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Guidance on couples HIV testing and counselling including antiretroviral therapy for treatment and prevention in serodiscordant couples: Recommendations for a public health approach.
Geneva, Switzerland, WHO, Department of HIV / AIDS, 2012 Apr.  p.These guidelines recommend increasing the offering of HIV testing and counselling (HTC) to couples and partners, with support for mutual disclosure. They also recommend offering antiretroviral therapy (ART) for HIV prevention in serodiscordant couples. Recommendations include: 1.Couples and partners should be offered voluntary HIV testing and counselling with support for mutual disclosure (Strong recommendation, low-quality evidence). 2. Couples and partners in antenatal care settings should be offered voluntary HIV testing and counselling with support for mutual disclosure (Strong recommendation, low-quality evidence). 3. Couples and partner voluntary HIV testing and counselling with support for mutual disclosure should be offered to individuals with known HIV status and their partners (Strong recommendation, low-quality evidence for all people with HIV in all epidemic settings / Conditional recommendation, low-quality evidence for HIV-negative people depending on country-specific HIV prevalence). 4. People with HIV in serodiscordant couples and who are started on antiretroviral therapy (ART) for their own health should be advised that ART is also recommended to reduce HIV transmission to the uninfected partner (Strong recommendation, high-quality evidence). 5. HIV-positive partners with >350 CD4 cel ls/µL in serodiscordant couples should be offered ART to reduce HIV transmission to uninfected partners (Strong recommendation, high-quality evidence. (Excerpts)
New York, New York, OSAGI, .  p.Her name is Joyce Puta, a 48-year-old Zambian army colonel on secondment to the United Nations. An unabashed fighter, her enemy for the last ten years has been HIV/AIDS. Her latest battleground is Liberia, and by all accounts she has been waging a successful campaign. Working with the United Nations Mission in Liberia (UNMIL), Colonel Puta points out that any environment requiring peacekeepers is also a risky one for the spread of HIV/AIDS. In post-conflict situations, social structures crumble and economies are unstable. In order to survive, desperate young women may turn to commercial sex work, often around military bases. So how did a career Zambian army officer find herself on the frontlines in the fight against HIV/AIDS? Joyce Puta joined the army at eighteen. Six years later she became a registered nurse and midwife, and then nursing services manager for Zambia's main military hospital. (excerpt)
Integrating sexual health interventions into reproductive health services: programme experience from developing countries.
Geneva, Switzerland, World Health Organization [WHO], 2005.  p. (Sexual Health Document Series)In 1994, at the International Conference on Population and Development (ICPD, 1994), 184 countries reached a landmark consensus on the need for a broad, integrated approach to sexual and reproductive health. Since that time, countries have been struggling to put the concept into practice. The first challenge has been to understand the broad concept of sexual and reproductive health, in order to identify the service interventions that should be added to an existing reproductive health (RH) or maternal and child health (MCH) programme to make it a sexual and reproductive health (SRH) programme. The second, more difficult, challenge has been to develop feasible, acceptable and cost effective strategies for providing these services within the existing, poorly resourced, primary health care programme base. To create SRH programmes, reproductive health services have to be expanded to better address sexual health. SRH programmes need to give attention to broader determinants of healthy sexuality and well-being. A recent WHO publication, Conceptual framework for programming in sexual health, offers a sexual health approach to service design and implementation. It stresses the need to recognize that not all sexual activity is for reproduction, and that other motivational factors, such as pleasure or a sense of obligation, are often more important determinants of individual sexual health and well being. To improve sexual health, programmes must address sexuality throughout the lifespan, from adolescence to old age, for both men and women. They must also recognize the role of power in sexual relationships and how it affects people's ability to make decisions about their own bodies and sexual life, free from violence, discrimination and stigma. Individual decision-making and the ability to make informed choices can also be limited by social, cultural and legal barriers. Broad sexual and reproductive health care services must recognize and begin to address these constraints through targeted interventions. (excerpt)