ABSTRACT While female intravenous drug users (IDUs) are at high risk of acquiring HIV from needle... more ABSTRACT While female intravenous drug users (IDUs) are at high risk of acquiring HIV from needle sharing and unsafe sex in numerous countries in Asia, Africa, Latin America and Eastern Europe, most programs have been designed for male IDUs. Harm reduction programs have been found to be effective and can be scaled up. Opioid substitution therapy is effective and can be used during pregnancy. Peer eduction can increase behaviors which protect against HIV acquisitioni. Harm reduction programs can also reduce HIV prevelance in female prison populations. Soem promising strategies include sex-segregated group sessions for IDUs to increase condom use and safe injections behaviors. Women's clubs can reduce HIV prevalence. Programming to prevent initiation of drug use can reduce behaviors that place women at risk of acquiring HIV. Many couples still need a better understanding of the risks of acquiring HIV through both sex and needle sharing. Increased access is needed for harm reduction. Interventions are needed to inform women IDUs of harm reduction early in pregnancy.
Harmful gender norms and inequalities, including gender-based violence, are important structural ... more Harmful gender norms and inequalities, including gender-based violence, are important structural barriers to effective HIV programming. We assess current evidence on what forms of gender-responsive intervention may enhance the effectiveness of basic HIV programmes and be cost-effective. Effective intervention models were identified from an existing evidence review ("what works for women"). Based on this, we conducted a systematic review of published and grey literature on the costs and cost-effectiveness of each intervention identified. Where possible, we compared incremental costs and effects. Our effectiveness search identified 36 publications, reporting on the effectiveness of 22 HIV interventions with a gender focus. Of these, 11 types of interventions had a corresponding/comparable costing or cost-effectiveness study. The findings suggest that couple counselling for the prevention of vertical transmission; gender empowerment, community mobilization, and female condom ...
... Autor: Mora, German; Betts, Claude; Gay, Jill; Hardee, Karen; Chambers, Virginia; Fox, Laurie... more ... Autor: Mora, German; Betts, Claude; Gay, Jill; Hardee, Karen; Chambers, Virginia; Fox, Laurie. TÃtulo: Quality of care in women's reproductive: a framework for Latin America and the Caribbean Draft. Fonte: Washington, DC; Pan American Health Organization; 1994. 140 p. tab. ...
Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV becau... more Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV because of gender inequalities, but much of HIV programming and evaluation lacks a specific focus on female adolescents.
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2014
Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV becau... more Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV because of gender inequalities, but much of HIV programming and evaluation lacks a specific focus on female adolescents.
There is growing interest in expanding public health approaches that address social and structura... more There is growing interest in expanding public health approaches that address social and structural drivers that affect the environment in which behaviour occurs. Half of those living with HIV infection are women. The sociocultural and political environment in which women live can enable or inhibit their ability to protect themselves from acquiring HIV. This paper examines the evidence related to six key social and structural drivers of HIV for women: transforming gender norms; addressing violence against women; transforming legal norms to empower women; promoting women's employment, income and livelihood opportunities; advancing education for girls and reducing stigma and discrimination. The paper reviews the evidence for successful and promising social and structural interventions related to each driver. This analysis contains peer-reviewed published research and study reports with clear and transparent data on the effectiveness of interventions. Structural interventions to address these key social and structural drivers have led to increasing HIV-protective behaviours, creating more gender-equitable relationships and decreasing violence, improving services for women, increasing widows' ability to cope with HIV and reducing behaviour that increases HIV risk, particularly among young people.
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2014
Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV becau... more Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV because of gender inequalities, but much of HIV programming and evaluation lacks a specific focus on female adolescents.
In safe motherhood programming in the developing world, insufficient attention has been given to ... more In safe motherhood programming in the developing world, insufficient attention has been given to maternal morbidity, which can extend well beyond childbirth. For every woman who dies of pregnancy-related causes, an estimated 20 women experience acute or chronic morbidity. Maternal morbidity adversely affects families, communities and societies. Maternal morbidity has multiple causes, with duration ranging from acute to chronic, severity ranging from transient to permanent and with a range of diagnosis and treatment options. This article addresses six selected relatively neglected aspects of maternal morbidity to illustrate the range of acute and chronic morbidities that can affect women related to pregnancy and childbearing that are prevalent in developing countries: anaemia, maternal depression, infertility, fistula, uterine rupture and scarring and genital and uterine prolapse. Based on this review, recommendations to reduce maternal morbidity include: expand the focus of safe motherhood to explicitly include morbidity; improve data on incidence and prevalence of maternal morbidity; link mortality and morbidity outcomes and programming; increase access to facility-and community-based maternal health care and reproductive health care; and address the antecedents to poor maternal health through a lifecycle approach. incur costs and debt for treatment (Ronsmans 2009), and can affect women's ability to work, resulting in loss of productivity and negative outcomes for infants and children (Hoque and Powell-Jackson 2010). An analysis of the global costs of maternal disability calculated an annual cost of US$6.8 billion .
