Operationalising structural interventions for HIV prevention: Lessons from Zambia

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Global guidance acknowledges the importance of structural interventions to tackle HIV, but evidence of their effectiveness lags behind that of other means of prevention. This paper discusses the challenges to implementation at the community and national levels using the experience of PEPFAR and USAID in Zambia. The authors propose several ways to speed up  implementation of structural interventions.

Incorporating a structural approach within combination HIV prevention

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Hargreaves proposes a three-pronged structural approach to HIV prevention, which overlaps with the investment framework proposed by UNAIDS in 2011:

Intervening upstream: A good investment for HIV prevention

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This paper examines evidence linking structural factors to HIV risk. It addresses research gaps, including the pathways through which factors affect HIV vulnerability and interaction among such factors. Advantages of taking a 'structurally informed' approach to HIV planning and implementation include influencing clustered risk factors and multiple outcomes, and opportunities for co-financing.

Policy and programme responses for addressing the structural determinants of HIV

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Over the past decade, an increasing number of practical interventions have successfully addressed HIV’s structural factors. This paper profiles such efforts and their effects on HIV-related behavioural and biological outcomes. The lessons that emerge stress the importance of cross-sectoral approaches in the global response to HIV.

Structural drivers, interventions, and approaches for prevention of HIV in general populations

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Lessons from the past 30 years point to three key objectives for behaviour-change HIV prevention efforts:

  1. address the broader structures shaping behavioural risk and vulnerability
  2. tailor responses to the factors affecting the target population's vulnerability
  3. ensure that multiple factors can be addressed when needed

This paper provides definitions of key terms and concepts to help in the operationalization of such approaches.

Negotiating pharmaceutical uncertainty: women’s agency in a South African HIV prevention trial

, ; ISBN10: 0826521398

Telling the story of a clinical trial testing an innovative gel designed to prevent women from contracting HIV, Negotiating Pharmaceutical Uncertainty provides new insight into the complex and contradictory relationship between medical researchers and their subjects.

Preferences for ARV-based HIV prevention methods among men and women, adolescent girls and female sex workers in Gauteng Province, South Africa: a protocol for a discrete choice experiment

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For the past few decades, condoms have been the main method of HIV prevention. Recent advances in antiretroviral (ARV)-based prevention products have substantially changed the prevention landscape, yet little is known about how popular these products will be among potential users, or whether new methods might be used in conjunction with, or instead of, condoms.

This study uses a discrete choice experiment (DCE) to:

The barriers and enablers to education among scheduled caste and scheduled tribe adolescent girls in northern Karnataka, South India: A qualitative study

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This qualitative study explored the barriers and enablers to scheduled caste/scheduled tribe (SC/ST) adolescent girls entering into, and completing secondary education in northern Karnataka, South India.

In-depth interviews were conducted with 22 adolescent girls, their respective parent/guardian and 11 teachers, recruited purposively from 11 villages within two districts in northern Karnataka.

The study found that:

Challenging gender norms in the Mumbai slums

A Kabaddi tournament and graduation ceremony event marks the successful conclusion of the Parivartan – change at play programme.

What do we know about HIV stigma and rights-based prevention?

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