increase funding, and change underlying social norms accepting GBV.
“Women are not only victims, they have driving power of changes, exclusive knowledge and skills that have crucial importance for providing solutions and managing risks”.
During the last 10 years 3 400 natural disasters took place in the world – hurricanes, floods earthquakes and other natural calamities. More than 700000 people died, more than 1,4 mln were injured and 23mln lost shelter. In general disaster affected 1,5 bln people and women, children and vulnerable people were most affected.
This document discusses case studies of how women were impacted during natural disasters at both the national and global level. At the national level, it examines the 2001 Bhuj earthquake in Gujarat, India. It notes that women suffered greater casualties than men during the earthquake since they were typically doing household chores indoors. In the aftermath, many women were widowed or orphaned, leaving them vulnerable without support. At the global level, it examines the 2008 Cyclone Nargis in Myanmar and the challenges women faced during the relief efforts.
AIDSTAR-One Case Study: Jane Goodall Institute in TanzaniaAIDSTAROne
1) The Jane Goodall Institute (JGI) in Tanzania works to mainstream HIV programming into its natural resource management and economic growth activities.
2) JGI home-based care provider Jumanne helps an HIV-positive family in Kasuku village, including transporting the sick daughter to the hospital and supporting their adherence to antiretroviral treatment.
3) By addressing local health, education, and economic priorities, JGI's community-centered conservation model fosters synergies between natural resource protection and socioeconomic development in communities surrounding Gombe National Park.
Bristol-Myers Squibb Foundations SECURE THE FUTURE? Programme Announces New F...Koos Dorssers
New research found that the Grandmothers Against Poverty & AIDS (GAPA) program in Tanzania has had a positive impact on grandmothers caring for families affected by HIV/AIDS. The GAPA program provides community support, psychosocial support, and income generation activities to empower grandmothers. A study of 301 grandmothers found that being part of a GAPA peer support group improved self-esteem and community cooperation, and helped grandmothers earn income. The GAPA program aims to reduce poverty and stigma faced by grandmothers caring for orphans due to HIV/AIDS.
The presentation identifies vulnerable populations in rural areas and their health disparities. Rural areas are defined as having low population density and distance from urban centers with few economic activities. Approximately 19% of Americans live in rural areas and are more likely to be uninsured compared to urban residents. Rural residents experience higher rates of chronic diseases, injuries, cancer deaths and less access to preventive healthcare services. The presentation proposes a plan to address mammography compliance among uninsured rural women using a mobile mammography unit on a quarterly basis. Key elements of the plan include qualifying patients, an interdisciplinary team and addressing challenges of cost, participation and evaluating effectiveness.
Defines disasters and conflict, delineates gender issues in conflicts and disasters, summarises UN Conventions/agreements on gender, disasters and conflict and good practices in addresses gender issues in conflicts and disasters
The document discusses how climate change disproportionately impacts women. It notes that women are more dependent on natural resources for tasks like collecting water and food. Climate disasters exacerbate gender inequalities by increasing women's workloads and restricting their access to education and resources. The impacts of climate change on women are often overlooked in international agreements. Studies show women face higher risks during natural disasters and their agricultural livelihoods are threatened by climate impacts like changing rainfall patterns and food price increases.
Gender And Disaster Risk Reduction Ifrc CaribbeanLn Perch
This document provides an overview of gender and disaster risk reduction. It begins with definitions of key terms like gender mainstreaming and gender analysis. It then presents case studies on the different impacts of disasters on women and men in Grenada, St. Lucia, and St. Kitts and Nevis. The document discusses how gender analysis is important for understanding social inequalities and power differentials between women and men. It also explores how gender should be considered in areas like vulnerability, response, and management in disaster and environmental contexts.
Overcoming barriers: The Role of Gender in DisasterSarah K Miller
This document discusses how gender plays a role in vulnerability during disasters. It notes that women often face greater vulnerabilities such as higher rates of poverty, single parenthood, and abuse. However, men also have unique vulnerabilities. The document examines gender-based impacts and needs during different types of disasters both domestically and internationally. It emphasizes the need to incorporate gender considerations into all phases of emergency management. This includes partnering with gender-focused organizations, addressing specific needs like affordable housing, and designing sensitive risk communication. The goal is to promote more equitable resilience and response for people of all genders affected by disasters.
Nicaragua identifying factors that affect childrens healthImelda Medina, MD
Children's growth up to age five is influenced more by nutrition, environment and health care than by genetics or ethnicity. The document states that factors like nutrition, environment and health care have a greater influence on children's development in the first five years than genetic or ethnic factors.
The document summarizes the key findings of a consultation on the issues and barriers facing transgender people in accessing HIV and other services in Yangon, Myanmar. The consultation identified low levels of condom use and HIV awareness within the transgender community. It also found that transgender people face discrimination in healthcare settings, preventing access to prevention, treatment, and support services. Common issues included stigma, unfriendly services, and a lack of tailored HIV prevention interventions. The document recommends improving health services, reducing risk behaviors, and addressing discrimination in order to improve transgender health outcomes in Yangon.
Attitude of the youth towards voluntary counselling and testing (vct) of hiv ...Alexander Decker
This document summarizes a study on the attitudes of youth in Accra, Ghana toward voluntary counseling and testing (VCT) for HIV/AIDS. The study found that while knowledge of HIV/AIDS was high, awareness and use of VCT services was low. Most respondents were unaware that VCT services existed or where they could access them. Of those aware of VCT, very few had utilized the services themselves. Fear of knowing their HIV status appeared to be a major barrier preventing youth from seeking VCT. The study concluded that efforts must be made to increase awareness and use of VCT, especially among youth, through expanded information and education campaigns.
#WCIP IASG - thematic paper reproductive health rev1Dr Lendy Spires
This document discusses the sexual and reproductive health and rights of indigenous peoples. It notes that indigenous peoples face numerous obstacles to realizing these rights, including discrimination, lack of access to healthcare, and lack of recognition of their collective rights. The document advocates for intercultural approaches to healthcare that respect indigenous traditions and knowledge, as well as programs that target issues like maternal health, HIV prevention, and the needs of indigenous adolescents. It argues that recognizing indigenous peoples' rights and participating them in healthcare policy and services is key to improving outcomes.
Restrictions-on-a-Woman-s-Reproductive-ChoiceLucinda Lee
Restricting access to reproductive healthcare and factual information leads to negative outcomes. It increases rates of preventable sexually transmitted diseases like HIV and HPV by limiting condom access and sex education. It also increases unintended pregnancy by promoting ineffective abstinence-only programs instead of contraception education and access. This damages individuals' health and economic opportunities, as well as increasing healthcare and social costs to society. Evidence shows that providing open access to factual information and medical services through education and contraception improves public health outcomes.
This document discusses the vulnerable homeless population and their health concerns. It defines four categories of homelessness and estimates that over 1.5 million people are homeless in the US. The homeless have less access to healthcare and are more likely to experience health issues like substance abuse, malnutrition, hypertension, and frostbite/hypothermia. The demographics of the homeless population are also described, with most being adult males between 31-61 years old. The document calls for improvements like more affordable housing, jobs, healthcare access, and counseling services to help address the needs of this vulnerable group.
The document discusses several initiatives that have been taken in Asia to promote gender equality in humanitarian response efforts. It provides examples of:
1) A "DRR Gender Checklist" used in the Philippines to ensure gender inclusion in disaster risk reduction programming.
2) "Women Friendly Spaces" set up in Pakistan after floods to provide psychosocial support and empowerment opportunities for women.
3) A "Gender Emergency Checklist" developed for Pakistan and Afghanistan to remind aid groups of key gender issues to consider in emergency response.
4) Efforts in Nepal after the 2015 earthquake to establish a gender working group, develop gender indicators, and advocate for women's participation in recovery planning.
This document assesses four vulnerability indicators used to identify at-risk neighborhoods for prioritizing pandemic interventions. It finds low concordance rates between indicators, meaning they identify different tracts as vulnerable. It also finds substantial differences in the racial composition and proportion of minority neighborhoods included between indicators. Specifically, an indicator based on pre-existing health conditions performs best at including African American populations and neighborhoods. The choice of indicator thus has significant implications for which groups and places receive priority support.
The document provides information about adult day care programs and the FiftyForward adult day program in Nashville, TN. It summarizes that adult day programs provide supervision and care for seniors, allowing caregivers to work and providing social interaction for participants. It then discusses trends showing Nashville's senior population is projected to increase substantially. The purpose of the study was to describe client needs at FiftyForward. The methodology section outlines that the study used a survey of 28 current FiftyForward participants to collect demographic and health information to describe participants. Key findings included that most participants were aged 81-85, female, and Caucasian.