There is growing interest in expanding public health approaches that address social and structura... more There is growing interest in expanding public health approaches that address social and structural drivers that affect the environment in which behaviour occurs. Half of those living with HIV infection are women. The sociocultural and political environment in which women live can enable or inhibit their ability to protect themselves from acquiring HIV. This paper examines the evidence related to six key social and structural drivers of HIV for women: transforming gender norms; addressing violence against women; transforming legal norms to empower women; promoting women's employment, income and livelihood opportunities; advancing education for girls and reducing stigma and discrimination. The paper reviews the evidence for successful and promising social and structural interventions related to each driver. This analysis contains peer-reviewed published research and study reports with clear and transparent data on the effectiveness of interventions. Structural interventions to address these key social and structural drivers have led to increasing HIV-protective behaviours, creating more gender-equitable relationships and decreasing violence, improving services for women, increasing widows' ability to cope with HIV and reducing behaviour that increases HIV risk, particularly among young people.
Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV becau... more Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV because of gender inequalities, but much of HIV programming and evaluation lacks a specific focus on female adolescents.
Introduction: Harmful gender norms and inequalities, including gender-based violence, are importa... more Introduction: Harmful gender norms and inequalities, including gender-based violence, are important structural barriers to effective HIV programming. We assess current evidence on what forms of gender-responsive intervention may enhance the effectiveness of basic HIV programmes and be cost-effective. Methods: Effective intervention models were identified from an existing evidence review (''what works for women''). Based on this, we conducted a systematic review of published and grey literature on the costs and cost-effectiveness of each intervention identified. Where possible, we compared incremental costs and effects. Results: Our effectiveness search identified 36 publications, reporting on the effectiveness of 22 HIV interventions with a gender focus. Of these, 11 types of interventions had a corresponding/comparable costing or cost-effectiveness study. The findings suggest that couple counselling for the prevention of vertical transmission; gender empowerment, community mobilization, and female condom promotion for female sex workers; expanded female condom distribution for the general population; and postexposure HIV prophylaxis for rape survivors are cost-effective HIV interventions. Cash transfers for schoolgirls and school support for orphan girls may also be cost-effective in generalized epidemic settings.
ABSTRACT While female intravenous drug users (IDUs) are at high risk of acquiring HIV from needle... more ABSTRACT While female intravenous drug users (IDUs) are at high risk of acquiring HIV from needle sharing and unsafe sex in numerous countries in Asia, Africa, Latin America and Eastern Europe, most programs have been designed for male IDUs. Harm reduction programs have been found to be effective and can be scaled up. Opioid substitution therapy is effective and can be used during pregnancy. Peer eduction can increase behaviors which protect against HIV acquisitioni. Harm reduction programs can also reduce HIV prevelance in female prison populations. Soem promising strategies include sex-segregated group sessions for IDUs to increase condom use and safe injections behaviors. Women's clubs can reduce HIV prevalence. Programming to prevent initiation of drug use can reduce behaviors that place women at risk of acquiring HIV. Many couples still need a better understanding of the risks of acquiring HIV through both sex and needle sharing. Increased access is needed for harm reduction. Interventions are needed to inform women IDUs of harm reduction early in pregnancy.
Harmful gender norms and inequalities, including gender-based violence, are important structural ... more Harmful gender norms and inequalities, including gender-based violence, are important structural barriers to effective HIV programming. We assess current evidence on what forms of gender-responsive intervention may enhance the effectiveness of basic HIV programmes and be cost-effective. Effective intervention models were identified from an existing evidence review ("what works for women"). Based on this, we conducted a systematic review of published and grey literature on the costs and cost-effectiveness of each intervention identified. Where possible, we compared incremental costs and effects. Our effectiveness search identified 36 publications, reporting on the effectiveness of 22 HIV interventions with a gender focus. Of these, 11 types of interventions had a corresponding/comparable costing or cost-effectiveness study. The findings suggest that couple counselling for the prevention of vertical transmission; gender empowerment, community mobilization, and female condom ...
... Autor: Mora, German; Betts, Claude; Gay, Jill; Hardee, Karen; Chambers, Virginia; Fox, Laurie... more ... Autor: Mora, German; Betts, Claude; Gay, Jill; Hardee, Karen; Chambers, Virginia; Fox, Laurie. TÃtulo: Quality of care in women's reproductive: a framework for Latin America and the Caribbean Draft. Fonte: Washington, DC; Pan American Health Organization; 1994. 140 p. tab. ...
Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV becau... more Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV because of gender inequalities, but much of HIV programming and evaluation lacks a specific focus on female adolescents.
