structural barriers

Battling the perfect storm

At the 9th South African AIDS Conference (SA AIDS 2019), I can only reflect on the work we have done over the years in the fight against HIV. So many inspiring scientists, community representatives and activists in the room working to turn the tide on this virus. ‘Unprecedented innovation and technologies’ was a fitting theme for this year’s biennial conference: 19 years on from the first SA AIDS Conference, South Africa has become a world leader in the work to end AIDS.
Author
Leora Casey, Key Populations Manager, NACOSA

Does distance to clinic affect utilization of HIV care and treatment services

Author
Dr Gesine Meyer-Rath

We assessed the relationship between distance to clinic and progression through the HIV care cascade. We have two key findings. First, distance matters but only for women. Second, for women, distance affected linkage to care, but was not associated with later transitions in the care cascade. It is possible that distance is a less important barrier once people find out their HIV status, learn about treatment, and overcome the hurdle of their first clinic visit.

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Costs of accessing HIV testing services among rural Malawi communities

Author
Linda Sande, Hendramoorthy Maheswaran, Collin Mangenah, Lawrence Mwenge, Pitchaya Indravudh, Phillip Mkandawire, Nurilign Ahmed, Marc d’Elbee, Cheryl Johnson, Karin Hatzold, Elizabeth L. Corbett, Melissa Neuman & Fern Terris-Prestholt

HIV testing is free in Malawi, but users may still incur costs that can deter or delay them accessing these services. We sought to identify and quantify these costs among HIV testing service clients in Malawi. We asked residents of communities participating in a cluster randomised trial investigating the impact of HIV self-testing about their past HIV testing experiences and the direct non-medical and indirect costs incurred to access HIV testing. We recruited 749 participants whose most recent HIV test was within the past 12 months.

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New research underscores the connection between economics and HIV

Over the last three decades, a range of biomedical and behavioral approaches have dramatically reduced HIV incidence throughout the world and improved the quality and availability of life-saving treatment for those living with HIV. Yet HIV remains a major public health issue and the leading cause of adult death in sub-Saharan Africa.

Author
Mandy Swann
Source
Research for Evidence

AIDS 2018: Finding ways to break barriers and build bridges to improve HIV prevention, care, and treatment

People infected and affected by HIV face multiple, far-reaching barriers every day – from structural barriers affecting their access to services and care, to societal and scientific barriers keeping them from enjoying healthy, safe, and full lives. We highlight some of these barriers, and what innovative approaches are being developed to bridge them.
Author
SHARE staff

The global response and unmet actions for HIV and sex workers

Author
Kate Shannon, Anna-Louise Crago, Stefan D Baral, Linda-Gail Bekker, Deanna Kerrigan, Michele R Decker, Tonia Poteat, Andrea L Wirtz, Brian Weir, Marie-Claude Boily, Jenny Butler, Steffanie A Strathdee, Chris Beyrer

Female, male, and transgender sex workers continue to have disproportionately high burdens of HIV infection in low-income, middle-income, and high-income countries in 2018. 4 years since our Lancet Series on HIV and sex work, our updated analysis of the global HIV burden among female sex workers shows that HIV prevalence is unacceptably high at 10·4% (95% CI 9·5–11·5) and is largely unchanged. Comprehensive epidemiological data on HIV and antiretroviral therapy (ART) coverage are scarce, particularly among transgender women.

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Forget about forgetting: structural barriers and severe non-adherence to antiretroviral therapy

Is the resource available on the Internet?
Yes
Author
Kalichman SC, Kalichman MO, Cherry C

HIV infection is now clinically manageable with antiretroviral therapy (ART). However, a significant number of people with HIV do not benefit from ART because of non-adherence. This study examined the use of adherence strategies and barriers to adherence among persons at substantial risk for developing resistant virus (less than 75% adherent).

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Learning lab: Stigma and HIV Overview

Is the resource available on the Internet?
Yes
Author
Anne Stangl

An overview of this key structural barrier to an effective HIV response, giving definitions, tools and experiences from interventions.

Presented by Anne Stangl, Behavioral Scientist and Stigma Specialist, International Center for Research on Women, Washington, DC, 12 October 2011.

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Global Fund funding opportunity: Key Population Investment Fund (KPIF)

Closing date

At AIDS 2016, the Department of State’s Office of the U.S. Global AIDS Coordinator and Health Diplomacy (S/GAC) announced the establishment of a Key Populations Investment Fund (KPIF) of US$100 million over five years. The KPIF aims to support the scale-up of key population led community approaches to enhance and expand quality HIV/AIDS services for key populations, and will address stigma, discrimination, and violence against key population groups.

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