The Thai government took actions in the past that reduced HIV prevalence, such as promoting condom use and increasing access to treatment. However, the new government has not done enough, resulting in increased discrimination against people living with HIV and a rise in HIV prevalence. People living with HIV now often go to "AIDS temples" to die, since they face rejection from hospitals and society. While some laws protect people with HIV, discrimination remains common in workplaces, families, and healthcare settings. More action is needed from the government to continue reducing HIV rates and end the stigma faced by those living with the virus.
The document discusses the development of a teaching program to raise awareness of vulnerable populations in a workplace. It describes nursing theorists Leininger and Watson who emphasized holistic and culturally competent care. The author developed posters on ethical cultural competence that were displayed and will be used in a September presentation. The presentation aims to discuss how understanding different cultures can help provide equitable, patient-centered care and meet quality standards. Understanding cultural factors is important for implementing effective health interventions in a holistic manner.
1. Jesús se encuentra con Nicodemo, un fariseo y líder de los judíos, quien reconoce que Jesús ha hecho señales que demuestran que viene de Dios.
2. Jesús le dice a Nicodemo que para entrar en el reino de Dios uno debe nacer de nuevo del Espíritu, no sólo físicamente.
3. Aunque Nicodemo no entiende esto completamente, Jesús explica que Él habla de cosas celestiales y que los creyentes darán testimonio de Él a pesar de no ver el C
Sortie officielle de l'album "Mfiè" ce 31 Juillet 2015 dans les plate formes digitales. Disponible sur Itunes depuis le 17 Juillet. Bonne dégustation !
“Women are not only victims, they have driving power of changes, exclusive knowledge and skills that have crucial importance for providing solutions and managing risks”.
During the last 10 years 3 400 natural disasters took place in the world – hurricanes, floods earthquakes and other natural calamities. More than 700000 people died, more than 1,4 mln were injured and 23mln lost shelter. In general disaster affected 1,5 bln people and women, children and vulnerable people were most affected.
This document discusses case studies of how women were impacted during natural disasters at both the national and global level. At the national level, it examines the 2001 Bhuj earthquake in Gujarat, India. It notes that women suffered greater casualties than men during the earthquake since they were typically doing household chores indoors. In the aftermath, many women were widowed or orphaned, leaving them vulnerable without support. At the global level, it examines the 2008 Cyclone Nargis in Myanmar and the challenges women faced during the relief efforts.
AIDSTAR-One Case Study: Jane Goodall Institute in TanzaniaAIDSTAROne
1) The Jane Goodall Institute (JGI) in Tanzania works to mainstream HIV programming into its natural resource management and economic growth activities.
2) JGI home-based care provider Jumanne helps an HIV-positive family in Kasuku village, including transporting the sick daughter to the hospital and supporting their adherence to antiretroviral treatment.
3) By addressing local health, education, and economic priorities, JGI's community-centered conservation model fosters synergies between natural resource protection and socioeconomic development in communities surrounding Gombe National Park.
Bristol-Myers Squibb Foundations SECURE THE FUTURE? Programme Announces New F...Koos Dorssers
New research found that the Grandmothers Against Poverty & AIDS (GAPA) program in Tanzania has had a positive impact on grandmothers caring for families affected by HIV/AIDS. The GAPA program provides community support, psychosocial support, and income generation activities to empower grandmothers. A study of 301 grandmothers found that being part of a GAPA peer support group improved self-esteem and community cooperation, and helped grandmothers earn income. The GAPA program aims to reduce poverty and stigma faced by grandmothers caring for orphans due to HIV/AIDS.
The presentation identifies vulnerable populations in rural areas and their health disparities. Rural areas are defined as having low population density and distance from urban centers with few economic activities. Approximately 19% of Americans live in rural areas and are more likely to be uninsured compared to urban residents. Rural residents experience higher rates of chronic diseases, injuries, cancer deaths and less access to preventive healthcare services. The presentation proposes a plan to address mammography compliance among uninsured rural women using a mobile mammography unit on a quarterly basis. Key elements of the plan include qualifying patients, an interdisciplinary team and addressing challenges of cost, participation and evaluating effectiveness.
Defines disasters and conflict, delineates gender issues in conflicts and disasters, summarises UN Conventions/agreements on gender, disasters and conflict and good practices in addresses gender issues in conflicts and disasters
The document discusses how climate change disproportionately impacts women. It notes that women are more dependent on natural resources for tasks like collecting water and food. Climate disasters exacerbate gender inequalities by increasing women's workloads and restricting their access to education and resources. The impacts of climate change on women are often overlooked in international agreements. Studies show women face higher risks during natural disasters and their agricultural livelihoods are threatened by climate impacts like changing rainfall patterns and food price increases.
Gender And Disaster Risk Reduction Ifrc CaribbeanLn Perch
This document provides an overview of gender and disaster risk reduction. It begins with definitions of key terms like gender mainstreaming and gender analysis. It then presents case studies on the different impacts of disasters on women and men in Grenada, St. Lucia, and St. Kitts and Nevis. The document discusses how gender analysis is important for understanding social inequalities and power differentials between women and men. It also explores how gender should be considered in areas like vulnerability, response, and management in disaster and environmental contexts.
Overcoming barriers: The Role of Gender in DisasterSarah K Miller
This document discusses how gender plays a role in vulnerability during disasters. It notes that women often face greater vulnerabilities such as higher rates of poverty, single parenthood, and abuse. However, men also have unique vulnerabilities. The document examines gender-based impacts and needs during different types of disasters both domestically and internationally. It emphasizes the need to incorporate gender considerations into all phases of emergency management. This includes partnering with gender-focused organizations, addressing specific needs like affordable housing, and designing sensitive risk communication. The goal is to promote more equitable resilience and response for people of all genders affected by disasters.
Nicaragua identifying factors that affect childrens healthImelda Medina, MD
Children's growth up to age five is influenced more by nutrition, environment and health care than by genetics or ethnicity. The document states that factors like nutrition, environment and health care have a greater influence on children's development in the first five years than genetic or ethnic factors.
The document summarizes the key findings of a consultation on the issues and barriers facing transgender people in accessing HIV and other services in Yangon, Myanmar. The consultation identified low levels of condom use and HIV awareness within the transgender community. It also found that transgender people face discrimination in healthcare settings, preventing access to prevention, treatment, and support services. Common issues included stigma, unfriendly services, and a lack of tailored HIV prevention interventions. The document recommends improving health services, reducing risk behaviors, and addressing discrimination in order to improve transgender health outcomes in Yangon.
Attitude of the youth towards voluntary counselling and testing (vct) of hiv ...Alexander Decker
This document summarizes a study on the attitudes of youth in Accra, Ghana toward voluntary counseling and testing (VCT) for HIV/AIDS. The study found that while knowledge of HIV/AIDS was high, awareness and use of VCT services was low. Most respondents were unaware that VCT services existed or where they could access them. Of those aware of VCT, very few had utilized the services themselves. Fear of knowing their HIV status appeared to be a major barrier preventing youth from seeking VCT. The study concluded that efforts must be made to increase awareness and use of VCT, especially among youth, through expanded information and education campaigns.
#WCIP IASG - thematic paper reproductive health rev1Dr Lendy Spires
This document discusses the sexual and reproductive health and rights of indigenous peoples. It notes that indigenous peoples face numerous obstacles to realizing these rights, including discrimination, lack of access to healthcare, and lack of recognition of their collective rights. The document advocates for intercultural approaches to healthcare that respect indigenous traditions and knowledge, as well as programs that target issues like maternal health, HIV prevention, and the needs of indigenous adolescents. It argues that recognizing indigenous peoples' rights and participating them in healthcare policy and services is key to improving outcomes.
Restrictions-on-a-Woman-s-Reproductive-ChoiceLucinda Lee
Restricting access to reproductive healthcare and factual information leads to negative outcomes. It increases rates of preventable sexually transmitted diseases like HIV and HPV by limiting condom access and sex education. It also increases unintended pregnancy by promoting ineffective abstinence-only programs instead of contraception education and access. This damages individuals' health and economic opportunities, as well as increasing healthcare and social costs to society. Evidence shows that providing open access to factual information and medical services through education and contraception improves public health outcomes.