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2014
Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV becau... more Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV because of gender inequalities, but much of HIV programming and evaluation lacks a specific focus on female adolescents.
There is growing interest in expanding public health approaches that address social and structura... more There is growing interest in expanding public health approaches that address social and structural drivers that affect the environment in which behaviour occurs. Half of those living with HIV infection are women. The sociocultural and political environment in which women live can enable or inhibit their ability to protect themselves from acquiring HIV. This paper examines the evidence related to six key social and structural drivers of HIV for women: transforming gender norms; addressing violence against women; transforming legal norms to empower women; promoting women's employment, income and livelihood opportunities; advancing education for girls and reducing stigma and discrimination. The paper reviews the evidence for successful and promising social and structural interventions related to each driver. This analysis contains peer-reviewed published research and study reports with clear and transparent data on the effectiveness of interventions. Structural interventions to address these key social and structural drivers have led to increasing HIV-protective behaviours, creating more gender-equitable relationships and decreasing violence, improving services for women, increasing widows' ability to cope with HIV and reducing behaviour that increases HIV risk, particularly among young people.
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2014
Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV becau... more Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV because of gender inequalities, but much of HIV programming and evaluation lacks a specific focus on female adolescents.
In safe motherhood programming in the developing world, insufficient attention has been given to ... more In safe motherhood programming in the developing world, insufficient attention has been given to maternal morbidity, which can extend well beyond childbirth. For every woman who dies of pregnancy-related causes, an estimated 20 women experience acute or chronic morbidity. Maternal morbidity adversely affects families, communities and societies. Maternal morbidity has multiple causes, with duration ranging from acute to chronic, severity ranging from transient to permanent and with a range of diagnosis and treatment options. This article addresses six selected relatively neglected aspects of maternal morbidity to illustrate the range of acute and chronic morbidities that can affect women related to pregnancy and childbearing that are prevalent in developing countries: anaemia, maternal depression, infertility, fistula, uterine rupture and scarring and genital and uterine prolapse. Based on this review, recommendations to reduce maternal morbidity include: expand the focus of safe motherhood to explicitly include morbidity; improve data on incidence and prevalence of maternal morbidity; link mortality and morbidity outcomes and programming; increase access to facility-and community-based maternal health care and reproductive health care; and address the antecedents to poor maternal health through a lifecycle approach. incur costs and debt for treatment (Ronsmans 2009), and can affect women's ability to work, resulting in loss of productivity and negative outcomes for infants and children (Hoque and Powell-Jackson 2010). An analysis of the global costs of maternal disability calculated an annual cost of US$6.8 billion .
There is growing interest in expanding public health approaches that address social and structura... more There is growing interest in expanding public health approaches that address social and structural drivers that affect the environment in which behaviour occurs. Half of those living with HIV infection are women. The sociocultural and political environment in which women live can enable or inhibit their ability to protect themselves from acquiring HIV. This paper examines the evidence related to six key social and structural drivers of HIV for women: transforming gender norms; addressing violence against women; transforming legal norms to empower women; promoting women's employment, income and livelihood opportunities; advancing education for girls and reducing stigma and discrimination. The paper reviews the evidence for successful and promising social and structural interventions related to each driver. This analysis contains peer-reviewed published research and study reports with clear and transparent data on the effectiveness of interventions. Structural interventions to address these key social and structural drivers have led to increasing HIV-protective behaviours, creating more gender-equitable relationships and decreasing violence, improving services for women, increasing widows' ability to cope with HIV and reducing behaviour that increases HIV risk, particularly among young people.
Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV becau... more Background: Adolescent girls face unique challenges in reducing their risk of acquiring HIV because of gender inequalities, but much of HIV programming and evaluation lacks a specific focus on female adolescents.
Introduction: Harmful gender norms and inequalities, including gender-based violence, are importa... more Introduction: Harmful gender norms and inequalities, including gender-based violence, are important structural barriers to effective HIV programming. We assess current evidence on what forms of gender-responsive intervention may enhance the effectiveness of basic HIV programmes and be cost-effective. Methods: Effective intervention models were identified from an existing evidence review (''what works for women''). Based on this, we conducted a systematic review of published and grey literature on the costs and cost-effectiveness of each intervention identified. Where possible, we compared incremental costs and effects. Results: Our effectiveness search identified 36 publications, reporting on the effectiveness of 22 HIV interventions with a gender focus. Of these, 11 types of interventions had a corresponding/comparable costing or cost-effectiveness study. The findings suggest that couple counselling for the prevention of vertical transmission; gender empowerment, community mobilization, and female condom promotion for female sex workers; expanded female condom distribution for the general population; and postexposure HIV prophylaxis for rape survivors are cost-effective HIV interventions. Cash transfers for schoolgirls and school support for orphan girls may also be cost-effective in generalized epidemic settings.
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Papers by Jill Gay