Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee
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ds of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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KEY MESSAGES
Always talk to a GBV specialist first to understand what GBV services are available in your area. Some services may take the form of hotlines, a mobile app or other remote support.
Be aware of any other available services in your area. Identify services provided by humanitarian pa
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rtners such as health, psychosocial support, shelter and non-food items. Consider services provided by communities such as mosques/ churches, women’s groups and Disability Service Organizations.
Remember your role. Provide a listening ear, free of judgment. Provide accurate, up-to-date information on available services. Let the survivor make their own choices. Know what you can and cannot manage. Even without a GBV actor in your area, there may be other partners, such as a child protection or mental health specialist, who can support survivors that require additional attention and support. Ask the survivor for permission before connecting them to anyone else. Do not force the survivor if s/he says no.
Do not proactively identify or seek out GBV survivors. Be available in case someone asks for support.
Remember your mandate. All humanitarian practitioners are mandated to provide non-judgmental and non-discriminatory support to people in need regardless of: gender, sexual orientation, gender identity, marital status, disability status, age, ethnicity/tribe/race/religion, who perpetrated/committed violence, and the situation in which violence was committed. Use a survivor-centered approach by practicing:
Respect: all actions you take are guided by respect for the survivor’s choices, wishes, rights and dignity.
Safety: the safety of the survivor is the number one priority.
Confidentiality: people have the right to choose to whom they will or will not tell their story. Maintaining confidentiality means not sharing any information to anyone.
Non-discrimination: providing equal and fair treatment to anyone in need of support.
If health services exist, always provide information on what is available. Share what you know, and most importantly explain what you do not. Let the survivor decide if s/he wants to access them. Receiving quality medical care within 72 hours can prevent transmission of sexually transmitted infections (STIs), and within 120 hours can prevent unwanted pregnancy.
Provide the opportunity for people with disabilities to communicate to you without the presence of their caregiver, if wished and does not endanger or create tension in that relationship.
If a man or boy is raped it does not mean he is gay or bisexual. Gender-based violence is based on power, not someone’s sexuality.
Sexual and gender minorities are often at increased risk of harm and violence due to their sexual orientation and/or gender identity. Actively listen and seek to support all survivors.
Anyone can commit an act of gender-based violence including a spouse, intimate partner, family member, caregiver, in-law, stranger, parent or someone who is exchanging money or goods for a sexual act.
Anyone can be a survivor of gender-based violence – this includes, but isn’t limited to, people who are married, elderly individuals or people who engage in sex work.
Protect the identity and safety of a survivor. Do not write down, take pictures or verbally share any personal/identifying information about a survivor or their experience, including with your supervisor. Put phones and computers away to avoid concern that a survivor’s voice is being recorded.
Personal/identifying information includes the survivor’s name, perpetrator(s) name, date of birth, registration number, home address, work address, location where their children go to school, the exact time and place the incident took place etc.
Share general, non-identifying information
To your team or sector partners in an effort to make your program safer.
To your support network when seeking self-care and encouragement.
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The intended purpose of this compendium is to provide program managers, organizations, and policy makers with a menu of indicators to better “know their HIV epidemic/know their response” from a gender perspective. The indicators in the compendium are all either part of existing indicators used i
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n studies or by countries or have been adapted from existing indicators to address the intersection of gender and HIV. The indicators can be measured through existing data collection and information systems (e.g. routine program monitoring, surveys) in most country contexts, though some may require special studies or research.
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The toolkit comprises ready-to-use material designed expressly for World Bank task managers working in the water and sanitation sector. It presents a range of tools for gender analysis and practical “how-to” strategies collected from program and project experience around the world. It is one of
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a series of toolkits being designed to assist task managers in improving project performance by incorporating gender into their work.
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Humanitarian crises can affect women, men, girls and boys in radically different ways. To address the different impacts of conflict and disasters on each group and promote the potential for positive transformation of gender norms, Oxfam calls for humanitarian agencies to analyse, plan, and respond t
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o crises in ways that address practical gender needs and promote women’s rights. Oxfam is committed to promoting gender equality and preventing gender-based violence, through the implementation of its Minimum Standards for Gender in Emergencies. In addition, the promotion of gender equality must be central to the broader efforts to protect civilians and manage and prevent conflict and armed violence.
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This tool is a living document that provides guidance on good partnership practices that promote strong relationships between civil society organizations and government representatives on engaging men and boys in gender equality and sexual and reproductive health and rights
(SRHR).
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Its goal is to strengthen these partnerships in order to enable the scale up and/or institutionalization of evidence-based approaches to engaging men and boys.