This document discusses the vulnerable homeless population and their health concerns. It defines four categories of homelessness and estimates that over 1.5 million people are homeless in the US. The homeless have less access to healthcare and are more likely to experience health issues like substance abuse, malnutrition, hypertension, and frostbite/hypothermia. The demographics of the homeless population are also described, with most being adult males between 31-61 years old. The document calls for improvements like more affordable housing, jobs, healthcare access, and counseling services to help address the needs of this vulnerable group.
The document discusses several initiatives that have been taken in Asia to promote gender equality in humanitarian response efforts. It provides examples of:
1) A "DRR Gender Checklist" used in the Philippines to ensure gender inclusion in disaster risk reduction programming.
2) "Women Friendly Spaces" set up in Pakistan after floods to provide psychosocial support and empowerment opportunities for women.
3) A "Gender Emergency Checklist" developed for Pakistan and Afghanistan to remind aid groups of key gender issues to consider in emergency response.
4) Efforts in Nepal after the 2015 earthquake to establish a gender working group, develop gender indicators, and advocate for women's participation in recovery planning.
This document assesses four vulnerability indicators used to identify at-risk neighborhoods for prioritizing pandemic interventions. It finds low concordance rates between indicators, meaning they identify different tracts as vulnerable. It also finds substantial differences in the racial composition and proportion of minority neighborhoods included between indicators. Specifically, an indicator based on pre-existing health conditions performs best at including African American populations and neighborhoods. The choice of indicator thus has significant implications for which groups and places receive priority support.
The document provides information about adult day care programs and the FiftyForward adult day program in Nashville, TN. It summarizes that adult day programs provide supervision and care for seniors, allowing caregivers to work and providing social interaction for participants. It then discusses trends showing Nashville's senior population is projected to increase substantially. The purpose of the study was to describe client needs at FiftyForward. The methodology section outlines that the study used a survey of 28 current FiftyForward participants to collect demographic and health information to describe participants. Key findings included that most participants were aged 81-85, female, and Caucasian.
The Thai government took actions in the past that reduced HIV prevalence, such as promoting condom use and increasing access to treatment. However, the new government has not done enough, resulting in increased discrimination against people living with HIV and a rise in HIV prevalence. People living with HIV now often go to "AIDS temples" to die, since they face rejection from hospitals and society. While some laws protect people with HIV, discrimination remains common in workplaces, families, and healthcare settings. More action is needed from the government to continue reducing HIV rates and end the stigma faced by those living with the virus.
The document discusses the development of a teaching program to raise awareness of vulnerable populations in a workplace. It describes nursing theorists Leininger and Watson who emphasized holistic and culturally competent care. The author developed posters on ethical cultural competence that were displayed and will be used in a September presentation. The presentation aims to discuss how understanding different cultures can help provide equitable, patient-centered care and meet quality standards. Understanding cultural factors is important for implementing effective health interventions in a holistic manner.
1. Jesús se encuentra con Nicodemo, un fariseo y líder de los judíos, quien reconoce que Jesús ha hecho señales que demuestran que viene de Dios.
2. Jesús le dice a Nicodemo que para entrar en el reino de Dios uno debe nacer de nuevo del Espíritu, no sólo físicamente.
3. Aunque Nicodemo no entiende esto completamente, Jesús explica que Él habla de cosas celestiales y que los creyentes darán testimonio de Él a pesar de no ver el C
Sortie officielle de l'album "Mfiè" ce 31 Juillet 2015 dans les plate formes digitales. Disponible sur Itunes depuis le 17 Juillet. Bonne dégustation !
This summary provides the key details from the long short story "Wedding Dance" in 3 sentences:
Awiyao has separated from his wife Lumnay after 7 years of marriage without children, in order to marry Madulimay and try to have a child. On the night of his wedding celebration, Awiyao visits Lumnay one last time to say goodbye and try to comfort her. Though heartbroken, Lumnay tells Awiyao to return to the celebration and hopes he is able to have a child with his new wife, while she decides to leave the village and live alone in the mountains.
Custom dictates social norms and behaviors, controlling people's feelings and manners like a despotic ruler. The document provides biographical information about Amador T. Daguio, including his birthdate in 1912 in Laoag, Ilocos Norte, graduating with honors from U.P. in 1932, obtaining his M.A. in English from Stanford University in 1952 as a Fulbright scholar, and writing his first work "Man of Earth" at the young age of 20 in 1932. The document also prompts the reader to watch a related video.
The document summarizes a short story called "Wedding Dance". It describes the characters of Lumnay, a woman left by her husband Awiyao to marry another woman named Madulimay, as Awiyao and Lumnay were unable to have children after 7 years of marriage. On the night of Awiyao and Madulimay's wedding, Awiyao goes to personally invite Lumnay, the best dancer in the tribe, to the traditional wedding dance. However, Lumnay refuses to attend. It is revealed they still love each other but their tribe's customs force them to separate so Awiyao can have a child.
This document provides plot summaries and character descriptions for three short stories - "Wedding Dance", "Faith, Love, Time and Dr. Lazaro", and "Footnote to Youth". For "Wedding Dance", it summarizes the plot as being about a married couple who must separate because the wife cannot bear children, as required by their tribe's tradition. It also identifies the main characters of Awiyao, Lumnay, and Madulimay. For "Faith, Love, Time and Dr. Lazaro", it summarizes the central conflict as being between the main character Dr. Lazaro's profession and faith, as he tries to save a baby. It identifies the characters of Dr. Lazaro
This document discusses a study on knowledge, attitude, and practices regarding condom use among secondary school pupils in Choma District, Zambia to prevent STIs/HIV. The study found:
1) There was a significant relationship between knowledge and attitude, and between knowledge and practice regarding condom use.
2) There was also a significant relationship between attitude and practice of condom use.
3) However, there was no significant relationship found between attitude and traditional or religious factors regarding condom use.
The study recommends improving education around proper condom use through various media and seminars to promote positive behavior changes among youth.
This document proposes implementing school-based HPV vaccination programs to increase vaccination rates. It analyzes barriers to vaccination completion across socioecological levels and identifies interventions. The proposed intervention would educate students and parents about HPV and offer free vaccination series through schools. Applying interventions across all socioecological levels could help address multiple barriers and contribute to positive health outcomes by increasing HPV vaccination completion rates.
Clinical Case Presentation SummarySummary of Primary and Secon.docxmccormicknadine86
Clinical Case Presentation Summary
Summary of Primary and Secondary Syphilis
In 2017, a total of 30,644 cases of primary and secondary syphilis were reported in the United States, yielding a rate of 9.5 cases per 100,000 population (CDC, 2018). According to the CDC (2018), this rate signifies a 10.5% increase compared with 2016 (8.6 cases per 100,000 population). Syphilis has a high prevalence among certain racial/ethnic groups, as well as in other groups, such as adolescents, sex workers, men who have sex with men (MSM), and sexually abused women (Hollier, 2018). Syphilis is transmitted through direct contact with an ulcerative lesion, or chancre which appears during the primary stage (most infectious) of syphilis (Hollier, 2018). Patients with this infection may seek medical treatment for signs and/or symptoms of primary syphilis (chancre/ulcer), or secondary syphilis (diffuse rash on palms and soles) (Hollier, 2018). On the other hand, patients may be completely asymptomatic and only diagnosed on routine screening.
Yonglin suggested to me one prevention strategy from the CDC called the “Talk, Test, Treat” method that has been suggested by the CDC is the “Talk, Test, Treat” method. Talking involves discussing sexual health history, testing involves screening for syphilis. The CDC recommends screening all sexually active men who have sex with men at least once a year, and more frequently if they are at-risk for infection. Pregnant women should be tested at their first prenatal visit, and at-risk women should be rescreened in their third trimester and again at delivery to prevent congenital syphilis. Lastly, patients need to be treated with benzathine penicillin G who test positive for syphilis.
Evidence-Based Action Plan #1
Implementing a mobile health unit (MHU) or van that offers community-based screening services for at-risk populations, such as female sex workers, men who have sex with men (MSM), and IV drug users could assist with reducing the transmission of primary and secondary syphilis. An MHU can be used as part of a community education, screening, and counselling program to serve urban and rural communities (Khanna & Narula, 2016). The MHU would have to be clearly identified as a free syphilis testing unit in order to make it more appealing to interested individuals who may approach. The health care providers working the mobile unit would be required to obtain a focused health history and patient contact information in order to provide screening results and the necessary follow-up instructions for any positive test results. Studies have shown that MHUs have been very helpful in detecting new cases of syphilis and beneficial to the at-risk population (Lipsitz et al., 2014). Also, MHUs may even increase patient compliance with the follow-up serologic testing that is required after being treated for syphilis, which may be a barrier for patients of low income or who lack transportation. This evidence-based intervention could be ...
