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Medical Journal of Australia. 2015 Apr 6; 202(6):289-90.Add to my documents.
Geneva, Switzerland, UNAIDS, 2005 Dec.  p. (UNAIDS/05.19E)Acquired Immunodeficiency Syndrome (AIDS) has killed more than 25 million people since it was first recognized in 1981, making it one of the most destructive epidemics in recorded history. Despite recent, improved access to antiretroviral treatment and care in many regions of the world, the AIDS epidemic claimed 3.1 million [2.8--3.6 million] lives in 2005; more than half a million (570 000) were children. The total number of people living with the human immunodeficiency virus (HIV) reached its highest level: an estimated 40.3 million [36.7--45.3 million] people are now living with HIV. Close to 5 million people were newly infected with the virus in 2005. There is ample evidence that HIV does yield to determined and concerted interventions. Sustained efforts in diverse settings have helped bring about decreases in HIV incidence among men who have sex with men in many Western countries, among young people in Uganda, among sex workers and their clients in Thailand and Cambodia, and among injecting drug users in Spain and Brazil. Now there is new evidence that prevention programmes initiated some time ago are finally helping to bring down HIV prevalence in Kenya and Zimbabwe, as well as in urban Haiti. The number of people living with HIV has increased in all but one region in the past two years. In the Caribbean, the second-most affected region in the world, HIV prevalence overall showed no change in 2005, compared with 2003. (excerpt)
Geneva, Switzerland, WHO, 2004. 6 p.WHO and UNAIDS are actively promoting the scale-up of programmes to deliver antiretroviral therapy (ART), with the aim of reaching three million people by the end of 2005 ('3 by 5 Initiative'). Equity in access to HIV treatment is a critical element of the '3 by 5' and will contribute to the broader 'right to health' for all. Attention must therefore be given to ensuring access to ART and other treatment, care and prevention, for people who risk exclusion including on the basis of their sex. Currently there is limited information available on the sex and age distribution of those receiving ART, however, we know that gender-based inequalities often affect women's ability to access services. Attention is therefore required to ensure that women and girls have equitable access to ART as it becomes available. Gender-based inequalities put women and girls at increased risk of acquiring HIV. Women's limited ability to negotiate safer sex practices with their partners, including condom use, can place even women who are faithful to one partner at risk of HIV infection. Married adolescent girls may be particularly vulnerable. Sexual violence, including rape, likewise increases the risk of HIV for women and girls. In addition, they typically have less access to education, income-generating opportunities, property ownership and legal protection than men. This means many women are not able to leave relationships even when they know that they may be at risk of HIV. (excerpt)
Geneva, Switzerland, WHO, Department of Gender and Women's Health, 2002. x, 83 p.This critical review of tools for gender analysis and their application to health was carried out to support who’s Gender Team in identifying possible strategies for implementing the Gender Policy for who. One component of implementation is providing who staff with support in a) understanding why it is necessary to address the impact of gender on health and health services and b) knowing how to address this impact as it pertains to their own field of work. Since many agencies facing similar tasks have developed tools for mainstreaming gender, it seemed appropriate for the Gender Working Group to consider their usefulness for health rather than immediately embarking on a process of developing its own tools. This review is intended as background for use by anyone working on or interested in gender and health, and particularly by who staff working on gender issues. It assumes an understanding of the who Gender Policy for who, and of the challenges in mainstreaming gender. It is therefore written in a shorthand form, aiming simply to clarify the content of different tools, and to what extent they could be used in support of implementing who’s Gender Policy. There is a complementary volume to this review which is designed as an educational tool for those not necessarily familiar with gender analysis, which provides an overview of gender tools that may be used for integrating gender issues in health. (excerpt)
Lancet. 2003 Jul 19; 362(9379):233-241.Gaps in child mortality between rich and poor countries are unacceptably wide and in some areas are becoming wider, as are the gaps between wealthy and poor children within most countries. Poor children are more likely than their better-off peers to be exposed to health risks, and they have less resistance to disease because of undernutrition and other hazards typical in poor communities. These inequities are compounded by reduced access to preventive and curative interventions. Even public subsidies for health frequently benefit rich people more than poor people. Experience and evidence about how to reach poor populations are growing, albeit largely through small-scale case studies. Successful approaches include those that improve geographic access to health interventions in poor communities, subsidised health care and health inputs, and social marketing. Targeting of health interventions to poor people and ensuring universal coverage are promising approaches for improvement of equity, but both have limitations that necessitate planning for child survival and effective delivery at national level and below. Regular monitoring of inequities and use of the resulting information for education, advocacy, and increased accountability among the general public and decision makers is urgently needed, but will not be sufficient. Equity must be a priority in the design of child survival interventions and delivery strategies, and mechanisms to ensure accountability at national and international levels must be developed. (author's)
Prediction of community prevalence of human onchocerciasis in the Amazonian onchocerciasis focus: Bayesian approach. [Prévisions portant sur la prévalence communautaire de l'onchocercose humaine au niveau du foyer amazonien de l'onchocercose : approche bayésienne]
Bulletin of the World Health Organization. 2003 Jul; 81(7):482-490.Objective: To develop a Bayesian hierarchical model for human onchocerciasis with which to explore the factors that influence prevalence of microfilariae in the Amazonian focus of onchocerciasis and predict the probability of any community being at least mesoendemic (>20% prevalence of microfilariae), and thus in need of priority ivermectin treatment. Methods: Models were developed with data from 732 individuals aged515 years who lived in 29 Yanomami communities along four rivers of the south Venezuelan Orinoco basin. The models’ abilities to predict prevalences of microfilariae in communities were compared. The deviance information criterion, Bayesian P-values, and residual values were used to select the best model with an approximate cross-validation procedure. Findings: A three-level model that acknowledged clustering of infection within communities performed best, with host age and sex included at the individual level, a river-dependent altitude effect at the community level, and additional clustering of communities along rivers. This model correctly classified 25/29 (86%) villages with respect to their need for priority ivermectin treatment. Conclusion: Bayesian methods are a flexible and useful approach for public health research and control planning. Our model acknowledges the clustering of infection within communities, allows investigation of links between individual- or community-specific characteristics and infection, incorporates additional uncertainty due to missing covariate data, and informs policy decisions by predicting the probability that a new community is at least mesoendemic. (author's)