Young women who have sexual relationships with older men often are dealing with inequitable power dynamics, little capacity to negotiate safe sex or to refuse sex, and—therefore —a greater risk of acquiring HIV. In sub-Saharan Africa, adolescent girls and young women are disproportionately affected by HIV, which has led to a heightened emphasis on understanding the characteristics of their male sexual partners. It also points attention to the fact that men are less often reached with HIV testing, care, and continued treatment—the 90-90-90 HIV care cascade.
uptake of services
Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe
Globally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake.
This guide is one of a series of good practice guides, and contains information, strategies and resources to help HIV programmers implement HIV programming for adolescents.
A greater understanding of HIV in high prevalence countries has increased awareness of the need to prioritise adolescents in HIV prevention, treatment, care and support. At the same time, a growing recognition that adolescence is a distinct time of life has focused attention on adolescents’ different needs. Adolescents are now included as a separate target group in global and national strategies.
PMTCT Service Uptake among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe
To understand the uptake of HIV services by adolescent women, the authors conducted a retrospective analysis of patient-level data (2011–2013) on services for antenatal care (ANC) and prevention of mother-to-child transmission (PMTCT) in 36 facilities in 5 districts in Zimbabwe. Zimbabwe's Option A policy encourages pregnant women to attend ANC before 14 weeks gestation and to begin antiretroviral therapy (ART) if eligible. The authors compared service uptake by 22,215 adolescent (19 years).
Maria Fulai, a well-regarded and influential community leader, learned about the benefits of voluntary medical male circumcision (VMMC) from AIDSFree and mobilized community members to learn about and receive VMMC services.
Conditional cash transfers and uptake of and retention in prevention of mother-to-child HIV transmission care: a randomised controlled trial
Novel strategies are needed to increase retention in and uptake of prevention of mother-to-child HIV transmission (PMTCT) services in sub-Saharan Africa. We aimed to determine whether small, increasing cash payments, which were conditional on attendance at scheduled clinic visits and receipt of proposed services can increase the proportions of HIV-infected pregnant women who accept available PMTCT services and remain in care.
Depression, retention in care, and uptake of PMTCT service in Kinshasa, the Democratic Republic of Congo: a prospective cohort
Based on the hypothesis that poor mental health may affect adherence to HIV treatment in newly diagnosed mothers, this study assessed the association between prenatal depression and loss-to-follow-up and uptake of PMTCT services. At enrollment, 11.8% of study participants reported symptoms of moderate to severe depression. The study indicated that prenatal depression assessed was not a strong predictor of loss-to-follow-up among newly diagnosed HIV-infected women in Kinshasa, the Democratic Republic of Congo.
HIV stigma trends in the general population during antiretroviral treatment expansion: analysis of 31 countries in sub-Saharan Africa, 2003–2013
Background: HIV-related stigma is associated with increased risk-taking behavior, reduced uptake of HIV testing, and decreased adherence to antiretroviral therapy (ART). Although ART scale-up may reduce HIV-related stigma, the extent to which levels of stigma in the general population have changed during the era of ART scale-up in sub-Saharan Africa is unknown.
Acceptability of a Community-Based Outreach HIV-Testing Intervention Using Oral Fluid Collection Devices and Web-Based HIV Test Result Collection Among Sub-Saharan African Migrants: A Mixed-Method Study
Late human immunodeficiency virus (HIV) diagnosis is common among sub-Saharan African migrants. To address their barriers to HIV testing uptake and improve timely HIV diagnoses and linkage to care, the outreach HIV testing intervention, “swab2know,” was developed. It combined a community-based approach with innovative testing methods: oral fluid self-sampling and the choice between Web-based HIV test result collections using a secured website or post-test counseling at a sexual health clinic.