THEORETICAL CONCEPT The Health Belief Model (HBM) is by far the mo.docxchristalgrieg
THEORETICAL CONCEPT The Health Belief Model (HBM) is by far the most commonly used theory in health education and health promotion (Glanz, Rimer, & Viswanath, 2008; National Cancer Institute [NCI], 2005). The underlying concept of the HBM is that health behavior is determined by personal beliefs or perceptions about a disease and the strategies available to decrease its occurrence (Hochbaum, 1958). Personal perception is influenced by the whole range of intrapersonal factors affecting health behavior, including, but not limited to: knowledge, attitudes, beliefs, experiences, skills, culture, and religion.
THEORETICAL CONSTRUCTS
The following four perceptions serve as the main constructs of the model: perceived seriousness, perceived susceptibility, perceived benefits, and perceived barriers. Each of these perceptions, individually or in combination, can be used to explain health behavior. More recently, other constructs have been added to the HBM; thus, the model has been expanded to include cues to action, motivating factors, and self-efficacy. PERCEIVED SERIOUSNESS The construct of perceived seriousness speaks to an individual’s belief about the seriousness or severity of a disease. While the perception of seriousness is often based on medical information or knowledge, it may also come from beliefs a person has about the consequences an illness might have on him or her personally. For example, most of us perceive seasonal flu as a relatively minor ailment. We get it, stay home a few days, and get better. However, if you have asthma, contracting the flu could land you in the hospital. In this case, your perception of the flu might be that it is a serious disease. Or, if you are self-employed, having the flu might mean a week or more of lost wages. Again, this would influence your perception of the seriousness of this illness. Perception of seriousness can also be colored by past experience with the illness. No doubt, most people would consider skin cancer a serious disease. However, the perception of serious might be diminished in someone who had a cancerous lesion removed and recovered without much more than a sore area and a Band-Aid for a few days.
PERCEIVED SUSCEPTIBILITY
Personal risk or susceptibility is one of the more powerful perceptions in prompting people to adopt healthier behaviors. The greater the perceived risk, the greater the likelihood of engaging in behaviors to decrease the risk. This is what prompts men who have sex with men to be vaccinated against hepatitis B (de Wit, Vet, Schutten, & van Steenbergen, 2005) and to use condoms in an effort to decrease susceptibility to HIV infection (Belcher, Sternberg, Wolotski, Halkitis, & Hoff, 2005). Perceived susceptibility motivates people to be vaccinated for influenza (Chen, Fox, Cantrell, Stockdale, & Kagawa-Singer, 2007) to use sunscreen to prevent skin cancer, and to floss their teeth to prevent gum disease and tooth loss (Figure 4– 1). It is only logical that when peop ...
The document discusses the ethical dilemma of needle exchange programs (NEP). NEPs aim to decrease disease transmission among intravenous drug users (PWID) by providing clean needles. However, some argue NEPs increase drug use and disease. The document outlines arguments on both sides and notes the first NEP began in the 1980s in response to the AIDS epidemic. It discusses ethical principles like non-maleficence and virtues/vices involved. While NEPs aim to help PWID safely, the effectiveness of these programs remains an ongoing debate.
This document discusses considerations for developing an effective disaster preparedness plan for infectious disease outbreaks at Saint Leo University Hospital. It outlines key factors such as identifying the cause of the outbreak, implementing isolation and quarantine protocols, applying a systematic approach to healthcare delivery, ensuring strong leadership and coordination, establishing an organizational structure, managing conflicts, and learning from past failures in disaster response. The plan aims to recognize, contain and prevent the spread of infectious diseases through prepared strategies and coordination between healthcare professionals and organizations.
This document discusses strategies that can influence change for women and girls living with HIV/AIDS. It begins by outlining the disproportionate burden faced by these groups, then examines prevalence data showing women, especially minorities in the US South, are at high risk. Risk factors like gender inequality, poverty and violence are discussed. Effective strategies are proposed that target multiple levels - behavioral approaches educate women, environmental strategies address living conditions, and policy aims to improve integrated healthcare access. A woman-centered approach recognizes women's experiences and empowers them as leaders. Comprehensive, sustainable interventions across all levels throughout the life course are needed to promote gender equity and alleviate disparities.
Technical brief decision making for condom use and hiv testing among fisherf...Jane Alaii
A research brief assessing motivators and decision-making factors among fisherfolk who take up condom use and HIV testing services in a selected hot spot in Uganda.
Using Everett Rogers' Diffusion of Innovations Theory an intervention for automatic STI screening for adolescents is applied to primary care settings in Baltimore, Maryland.
This document discusses the use of physical restraints in healthcare settings. It defines a restraint as any physical or chemical measure used to limit a patient's freedom of movement. While restraints are sometimes used to protect patients or facilitate treatment, they can also cause physical and psychological harm. The document discusses two studies that found educational interventions combined with policy changes were effective at reducing restraint use long-term. Providing nurses with alternatives to restraints and changing policies to restrict certain restraints can help address issues around overuse of restraints.
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The perceptions of health workers on the effectiveness of HIV Prevention Programmes for MSM in Jamaica
May 2013
Abstract
The Jamaican Ministry of Health (MOH) has framed a policy and strategy that allows for sexual health promotion and HIV prevention programmes to be conducted for men who have sex with men (MSM), despite an enforced legal framework which makes it illegal to participate in anal sex. The population of Jamaica’s MSM accounts for the highest HIV prevalence rate on the island. While the National HIV/ STI Programme conducts a government-run programme, a significant portion of the work is conducted by local and internationally funded non-government organizations (NGO). This study seeks to explore the efficiency of these HIV/AIDS prevention programmes from the experiences and perspectives of the health care workers involved in their implementation. It will utilize qualitative research methodology of a descriptive cross-sectional design. The procedure will involve the use of interviews. These will be conducted with health workers in MSM programmes from NGOs and the Jamaica National HIV/STI Programme. It is expected that the results may indicate a view of success with many programmes, with limitations being attributed to the societal and legal framework within which they work. It may also show disparities between government and locally ran programmes conducted by NGOs. The results of this study will be shared and made available to public libraries, the government of Jamaica and other stakeholders working to alleviate the impact of HIV and AIDS in Jamaica and the world. *
Keywords: HIV/AIDS, health promotion and HIV prevention, men who have sex with men (MSM), Jamaica, sexual health, gay men, other MSM and transgender individuals (GMT).Table of Contents
Page #
Abstract
Introduction
Methodology
Discussion
Conclusion
Reflection
References
Appendix Consent
Appendix Draft Interview
Glossary
Privacy Statement
1. Introduction
This study explores the effectiveness of the HIV and AIDS response within the target population of MSM in Jamaica. It investigates, the views and perspectives of the health workers who carry out or implement these programmes.
Thanks to science, the ability to treat and care for persons living with HIV (PLHIV) and AIDS has grown exponentially. Individuals are defying their prognoses and are living with HIV and AIDS for record number of years than they did when the virus was first discovered. Gay, bisexual, transgendered and other men who have sex with men but may not identify as gay, are disproportionately affected by sexually transmitted infections like HIV (MOH, 2011a). For the purpose of this research the term MSM will be defined and utilized as the public health terminology to capture the target audience of all males who have sex with males.
For the purpose of this research.
Choose an organization according to the following· Current empl.docxmccormicknadine86
Choose an organization according to the following:
· Current employer
· Most recent or former employer
· Place of business that you have patronized or have been familiar with over a long period of time.
· Avoid choosing an organization that is so large that historical data would be difficult to apply. Firms in the Russell 2000® index may fit well, whereas firms in the Dow 30 Industrial index probably do not.
· The organization can be a start-up that you or a significant other may create in the future. For a start-up, focus on an entrepreneurial idea that is of substantive interest, so this project leaves you with a product you may leverage in the future.
Write a 1,000-word (maximum word count) paper in which you address the following:
· Identify the major components of the strategic management process.
· Discuss how these components work together to create value for the organization.
· Evaluate the company's mission statement, vision statement, motivation strategy, innovation strategy, and people strategy. If the organization does not have one or more of these, how does that affect the organization and its people?
· Explain the role of ethics and corporate social responsibility in strategic planning. How does this direct their strategy? How does the organization's vision and mission align with your own values and vision? If you are currently working for the organization, how does your role influence this and vice versa?
