Orza Luisa, Bass Emily, Bell Emma, Crone E Tyler, Damji Nazneen, Dilmitis Sophie, Tremlett Liz, Aidarus Nasra, Stevenson Jacqui, Bensaid Souhaila, Kenkem Calorine, Ross Gracia Violeta, Kudravtseva Elena, Welbourn Alice
SRHR Technical Lead at the International HIV/AIDS Alliance.
Director of strategy and content at AVAC.
Health Hum Rights. 2017 Dec;19(2):155-168.
There is rightly a huge global effort to enable women living with HIV to have long productive lives, through treatment access. However, many women living with HIV experience violence against women (VAW), in both domestic and health care settings. The ways in which VAW might prevent treatment access and adherence for women has not to date been reviewed coherently at the global level, from women's own perspectives. Meanwhile, funding for global health care, including HIV treatment, is shrinking. To optimize women's health and know how best to optimize facilitators and minimize barriers to access and adherence, especially in this shrinking funding context, we need to understand more about these issues from women's own perspectives. In response, we conducted a three-phase review: (1) a literature review (phase one); (2) focus group discussions and interviews with nearly 200 women living with HIV from 17 countries (phase two); and (3) three country case studies (phase three). The results presented here are based predominantly on women's own experiences and are coherent across all three phases. Recommendations are proposed regarding laws, policies, and programs which are rights-based, gendered, and embrace diversity, to maximize women's voluntary, informed, confidential, and safe access to and adherence to medication, and optimize their long-term sexual and reproductive health.
全球正在做出巨大努力,通过提供治疗机会,使感染艾滋病毒的女性能够过上长寿且富有成效的生活。然而,许多感染艾滋病毒的女性在家庭和医疗环境中都遭受过性别暴力(VAW)。从女性自身的角度来看,性别暴力可能阻碍女性获得治疗和坚持治疗的方式,迄今为止尚未在全球层面得到系统的审视。与此同时,包括艾滋病毒治疗在内的全球医疗保健资金正在减少。为了优化女性健康,并了解如何最好地优化促进因素,以及在资金不断缩减的情况下尽量减少获取治疗和坚持治疗的障碍,我们需要从女性自身的角度更多地了解这些问题。为此,我们开展了一个分三个阶段的审查:(1)文献综述(第一阶段);(2)与来自17个国家的近200名感染艾滋病毒的女性进行焦点小组讨论和访谈(第二阶段);以及(3)三个国家案例研究(第三阶段)。这里呈现的结果主要基于女性自身的经历,并且在所有三个阶段都保持连贯一致。我们提出了基于权利、考虑性别因素且包容多样性的法律、政策和项目建议,以最大限度地让女性自愿、知情、保密且安全地获取并坚持药物治疗,并优化她们的长期性健康和生殖健康。