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Unchecked inequality and failure to protect the rights of poorest women could undermine peace and world’s development goals, new UNFPA report warns:
- Only about half of the world’s women hold paid jobs
- Globally, women earn 77 per cent of what men get
- Three in five women worldwide lack m
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aternity leave, many pay "motherhood penalty"
The report is also available in French: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_FR_swop_Etat_de_la_population_mondiale.pdf; in Spanish: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_ES_SWOP_Estado_de_la_Poblacion_Mundial.pdf; in Russian: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_RU_SWOP_NARODONASELENIE_MIRA_V_2017_GODU.pdf and in Arabic: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_AR_SWOP_Hl_skn_llm_.pdf
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Gerechtigkeit zwischen den Geschlechtern zu schaffen ist ein zentrales Anliegen der Weltgemeinschaft. In der
„Agenda 2030 für nachhaltige Entwicklung“ haben die 193 Mitgliedstaaten der Vereinten Nationen dies im Jahr
2015 festgelegt. Kern der Agenda 2030 sind 17 Ziele für na
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chhaltige Entwicklung (Sustainable Development Goals,
SDG) mit 169 Unterzielen. Geschlechtergerechtigkeit ist dabei ein eigenständiges Ziel mit neun Unterzielen. Hier
und in weiteren neun SDG werden explizit Qürbezüge zu anderen Themen geschaffen.
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D’un format facilement accessible, simple à utiliser, le présent document décrit succinctement
les problèmes liés à la santé et aux droits en matière de sexualité et de reproduction qui peuvent
affecter les droits fondamentaux, la santé et le bien-être des adolescents (âgés de 10 à
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19 ans)
et il présente les lignes directrices pertinentes de l’Organisation mondiale de la Santé (OMS). Ce
document donne accès aux nombreuses lignes directrices formulées par l’OMS, et il constitue
une source d’informations utile pour les activités de sensibilisation, la conception des politiques
et des programmes ou projets et la recherche. Son objectif est de soutenir la mise en oeuvre
de la stratégie mondiale pour la santé des femmes, des enfants et des adolescents 2016–2030 (1), en conformité avec le cadre pour une action mondiale accélérée en faveur de la santé des
adolescents et avec le cadre opérationnel de l’OMS sur la santé sexuelle et ses liens avec la
santé reproductive (2,3).
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This document provides an overview of sexual and reproductive health and rights issues that may be important for the human rights, health and well-being of adolescents (aged 10–19 years) and the relevant World Health Organization (WHO) guidelines on how to address them in an easilyaccessible, user
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-friendly format. The document serves as a gateway to the rich body of WHO guidelines, and as a handy resource to inform advocacy, policy and programme/project design and research. It aims to support the implementation of the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016–2030 (1), and is aligned with the WHO Global Accelerated Action for the Health of Adolescents (AA-HA!) as well as the WHO Operational Framework on Sexual Health and Its Linkages to Reproductive Health (2,3).
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En este documento se ofrece, en un formato de fácil consulta, el panorama general de las cuestiones relativas a la salud y los derechos sexuales y reproductivos que pueden afectar a los derechos humanos, la salud y el bienestar de los adolescentes (de edades comprendidas entre los 10 y los 19 años
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) y las directrices pertinentes de la Organización Mundial de la Salud (OMS) para abordar dichas cuestiones. Este documento permite acceder al amplio conjunto de directrices de la OMS al respecto y constituye un útil recurso para la labor de promoción, formulación de políticas, investigación y diseño de programas y proyectos. Tiene por finalidad apoyar la aplicación de la Estrategia Mundial para la Salud de la Mujer, el Niño y el Adolescente 2016-2030 (1) y está armonizado con las medidas mundiales aceleradas en favor de la salud de los adolescentes (AA HA!) de la OMS y el marco operativo de la OMS sobre salud sexual y su relación con la salud reproductiva (2, 3).
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The revision of the SRHR Policy is based on the results of the analysis of the implementation process of the past policy, which has provided evidence to
ensure that the revised policy is relevant and effective. The revision has also been done with the participation of all national stakeholders who
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have
also international experience on SRHR issues. The Ministry urges all public and private institutions to use this policy as a guide in the implementation of
SRHR services in the country.
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The purpose of this multi-year strategy is to guide the strategic direction for the collective work of the Protection against Sexual Exploitation and Abuse (PSEA) Programme in Ukraine. It replaces the 2017 HCT Framework on PSEA in Ukraine, incorporates the priorities set by the IASC Vision and Strat
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egy on Protection from Sexual Exploitation and Abuse and Sexual Harassment 2022-26 and the key outcome areas and statements contained in the UNCT Ukraine Action Plan. The Strategy was endorsed by the Humanitarian Country Team in Ukraine and will be implemented through the adoption of annual workplans for the PSEA Network in Ukraine.
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According to the latest available data, over half of the world’s population lack access to essential health services, and health worker shortages are estimated to reach 10 million by 2030. These contextual factors point to an urgent need to explore innovative strategies – that go beyond a conven
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tional health-sector response – for reaching people with the health services they need.
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Les interventions d’autosoins offrent un énorme potentiel pour renforcer l’action individuelle et réduire les inégalités
en matière de santé en augmentant la disponibilité d’options de soins de santé accessibles, acceptables et abordables qui s’ajoutent aux services et soins reçus
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dans un établissement de soins de santé et peuvent les compléter. Alors que nous arrivons à mi-parcours de la période de 15 ans des objectifs de développement durable (ODD) et que nous examinons les défis auxquels
le monde est confronté, nous devons adopter des solutions potentiellement transformatrices
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