Format your paper according to APA guidelines.
Using the information below Create a 3-4 -slide PowerPoint presentation. Include speaker notes and citations for each slide, and create a slide at the end for References.
Immunization is important to infants as it prevents them from diseases which would be expensive to treat. The benefit of immunization and prevention of infectious diseases among mothers and infants cost-effective healthcare intervention and contribute significantly in reduction of mortality and morbidity in the country (Walls et al. 2018). Immunization also helps the mother to spend less on possible diseases that could affect their children. Prevention of infectious diseases is important to both the victim and other people who might be close to them, including the caregivers. In the maternal and infant population, immunization and infectious diseases continue to be a topic of debate. Averagely, immunization and prevention of infectious diseases has improved. In the United States the rate of immunization has gone up across all races, income groups and ethnicities. Similarities among the races where this special population are located narrowed down.
More so, prevention of diseases is less costly compared to the case where everyone is infected and needs medication. Despite the decreasing disparity, due to vaccination programs such as vaccination for infants, mother and infants from poor families, non-white have low immunization rates than those who were well off and white. Similarly, there are cost ba ...
1) Community-based interventions have been shown to successfully change risky behaviors and prevent HIV transmission when they incorporate cultural elements, community participation, and education programs delivered by community leaders.
2) Effective interventions identify factors influencing HIV transmission, tailor prevention strategies to specific populations, and address barriers like discrimination and lack of culturally competent healthcare services.
3) For HIV-positive injecting drug users, improved access to substance abuse treatment, healthcare, housing support and antiretroviral therapy through community programs can achieve comparable health outcomes to non-drug users.
Narrative review: Is it rational to pursue Zero Suicides among patients in he...Jan Mokkenstorm
Suicide prevention is a major health care responsibility in need of new perspectives. This study reviews Zero Suicide, an emerging approach to suicide prevention that embraces the aspirational goal of zero suicides among patients treated in health care systems or organizations. Zero Suicide is gaining international
momentum while at the same time evoking objections and concerns. Fundamental to Zero Suicide is a multilevel system view on suicide prevention, with three core elements: a direct approach to suicidal behaviors; continual improvement of the quality and safety of care processes; and an organizational commitment to the aspirational goal of zero suicides. The rationale and evidence
for these components are clarified and discussed against the backdrop of concerns and objections that focus on possible undesired consequences of the pursuit of zero suicide, in particular for clinicians and for those who are bereaved by suicide. It is concluded that it is rational to pursue zero suicides as
an aspirational goal, provided the journey toward zero suicides is undertaken in a systemic and sustained manner, in a way that professionals feel supported, empowered, and protected against blame and inappropriate guilt.
Condoms as a harm reduction approach in prisonsErin Bortel
Keeping High-Impact Prevention at the forefront of our attention will guide administrators and policy-makers implementing harm reduction strategies in incarcerated settings to End AIDS in NYS by 2020.
Fourteen years ago I was asked to prepare the following document. After it was completed, the contractor asked me to re-do it because they had made a mistake in the age they wanted covered. [They seemed to believe the information was too sensitive politically] and buried the report. I'm submitting it here now to learn what the LinkedIn audience thinks. Is it time to update it?
1. HIV remains a major public health problem, infecting 1.8 million people per year globally. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy, using antiretroviral drugs like Truvada to significantly reduce transmission risk.
2. While PrEP is highly effective at preventing HIV, it also increases the risk of other sexually transmitted infections. PrEP also faces stigma and the perception that it promotes reckless behavior.
3. Overall, PrEP is a markedly effective HIV prevention strategy that avoids unnecessary morbidity and mortality, though it comes with some adverse effects and challenges. Future PrEP methods may provide more convenient dosing options to improve safety, adherence and uptake.
Healthcare seeking and sexual behaviour of clients attending the suntreso sti...Alexander Decker
A study of 185 clients with sexually transmitted infections (STIs) attending an STI clinic in Kumasi, Ghana found that 64% delayed seeking treatment for more than 4 weeks after symptoms appeared. 61% had previously sought treatment elsewhere before coming to the clinic. 80% had unprotected sex while symptomatic. The document discusses factors that influence healthcare seeking behaviors for STIs, including long wait times, stigma, lack of privacy, and attitudes of healthcare providers. It also examines sexual behaviors among STI patients, noting that most engage in unprotected sex during symptomatic periods. Understanding these healthcare seeking patterns and behaviors can help develop more effective STI prevention and control programs.
The document discusses how corporate social responsibility involves businesses conducting their operations in an environmentally and socially responsible way, such as by avoiding pollution and resource depletion. It argues that CSR can benefit companies in the long run through improved public image and avoiding pressure from activists. Addressing serious social issues like poverty through CSR strategies could help reduce economic and social risks while allowing for more harmonious living on the planet.
The document summarizes 18 studies on preventing HIV among older adults. It finds that while HIV rates are rising in older populations, few prevention programs have targeted this group. The studies examined universal prevention programs for the general older population (3 studies), indicated prevention for older adults already infected (5 studies), and strategies/recommendations (10 studies). Most interventions showed improved HIV knowledge, though more research is needed due to the growing numbers of older adults at risk of infection.
Similar to AIDSTAR-One Reinvigorating Condoms as an HIV Prevention Tool (20)
AIDSTAR-One Report: Rapid Assessment of Pediatric HIV Treatment in NigeriaAIDSTAROne
This document summarizes a rapid assessment of pediatric HIV treatment in Nigeria conducted by AIDSTAR-One in 2011.
Part I identified several barriers to providing quality pediatric HIV care: human resource constraints, lack of caregiver involvement, limited disclosure to children and adolescents, adherence challenges, and inadequate resources at sites. It provides recommendations to address these barriers, such as limiting staff transfers, improving caregiver support, using age-appropriate adherence tools, and expanding electronic medical records.
Part II reviewed outcomes of 1,516 pediatric patients and found 4.2% mortality and 19.1% loss to follow up. Few health systems challenges significantly impacted treatment outcomes. Earlier treatment initiation and reduced loss to follow up are needed.
AIDSTAR-One Case Study: Targeted Outreach Program BurmaAIDSTAROne
The document summarizes the Targeted Outreach Project (TOP) in Burma, which works to scale up HIV programming among sex workers. TOP was launched in 2004 by Population Services International to provide health services and empowerment opportunities to female sex workers and men who have sex with men. It has expanded to 18 cities across Burma, reaching over 70% of estimated sex workers and 25% of estimated men who have sex with men. TOP operates drop-in centers that provide a range of free health services including STI testing/treatment, family planning, and HIV counseling/testing. It also offers social/economic support through small loans, education, and advocacy to improve participants' well-being and reduce risky behaviors. Evaluation data
AIDSTAR-One Co-trimoxazole Pilot Assessment ReportAIDSTAROne
AIDSTAR-One developed and piloted provider and patient educational tools to increase appropriate prescription and use of co-trimoxazole for eligible people living with HIV. Before and after the pilot, AIDSTAR-One conducted a mixed-methods assessment to analyze the effectiveness and acceptability of the co-trimoxazole tools. This report recommends adoption and scale-up of the tools in Uganda and other countries.
AIDSTAR-One conducted a 3-year demonstration project in Namibia to reduce heavy drinking and risky sexual behavior among bar patrons in a low-income neighborhood on the outskirts of Namibia's capital, Windhoek. This report describes how the intervention was implemented, monitored, and evaluated, and reports the final assessment results. It also offers key recommendations for future research and programming. http://aidstarone.com/focus_areas/prevention/resources/reports/alcohol_namibia_intervention_report
AIDSTAR-One Faith-Based Organizations and HIV Prevention with MARPs in MexicoAIDSTAROne
La Iglesia de la Reconciliación, VIHas de Vida, and El Mesón de la Misericordia are three faith-based organizations in Mexico that implement innovative HIV prevention activities with most-at-risk populations, including men who have sex with men and sex workers. They integrate messages on HIV prevention within a holistic approach that addresses spirituality, sexuality, and health. Through diverse activities like educational talks and workshops, as well as referrals to testing and care, these organizations help fill gaps and reduce stigma for at-risk groups.
