A Practical Guide to Integrating Reproductive Health and HIV/AIDS into Grant Proposals to the Global Fund

Integrating RH and HIV can greatly contribute to mitigating the AIDS pandemic by reducing unintended pregnancy; preventing perinatal transmission; expanding to more target groups; reducing gender based violence; meeting the needs of people living with HIV and providing our youth with the knowledge and services they need. Whether to integrate, how to integrate and exactly what to integrate will depend on a country's epidemiological profile, policies and program structures.Experience with implementation of integration initiatives in countries around the world shows that scale up and sustainability requires attention to policy and program operations issues. This document, with links to a range of resources, will help CCMs, civil society organizations and others developing proposals for the Global Fund that contribute to preventing HIV and mitigating the effects of the AIDS pandemic through programs that link and integrate RH and HIV/AIDS

Smarter Programming of the Female Condom: Increasing Its Impact on HIV Prevention in the Developing World

The purpose of this study was to investigate the relative value of the female condom for HIV prevention within heterosexual relationships in the developing world. In the last ten years, the world has witnessed both historic financial commitments to HIV/AIDS and new prevention options, including biomedical prevention research, male circumcision, and a dramatic scale-up of voluntary counseling and testing. At the same time, where HIV remains at epidemic levels in many countries, there has been a growing commitment to treatment access alongside prevention programs. However, portions of populations, particularly youth and women, remain highly vulnerable to HIV infection. Accordingly, the global health community can benefit from a better understanding of how existing prevention options should be effectively and efficiently delivered to reduce HIV in the developing world. This report provides guidance for the global health community for considering how the female condom fits within the set of prevention interventions currently available

Integrating Female Condoms into HIV Prevention Programs: A Case Study of Barriers, Facilitators, and Future Opportunities in Kenya

Female condoms are an important option for dual protection from unintended pregnancy and HIV and other sexually transmitted infections, especially when male condoms cannot be used. Incorporating female condoms into other HIV prevention channels is a potential strategy to increase access for women and men in need of dual protection beyond male condoms. Policies recommend incorporating female condoms into two HIV prevention programs that have gained significant momentum and political support -- prevention of mother-to-child transmission of HIV (PMTCT) and voluntary medical male circumcision (VMMC). However, there is a lack of clarity on how female condoms are being included at the programmatic level

Start With a Girl: A New Agenda for Global Health

Examines how social factors shape the health issues adolescent girls face in developing countries. Calls for a health agenda for girls, including focused HIV prevention and maternal health advocacy; elimination of child marriage; and secondary education

Substituting for families? Schools and social reproduction in AIDS-affected Lesotho

This is the post-print version of the final published article that is available from the link below. Copyright @ 2008 Editorial Board of Antipode.Families, the state and employers all have a broad if differentiated interest in securing the daily and generational reproduction of society. Whereas in Western countries, the past two decades have witnessed a progressive displacement of responsibility for social reproduction from the state to families, in southern Africa, day-to-day social reproduction has always remained overwhelmingly the preserve of families. Today, however, the AIDS pandemic is radically transforming family life for many children, and prompting concerns (arguably a moral panic) about the potential breakdown of social reproduction. Even in Africa, schools have long supplemented families in delivering generational reproduction, albeit geared around the transfer of “factual” knowledge and with a narrow focus on preparing new generations of workers. In light of the AIDS pandemic, a number of commentators have suggested ways in which schools could further substitute for the diminishing capacities of families. Based on interviews with decision-makers and analysis of policy documents, I explore a number of interventions being enacted in Lesotho's schools. I argue that such initiatives remain small in scale and often justified in relation to retaining children in school. In practice both government and employers remain more interested in the generational reproduction of workers than in daily reproduction. If the welfare needs of AIDS-affected children are to be met through schooling, there is a need for the education sector's role to be understood in relation to an ethics of care, rather than the functionalist production of a future workforce.RGS-IBG Small Research Gran

Previous reproductive history and post-natal family planning among HIV-infected women in Ukraine

BACKGROUND: Ukraine has the highest antenatal HIV prevalence in Europe. The national prevention of mother-to-child transmission (MTCT) programme has reduced the MTCT rate, but less attention has been given to the prevention of unintended pregnancy among HIV-positive women. Our objectives were to describe the reproductive health, condom use and family planning (FP) practices of HIV-positive childbearing Ukrainian women and to identify factors associated with different methods of post-natal contraception. METHODS: HIV-infected childbearing women, diagnosed before or during pregnancy, were enrolled prospectively in a post-natal cohort study in four regional HIV/AIDS centres in Ukraine from December 2007. Logistic regression models were used to identify factors associated with post-natal FP practices. RESULTS: Data were available for 371 women enrolled by March 2009; 82% (n = 303) were married or cohabiting, 27% (97 of 363) reported a current HIV-negative sexual partner and 69% were diagnosed with HIV during their most recent pregnancy. Overall, 21% (75 of 349) of women were not using contraception post-natally (of whom 80% reported no current sexual activity), 50% (174 of 349) used condoms, 20% (74 of 349) relied solely/partially on coitus interruptus and 4% used hormonal methods or intrauterine device. Among married/cohabiting women, consistent use of condoms in the previous pregnancy [AOR 1.96 (95%CI 1.06–3.62)], having an HIV-positive partner [AOR 0.42 (0.20–0.87)], current sexual activity [AOR 4.53 (1.19–17.3)] and study site were significantly associated with post-natal condom use; 16% of those with HIV-negative partners did not use condoms. Risk factors for non-use of FP were lack of affordability [AOR 6.34 (1.73–23.2)] and inconsistent use of condoms in the previous pregnancy [AOR 7.25 (1.41–37.2)]. CONCLUSIONS: More than 40% of HIV-positive women in this population are at risk of unintended pregnancy and the one in six women in HIV-discordant couples not using barrier methods risk transmitting HIV to their partners. Our study results are limited by the observational nature of the data and the potential for both measured and unmeasured confounding

Issues and Challenges of HIV/AIDS Prevention and Treatment Programme in Nepal

This paper explores some of the key issues and challenges of government HIV/AIDS prevention and treatment programme in Nepal. Providing HIV/AIDS prevention and treatment services in Nepal is associated with a number of issues and challenges which are shaped mostly on cultural and managerial issues from grass root to policy level. Numerous efforts have been done and going on by Nepal government and non-government organization but still HIV prevention and treatment service is not able to reach all the most at risk populations because cultural issues and managerial issues are obstructing the services. The existing socio-cultural frameworks of Nepal do not provide an environment for any safe disclosure for person who is HIV infected. Thus, there is an urgent need to address those issues and challenges and strengthen the whole spectrums of health systems through collaborative approach to achieve the millennium development goals. It will be the purpose of this paper to contribute to the policy makers by exploring the pertinent issues and challenges in the HIV/AIDS programme

Aid and AIDS: a delicate cocktail

Development assistance targeting health overwhelmingly concentrates on HIV/AIDS. This column argues that that focus neglects critical demographic issues and degrades health infrastructure, particularly in Sub-Saharan Africa. The prime rule for AIDS aid should be “First, do no harm”.