Structural Barriers and Facilitators in HIV Prevention: A Review of International Research

Klein, Charles H.; Easton, Delia; Parker, Richard

doi:10.1007/0-306-47518-9_2

Cited by 18 publications

(21 citation statements)

References 68 publications

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“…Although HIV has no socioeconomic boundaries, poverty is a common feature of HIV vulnerability throughout the world [6][7][8]. The complex relationship between poverty and HIV risk is inextricably tied to the socioeconomic context in which HIV occurs [6].…”

Section: Introductionmentioning

confidence: 99%

Acceptability of a Microenterprise Intervention Among Female Sex Workers in Chennai, India

et al. 2010

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Female sex workers have been central in India's HIV epidemic since it was first diagnosed among them in 1989. Female sex workers' risk of HIV is primarily economically motivated. The Pi pilot study examined the feasibility and association of a microenterprise intervention, the tailoring of canvas bags, on sexual risk behaviors among female sex workers (N = 100) in Chennai. Women were randomized to an intervention or control arm. Between-group comparisons at baseline and at six-month follow-up were performed. Multivariate linear regression with bootstrapping was conducted to estimate the intervention effect. At baseline, women were a median of 35 years old, 61% were married and they had an average of two children. Intervention participants reported a significantly lower number of sex partners and significant increases in income at the 6-month follow-up compared to control participants. In a multivariate model, intervention participants had a significantly lower number of paying clients per month at follow-up compared to control participants. By graduation, 75% of intervention arm participants had made at least one sellable canvas bag and 6 months after the study's end, 60% have continued involvement in bag production. The pilot study demonstrated that microenterprise interventions are successful in both providing FSWs with licit income opportunities and was associated with reductions in HIV risk behaviors.

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Section: Introductionmentioning

confidence: 99%

Acceptability of a Microenterprise Intervention Among Female Sex Workers in Chennai, India

et al. 2010

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“…Women's bodies are more susceptible to infection during sexual activity, however, when the physiological vulnerability is reinforced by the social vulnerability of women, their susceptibility to infection increases greatly (Howson et al , 1996, p. 247;Baylies , 2000;Ackermann & de Klerk, 2002). Klein et al (2002) argued that poverty, a high level of migration due to employment, and gender inequalities are the key forces that affect HIV prevalence , and when they intertwine, lead to an epidemic. (Mwale & Burnard, 1992).…”

Section: Poverty As Contributor To Hiv/aids Prevalencementioning

confidence: 99%

“…Most global AIDS prevention programs such as partner reduction , condom promotion and STD treatment are inadequate to protect most of the women in the world, who are poor and lack the power to negotiate within their sexual relationships (Klein et al, 2002).…”

Section: Poverty As Contributor To Hiv/aids Prevalencementioning

confidence: 99%

“…Despite the taboo about sexuality, multiple sexual partnerships are the norm in many societies. Mistrust between spouses and partners is common in sexual relationships leading to blaming of others, as well as doubts and misconceptions regarding condoms resulting in their rejection (Blair et al, 1997, p. 51;Klein et al, 2002).…”

Section: Poverty As Contributor To Hiv/aids Prevalencementioning

confidence: 99%

“…However, it soon became evident that the information was insufficient to produce risk-reducing behavioural change (Klein et al , 2002;Schoepf, 2001 ). Klein et al (2002) argued that developing methodologies to evaluate structural and environmental interventions and documenting the effects of largescale structural and environmental factors (e.g. poverty) on the highly localised events (e.g .…”

Section: Qualitative Data Analysismentioning

confidence: 99%

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HIV/AIDS in rural Botswana: poverty gender inequality marginalization and stigma

Watanabe¹

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HIV/AIDS in Africa has strong connections to development, poverty and gender inequality. Botswana continues to face one of the highest HIV/AIDS prevalence rates in the world. The common approaches to dealing with HIV prevalence based on medical and behaviour models have not been effective in curtailing this epidemic. Particularly in rural areas, people avoid facing the reality of HIV/AIDS due to fear and stigma.

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Housing Status and HIV Risk Behaviors: Implications for Prevention and Policy

et al. 2005

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This paper examines housing as a contextual factor affecting drug and sexual risk behaviors among HIV positive people using pooled interview data from 2149 clients presenting for services at 16 medical and social service agencies participating in a multi-site evaluation study. The odds of recent drug use, needle use or sex exchange at the baseline interview was 2-4 times as high among the homeless and unstably housed compared to persons with stable housing. Follow-up data collected 6-9 months after baseline showed that change in housing status was associated with change in risk behaviors. Persons whose housing status improved between baseline and follow-up significantly reduced their risks of drug use, needle use, needle sharing and unprotected sex by half in comparison to individuals whose housing status did not change. In addition, for clients whose housing status worsened between baseline and follow-up, their odds of recently exchanging sex was over five times higher than for clients whose housing status did not change. The provision of housing is a promising structural intervention to reduce the spread of HIV.

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Structural Barriers and Facilitators in HIV Prevention: A Review of International Research

Cited by 18 publications

References 68 publications

Acceptability of a Microenterprise Intervention Among Female Sex Workers in Chennai, India

Acceptability of a Microenterprise Intervention Among Female Sex Workers in Chennai, India

HIV/AIDS in rural Botswana: poverty gender inequality marginalization and stigma

Housing Status and HIV Risk Behaviors: Implications for Prevention and Policy

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