AIDSTAR-One HIV Treatment Guidelines in Guyana - The Fast Track to Diagnosis ...AIDSTAROne
This case study details Guyana's process for revision of their national HIV treatment guidelines, based on WHO's 2010 revised recommendations . While many countries are still working to revise their national guidelines in response to WHO's latest guidance, the National AIDS Programme in Guyana has been implementing elements of WHO's 2010 recommendations since 2006.
www.aidstar-one.com/focus_areas/treatment/resources/case_study/guyana_treatment_guidelines
AIDSTAR-One Implementation of WHO's 2008 Pediatric HIV Treatment GuidelinesAIDSTAROne
In April 2008, the WHO Technical Reference Group for Pediatric HIV/ART and Care released a series of nine updated recommendations for diagnostic testing, initiation of treatment, and appropriate treatment regimens for HIV-exposed and infected infants. This technical brief outlines practical implementation considerations for program planners and policymakers working to incorporate these recommendations into their local efforts.
http://www.aidstar-one.com/implementation_whos_2008_pediatric_hiv_treatment_guidelines
AIDSTAR-One Protecting Children Affected by HIV Against Abuse, Exploitation, ...AIDSTAROne
This document is intended to explore strategies to protect children orphaned or made vulnerable by HIV (OVC) from abuse, exploitation, violence, and neglect. The report draws from lessons learned by OVC program managers, designers, and policy developers—particularly those associated with the President’s Emergency Plan for AIDS Relief (PEPFAR).
http://www.aidstar-one.com/focus_areas/OVC/reports/protecting_children_affected_by_HIV
AIDSTAR-One Increasing Access to Prevention of Mother-to-Child Transmission S...AIDSTAROne
This technical report discusses the many services needed throughout the prevention of mother-to-child transmission (PMTCT) and infant care services continuum and identifies potential barriers to service coverage, access, and utilization. AIDSTAR-One provides examples of evidence-based and emerging practices to mitigate these barriers.
www.aidstar-one.com/focus_areas/pmtct/resources/report/increasing_access_to_pmtct_services
AIDSTAR-One Prevention of Alcohol-Related HIV Risk BehaviorsAIDSTAROne
A growing body of research suggests that alcohol consumption is associated with the sexual behaviors that put people at risk for HIV. In developing countries battling severe HIV epidemics, addressing harmful drinking in conjunction with interventions to reduce sexual risk behavior may reduce HIV transmission more quickly than conventional HIV prevention interventions alone. Developed for program planners and implementers, this technical brief reviews the evidence on new and innovative programs in this emerging area. The brief catalogs what is known about the relationship between harmful alcohol use and HIV sexual risk behavior and offers a critical analysis of interventions to address the issue.
www.aidstar-one.com/focus_areas/prevention/resources/technical_briefs/prevention_alcohol_related_risk_behavior
AIDSTAR-One Meeting the Psychosocial Needs of Children Living with HIV in AfricaAIDSTAROne
An abbreviated version of the Equipping Parents and Health Providers to Address the Psychological and Social Challenges of Caring for Children Living with HIV in Africa report, this technical brief documents promising practices in critical services related to the psychological and social wellbeing of perinatally-infected children in Africa. These promising practices include the identification, testing, and counseling of children so that they are linked to appropriate care as early as possible, as well as on-going support to help children and their families manage disclosure, stigma, grief and bereavement processes.
www.aidstar-one.com/focus_areas/care_and_support/resources/technical_briefs/foundation_future
AIDSTAR-One NuLife—Food and Nutrition Interventions for UgandaAIDSTAROne
This technical report examines a nutritional assessment, counseling, and support (NACS) program in Uganda that uses a quality improvement approach to services.
www.aidstar-one.com/focus_areas/care_and_support/resources/report/nulife_food_and_nutrition_interventions_uganda
AIDSTAR-One PRASIT: Using Strategic Behavioral Communication to Change Gender...AIDSTAROne
1) The PRASIT program in Cambodia uses strategic behavioral communication to promote positive gender norms and reduce HIV risk among at-risk populations.
2) It comprises three initiatives - SMARTgirl focuses on entertainment workers, MStyle targets men who have sex with men, and You're the Man addresses gender norms among male clients of entertainment workers.
3) The initiatives use branding, peer outreach, and educational sessions to promote safer sexual practices and empower at-risk groups. The goal is to challenge norms that increase HIV vulnerability and portray at-risk populations as intelligent and able to protect their health.
Prompted by a growing knowledge of the complexity of HIV transmission, many countries are reassessing the nature of their HIV epidemics. "Mixed" epidemics, or concurrent epidemics experienced by both the general population and members of most-at-risk populations (MARPs), are of growing importance in HIV programming. Nigeria, a country with a range of regional and local epidemics, is now attempting to incorporate programming for MARPs into the national HIV response. This case study documents the country's analysis of its epidemics and the efforts of the Nigerian government to adjust their national strategic plan according to the results of the analysis.
www.aidstar-one.com/focus_areas/prevention/resources/case_study_series/nigeria_mixed_epidemics
AIDSTAR-One Caring for Children Living with HIV in AfricaAIDSTAROne
This report, Equipping Parents and Health Providers to Address the Psychological and Social Challenges of Caring for Children Living with HIV in Africa, provides information to better understand the psychological and social challenges faced in Africa by perinatally-infected children (aged 0-12 years), their parents/caregivers, and their health providers. It explores factors that contribute to the ability of children living with HIV to cope and thrive, and identifies the tools and approaches being used to help parents/caregivers and health providers provide psychosocial support (PSS) to these children. The report elaborates on the themes discussed in the Meeting the Psychosocial Needs of Children Living with HIV in Africa technical brief.
www.aidstar-one.com/focus_areas/care_and_support/resources/report/clhiv_pss_needs_africa
AIDSTAR-One Sex Work and Life with Dignity: Sex Work, HIV, and Human Rights P...AIDSTAROne
In Peru, where cultural norms emphasize women's subordination and the importance of masculinity, programs with a focus on gender—particularly those involving sex workers—are often underfunded and underrepresented. This case study (one of nine in a series) describes how three organizations focused on sex workers and transgendered and transsexual people have joined together to advance the rights of sex workers. The Sex Work, HIV, and Human Rights Program uses a democratic and participatory approach in order to raise awareness of human rights and advocate for sex workers' rights on both national and local levels.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/life_with_dignity_peru
AIDSTAR-One Different Needs But Equal Rights: Giving Voice to Transgender Com...AIDSTAROne
Although transgender individuals are a highly vulnerable segment of El Salvador's population, the national political climate has only recently begun to support HIV programming that is tailored to their needs. Additionally, limited access to medical services and legal protection and considerable societal stigma and discrimination means that organizations working with transgender individuals must meet a variety of complex and varied needs. This case study, one of 9 in a series, describes the challenges and successes of the Solidarity Association to Promote Human Development (ASPIDH), an NGO that promotes transgender rights via sensitization, education, and advocacy activities.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/aspidh_salvador
AIDSTAR-One Breaking New Ground in VietnamAIDSTAROne
1) The STEP program in Vietnam aims to integrate gender considerations into CARE's work by providing support services to male and female drug users and sex workers both before and after their release from detention centers.
2) The program recognizes that gender inequality increases vulnerability and provides gender-sensitive counseling, health services, job training, and social support to help prevent violence and relapse.
3) Services include pre-release counseling at detention centers and post-release drop-in centers that provide counseling, referrals, home visits, and community education with the goal of smooth reintegration.
AIDSTAR-One Emergency Planning for ART During Post-Election Violence in KenyaAIDSTAROne
In 2007, Kenya experienced a wave of violence following its presidential elections. This case study documents the emergency plans that had been in place to ensure continuity of HIV treatment programs prior to the outbreak of violence, and the events that occurred during the period of violence. It also highlights the changes to contingency planning for HIV that have taken place since the violence ended.
www.aidstar-one.com/focus_areas/treatment/resources/case_study_series/emergency_planning_for_art_kenya
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
In a world overflowing with diet trends and conflicting nutrition advice, it’s easy to get lost in misinformation. This article cuts through the noise to debunk common nutrition myths that may be sabotaging your health goals. From the truth about carbohydrates and fats to the real effects of sugar and artificial sweeteners, we break down what science actually says. Equip yourself with knowledge to make informed decisions about your diet, and learn how to navigate the complexities of modern nutrition with confidence. Say goodbye to food confusion and hello to a healthier you!
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
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AIDSTAR-One Reinvigorating Condoms as an HIV Prevention Tool
1. AIDSTAR-One SpOTlIghT On pREVEnTIOn
Reinvigorating Condoms as an hIV prevention Tool
Krishna Jafa and Steven Chapman
The world is enticingly close to realizing the
vision of an AIDS-free generation. More HIV-
infected individuals are accessing treatment
earlier in the course of their disease, and
elimination of vertical (mother-to-child)
transmission—while still a challenge—is
closer to becoming a reality (Ciaranello et
al. 2012). However, this vision cannot be
achieved through treatment alone. HIV
will only slow down when new infections,
currently at two for every one person put on
treatment, diminish dramatically (Joint United
Nations Programme on HIV/AIDS 2010). This
means improved access to, and utilization of,
combination prevention—a mix of evidence-
based HIV prevention interventions including
condoms.
