HIV/AIDS INTERVENTIONS THAT WORK FOR WOMEN AND MEN

1. HIV/AIDS INTERVENTIONS THAT WORK FOR WOMEN AND MEN By Mabel Bianco FEIM/IAWC EuroNGOsConference Session II: “Gender, SRHR and theHealthMDGs”8thNovember 2010 - London

2. HealthMDGs Goal 4: Reduce child mortality • 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate Goal 5: Improve maternal health • 5.A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. • 5.B: Achieve, by 2015, universal access to reproductive health Goal 6: Combat HIV/AIDS, malaria and other diseases • 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS • 6.1 HIV prevalence among population aged 15-24 years • 6.2 Condom use at last high-risk sex • 6.3 Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS • 6.4 Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years

3. Evidence demonstrated by: The concept of “what works” Rigorous scientific research (control trials) Quasi-experimental research designs Retrospective observations Results-based program evaluation Testimonies EuroNGOs Conference – London 2010

4. Issues for evaluating “what works” • Prevention • For women, men and young people • Key populations: • Sex workers • People who use drugs • LGBT • Prisoners • Treatment • Care & Support EuroNGOs Conference – London 2010

5. PREVENTION WHAT WORKS FOR WOMEN • Direct: • Consistent condom use: male & female condoms • Faithfulness of male partners • Access STI diagnosis and treatment in comprehensive SRH services • Indirect: • Eliminate gender inequities • Control and prevention of VAW • Treatment for victims of sexual abuse EuroNGOs Conference – London 2010

6. WHAT WORKS FOR ALL MEN • Consistent condom use • Male circumcision: Pros & Cons • Access to confidential and voluntary counseling and testing • Reduction of concurrent sexual partners (?) • Other behavioral changes(?) • In case of HIV+ serostatus  ARV treatment EuroNGOs Conference – London 2010

7. WHAT WORKS FOR YOUNG PEOPLE • Achieve higher levels of education (especially for girls) • Comprehensive sexuality education (CSE) beginning since kindergarden/primary school • Access to free condoms and consistent condom use • Ensure access to youth-friendly health care services (VCT, free condoms distribution, counseling) • Mass media campaigns & peer education EuroNGOs Conference – London 2010

8. WHAT WORKS FOR SEX WORKERS • Comprehensive prevention programs including peer education, support groups, promoting/enabling safer sex • Clinical health services with outreach workers and involving sex workers • Free condom (female & male) distribution and social marketing with the participation of SW • Provision of STI diagnosis and treatment in confidential comprehensive SRH services • Interventions for male clients promoting condom use and elimination of violence EuroNGOs Conference – London 2010

9. WHAT WORKS FOR IDUs & THEIR PARTNERS • Comprehensive harm reduction programs (needle exchange, condom distribution) • Harm reduction and substitution therapy (methadone) • Peer education and prevention programs for people who use drugs and their partners, promoting protective behaviors • Improve access to confidential health services, including comprehensive SRHS, and nonpunitive attitudes EuroNGOs Conference – London 2010

10. WHAT WORKS FOR LGBT GB: • Access to free condoms and consistent condom use • Reduction of concurrent partners • Use of protection in sex with women • Prevention campaigns and peer education promoting safer sex EuroNGOs Conference – London 2010

11. WHAT WORKS FOR LGBT (cont.) LB: • Incorporate interventions targeting this population • Promote confidential, non-discriminatory attention in comprehensive SRHS including information about STI prevention • Prevention campaigns and peer education • Free distribution of prevention methods (latex barriers and condoms) EuroNGOs Conference – London 2010

12. WHAT WORKS FOR LGBT (cont.) TRANSGENDER PEOPLE: • Promote confidential, non-discriminatory services that recognize and respect sexual options and gender identity • Free condom distribution and social marketing with participation of transgender people • Prevention campaigns and peer education EuroNGOs Conference – London 2010

13. WHAT WORKS FOR PRISONERS • Access to comprehensive SRHS in prisons including for their partners • Prevention campaigns including free distribution of condoms and promotion of safer sex • Comprehensive harm reduction programs available in prisons for IDUs and their partners: prevention campaign and peer education; needle exchange; male and female condom provision; substitution therapy • Access to treatment for STIs and HIV/AIDS EuroNGOs Conference – London 2010

14. WHAT WORKS FOR WLWHA • Access to comprehensive SRHS as part of HIV services, including dual protection, IUDs, cancer control, and access to safe and voluntary abortion • Violence prevention and treatment • Prevention campaigns and peer education for safer sex • Interventions to support disclosure • Permanent and reliable access to ARVs EuroNGOs Conference – London 2010

15. WHAT WORKS FOR PMTCT • Prevention of unintended pregnancies • Provision of and access to VCT for women and their partners in antenatal care services • Provision of treatment for vertical transmission in accordance with MTCT-Plus Initiative • Post-partum ARV treatment for the mother and the child, if necessary • Prevention of breastfeeding and free supplementary milk provision EuroNGOs Conference – London 2010

16. FUTURE ACTIONS • Scale up evidence based interventions • Intensify the structural interventions to improve the enabling environment to reduce gender inequalities • Evaluate interventions that have not yet been (sufficiently) evaluated • Intensify the dissemination of what works in interventions for women and men EuroNGOs Conference – London 2010