In this editorial, we summarize the evidence on
condoms for HIV prevention, discuss barriers and
opportunities regarding supply, and propose ways to
reinvigorate the use of condoms as an HIV prevention
tool. This reinvigoration is needed now more than ever,
given the vital role of condoms in both primary HIV
prevention and in interventions to promote positive
health, prevention, and dignity for people living with
HIV.
Condoms Work, and Many People Use Them
Condoms are an effective barrier method for
preventing HIV, other sexually transmitted infections
(STIs), and unintended pregnancy, and are used in
hundreds of millions of sex acts each year (Davis
and Weller 1999; Pinkerton and Abramson 1997;
Weller and Davis-Beaty 2002). They play a key role
in sustaining the benefits of other high-impact HIV
prevention interventions such as male circumcision
and prevention of mother-to-child transmission. Thus,
condoms are a vital component of a comprehensive
HIV prevention strategy.
Condom promotion is generally considered a cost-
effective HIV prevention intervention as measured
by the cost per disability-adjusted life year (DALY)
averted. The DALY is a composite metric that
combines years lived with disability and years lost to
premature death, and one DALY averted represents
one year of healthy life. While cost effectiveness ratios
are context-specific and there isn’t universal agreement
on thresholds of cost effectiveness, a cost per DALY
averted ratio of under U.S.$50 is generally considered
cost-effective. The cost per DALY averted for male
condoms ranges from U.S.$19 to $205, and this
range indicates condom programs vary in design and
implementation (Jamison et al. 2006).
Condom promotion can be controversial. Earlier in
the course of the epidemic, there were concerns that
condoms were being promoted in ways that ignored
structural barriers and religious sensitivities, failed
to include communities, and potentially increased
promiscuity (Pfeiffer 2004). Were these concerns
overstated? Perhaps. We now know that condoms
The views in this editorial do not necessarily reflect those of USAID or the U.S. Government.
1 September 2012
2. 2
SPoTlIGHT oN PREVENTIoN • REINVIGoRATING CoNDoMS AS AN HIV PREVENTIoN Tool
have been essential to achieving significant prevention
gains in both generalized and concentrated HIV
epidemics. For example, a recent modeling paper
suggests that HIV incidence in South Africa among
15 to 49 year olds declined by as much as 23 to 37
percent from 2000 to 2008—and that much of this
decline can be attributed to increased condom use
(Johnson et al. 2012). Similarly, in Zimbabwe, reduction
of multiple and concurrent partnerships, high condom
use in non-regular partnerships, and improved
consistency of condom use among women with their
casual partners are thought to have contributed
to a fall in HIV prevalence from 29.3 percent in
1997 to 15.6 percent in 2007 (Gregson et al. 2010).
Thailand’s program requiring 100 percent condom
use during commercial sex had similar results from
1991 to 1995 among young Thai men—condom use
at last commercial sex increased from 61 percent to
92.5 percent, and HIV prevalence fell from between
10.4 and 12.5 percent to 6.7 percent (Nelson et al.
1996). Similar successes are noted in other countries
(Population Services International 2006; Population
Services International 2009; Riedner et al. 2006; World
Health Organization [WHO] 2000).
But Not Everyone Wants to Use—or Is Able
to Use—Condoms
Despite proven effectiveness, there are still several
challenges to condom use. Moving forward, programs
must address these barriers and incorporate (and test)
potential solutions as part of any prevention strategy.
Risky Behavior
Even the most ardent condom promoter will admit
that it is difficult to promote condoms among couples
in established sexual relationships, one or both of
whom may also have other sex partners. This is true
regardless of whether societal and cultural norms
condone multiple and concurrent sexual partnerships
(Halperin et al. 2011; Shelton 2006). Moreover, condom
use is self-reported and survey respondents may
therefore adjust their answers according to what seems
more socially desirable (Aho et al. 2010). Condom
promotion without efforts to reduce the number of
partners is only half a solution.
Two behavioral models of risk-taking provide insights
into why people use condoms less often, or stop using
condoms altogether, even when they are aware that
continued use protects against HIV and other STIs.
The risk compensation model suggests that when an
effective prevention or treatment intervention (or one
perceived to be effective) is available, an individual’s
perception of transmission risk may be reduced,
which in turn can lead to increased risk-taking (Eisele
et al. 2009; Kelly et al. 1998; Tun et al. 2004). For
example, men who become circumcised—and who
are thus partially protected from HIV acquisition—may
incorrectly perceive themselves to be at no risk for HIV,
and thus may choose to discontinue condom use or to
have more sex partners. The behavioral disinhibition
model suggests that when an effective intervention
such as antiretroviral treatment is available, an individual
may be less likely to exercise self-restraint and more
likely to focus on the pleasure of unprotected sex—and
not use a condom (Blower, Gershengorn, and Grant
2000; Law et al. 2001; Wilson et al. 2008). Substance
use is thought to further increase such risk-taking
because of its own disinhibiting effect.
Both models of risk-taking help to explain the rationale
for stopping or reducing condom use among men who
are medically circumcised (Agot et al. 2007; Bailey et
al. 2007; Gray et al. 2007), alcohol or substance users
with their partners (Fritz 2011), men who have sex with
men (MSM) (Grulich 2000; Hogg et al. 2001; Sampaio
et al. 2002), and discordant couples (Allen et al. 2003;
Coldiron et al. 2008; Eaton and van Der Straten
2009). There is mixed evidence of consistent condom
use in some of these populations. Furthermore, the
concept of partial protection that is conferred by
HIV prevention interventions such as medical male
circumcision, and the attendant need to continue using
condoms consistently, is difficult to convey.
3. 3
spotlight on Prevention • Reinvigorating Condoms as an HIV Prevention Tool
Understanding the underlying reasons for risk-taking
better, and designing interventions based on that
understanding, becomes even more important with
the U.S. Food and Drug Administration’s recent
approval of pre-exposure prophylaxis (U.S. Food and
Drug Administration 2012). Messages may need to
address several types of barriers—such as a risk-based
calculation that condom use is not as necessary, or
arousal-based barriers to condom use.
Structural Barriers
It is essential to consider, and address where possible,
structural factors that may contribute to increased risk-
taking. These barriers—including stigma, criminalization,
and other legislative and social barriers—can impede
condom use in important ways. For example, even
though we know that unprotected receptive anal sex is
the most efficient route for transmitting HIV, condom
promotion among MSM and transgendered people
is patchy or absent in a number of countries (Ayala
n.d.; Baggaley, White, and Boily 2010). A recent report
shows that limited or absent condom promotion
results from criminalization of same-sex behaviors,
homophobia, and discrimination against this vulnerable
population (Beyrer 2010; Global Commission on
HIV and The Law 2012). When condoms, lubricants,
and educational materials promoting condom use
are used as evidence of crime, it becomes difficult to
reach MSM—and other at-risk populations such as
sex workers—with these much-needed interventions.
Sadly, such criminalization continues despite growing
evidence that robust coverage of HIV interventions for
MSM has positive epidemiologic effects and is cost-
effective (Beyrer et al. 2011).
Dual Protection and Dual Use
Another prevention option that needs to be better
understood is the use of condoms for dual protection
(against STIs and pregnancy), as well as dual use
of condoms plus one other modern contraceptive
method to prevent unintended pregnancy and HIV
transmission or re-infection (Pazol, Kramer, and
Hogue 2010; Prata, Sreenivas, and Bellows 2008).
There is no globally accepted indicator for measuring
use of dual protection, and Demographic and Health
Surveys only report on the primary family planning
method used. These are missed opportunities to
understand the impact of family planning and HIV
integration programs—with potential negative impacts
on reduction of both heterosexual and vertical
transmission (Wilcher and Cates n.d.).
These and other challenges demand fresh thinking
about how to address impediments to equitable access,
as well as rigorous evaluation of which elements of
condom programming work—and, equally importantly,
don’t work—in both concentrated and generalized
epidemics (Hearst and Chen 2004).
The Supply Side: Who Procures and
Distributes Condoms?
Next, we discuss who buys and distributes condoms
for HIV prevention, quality considerations, and key
challenges in condom commodity procurement
planning and forecasting.
Donor Contributions
Condoms are listed on the WHO’s Model List of
Essential Medicines (2011). Male condoms are very
affordable (U.S.$0.02–0.04 per unit) and are widely
distributed. In 2010, procurement of male condoms
by bilateral and multilateral donors for public sector
distribution and social marketing exceeded 2 billion
for the first time and reflected a 22 percent increase
over 2009 (Reproductive Health Supplies Coalition
n.d.). The five leading agencies that purchased male
and female condoms in 2010 were the U.S. Agency
for International Development (USAID; 37 percent),
the UN Population Fund (UNFPA; 22 percent), the
Global Fund to Fight AIDS, Tuberculosis and Malaria
(9 percent), Kreditanstalt Für Wiederaufbau (KfW; 2
percent), and the UK Department for International
4. 4
spotlight on Prevention • Reinvigorating Condoms as an HIV Prevention Tool
Development (2 percent). Sub-Saharan African
countries are the major recipients of donated condoms.
Country Contributions
Unfortunately, very few governments in the countries
worst hit by the epidemic procure sizeable quantities
of condoms. By 2015, an estimated 13 billion condoms
will be required globally for HIV prevention, and an
additional 5 billion for family planning (Reproductive
Health Supplies Coalition 2009). While larger middle-
income countries such as Brazil, China, India, and
South Africa have begun, and will probably continue,
to include condoms in their own country budgets,
donors—and ministries of health with available
resources—will still need to help lower-income
countries purchase an estimated 2.4 billion condoms
for HIV prevention, and 2 billion condoms for family
planning in 2015. This signifies a 120 percent increase
over current donor procurement levels (Reproductive
Health Supplies Coalition 2009). Additional resources
would be needed for shipping, distribution, and
promotion. While the volume of condoms needed
seems large, the funding needed to support condom
commodity security in the highest-need countries is a
fairly modest $88 million (assuming a unit cost per male
condom of $0.02)—less than 1.5 percent of total HIV
funding disbursements made by donor governments
in 2010 (Kates et al. 2011). Separate calculations are
needed to estimate the funding needed for lubricants.
Quality Considerations
Also on the supply side, condom quality is an essential
consideration. Most donors and implementing agencies
procure condoms from manufacturers whose factories
are pre-qualified by WHO. However, from time to
time, reports of poor condom quality—often difficult
to substantiate—do surface, and these can rapidly
undermine condom promotion programs. There are
other quality-related issues too. While there were
26 pre-qualified male condom factories owned by 21
different manufacturers in 2011 (UNFPA 2012; WHO,
UNFPA, and Family Health International 2010), there
are only two WHO pre-qualified female condom
manufacturers at the time of writing. Also, while there
is clear guidance from WHO on male latex condom
specifications and procurement (WHO, UNFPA, and
Family Health International 2010), there is no globally
agreed protocol for ongoing quality control from the
point of manufacture to the end user.
Another issue is that male condoms are often
paired with lubricant for distribution to certain key
populations (MSM and transgendered people, and
sometimes sex workers). The absence of globally
accepted manufacturing specifications for lubricant, and
of evidence to strongly support lubricant use for HIV
prevention, is of concern. In vitro studies suggest that
hyperosmolar lubricant may increase the risk of HIV
transmission by causing damage to colonic and rectal
surface epithelial cells (Begay et al. 2011; Fuchs et al.
2007).
Challenges in Quantifying How Many Condoms are
Needed
In a number of settings, capacity to undertake accurate
forecasting and procurement planning is limited. It is
thus currently a challenge to precisely quantify how
many condoms are needed, and where. Even basic
current information on the quantities of condoms
procured by country governments, or distributed by
private sector players, is either difficult or prohibitively
expensive to obtain. This limits the ability to define
the size, value, and capacity of the total condom
market to meet current need to prevent HIV/STIs
and unintended pregnancy. Broader participation by
more agencies, country governments, and commercial
players in providing data to the Reproductive Health
Supplies Coalition’s RHInterchange will help make such
information more widely available.
Additionally, at the country level and often at the donor
level, condom requirements are typically calculated
separately for HIV prevention and family planning,
which can lead to losses in procurement efficiency.
USAID’s Central Contraceptive Procurement Project
5. 5
spotlight on Prevention • Reinvigorating Condoms as an HIV Prevention Tool
seeks to resolve this coordination problem by providing
guidance on condom procurement for both purposes
(Family Planning Logistics Management 2000).
As condom promotion programs strive for
sustainability, it is important to consider the total
market for condoms, including public-sector (free),
subsidized, and commercial distribution. Programs
should also monitor use in key populations, equity
of condom access, and levels of subsidy needed to
maintain high levels of consistent condom use among
the highest-risk populations. Finally, they should seek to
increase levels of use among non-users or inconsistent
users who are at higher risk for HIV (Chapman et al.
2012).
Call to Action to Reinvigorate Condom
Promotion
We propose a call to action to reinvigorate the
promotion of condoms as an HIV prevention tool.
We believe that if programs follow the steps outlined
below, condom promotion will be more effective and
cost-effective, and ultimately will achieve a higher health
impact:
• Consider and address behavioral disinhibition
and risk compensation when designing condom
promotion and combination prevention programs.
• Combine condom promotion with initiatives to
address the structural factors associated with risky
sexual behaviors, such as stigma, discrimination, and
criminalization of certain key populations.
• Develop a globally accepted indicator and a body
of evidence on dual use of condoms with other
modern family planning methods.
• Disseminate to policymakers evidence on the impact
of making HIV prevention interventions, including
condoms and lubricants, freely accessible to MSM.
• Address the evidence gap for lubricants in the
context of HIV transmission.
• Build consensus on protocols for condom quality
control at the country level to address quality
concerns among consumers.
• Advocate with country governments for the
inclusion of condom procurement within their health
budgets, while reaffirming donor commitments to
countries most in need.
• Strengthen capacity at the national and global levels
to coordinate condom procurement for both HIV
and family planning, and at national levels to improve
procurement planning to prevent stockouts and
shortages.
• Invite and involve private-sector players to join
rums such as the
, so that comprehensive supply information
becomes available.
• Develop country-level condom commodity
security strategies that consider the total market
for condoms, and not just the public and social
marketing sectors.
fo Reproductive Health Supplies
Coalition
Condoms are an effective, affordable, and vital part of
a comprehensive and combined response to the HIV
epidemic. Condom use can, and must, be included
among the critical strategies for achieving the vision of
an AIDS-free generation. g
About the Authors
Krishna Jafa is Director of Sexual & Reproductive
Health & Tuberculosis at PSI. She is a physician
and epidemiologist with experience in the design,
management, and monitoring and evaluation of public
health programs and research in Asia, Africa, and the
United States. Areas of technical expertise include: family
planning; sexual and reproductive health and rights; HIV
prevention and diagnosis; commodity security; quality
improvement of clinical services; correctional health;
post-conflict humanitarian response; and epidemic
response. Dr. Jafa has successfully led efforts to improve
6. 6
spotlight on Prevention • Reinvigorating Condoms as an HIV Prevention Tool
social marketing and social franchising programs for
sex workers, MSM, inmates, people who inject drugs,
and other vulnerable populations. She contributed to
the U.S. Centers for Disease Control and Prevention’s
(CDC’s) landmark 2005 recommendation to permit
condom distribution in U.S. prisons and jails. Dr. Jafa
obtained her medical degree from Rajasthan University,
India and her MPH from Harvard University; she is an
alumna of CDC’s Epidemic Intelligence Service.
Steven Chapman became Chief Technical Officer at
PSI in 2008 and leads PSI’s efforts to improve the
effectiveness, cost-effectiveness, and equity of its
interventions. Steven manages PSI’s Technical Services
team which consists of more than 50 specialists in five
departments: malaria and child survival; HIV, tuberculosis
and reproductive health; research and metrics; social
marketing; and learning and performance. He also heads
PSI’s strategic initiative on innovation, which aims to
increase the proportion of DALYs averted by PSI from
new interventions, and consists of an innovation fund,
cross departmental innovation teams, capacity building
efforts, and pilot projects.
Acknowledgments
This publication was made possible through the
support of the U.S. President’s Emergency Plan for
AIDS Relief (PEPFAR) through the U.S. Agency for
International Development under contract number
GHH-I-00-07-00059-00, AIDS Support and Technical
Assistance Resources (AIDSTAR-One) Project, Sector I,
Task Order 1.
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