"On the Horizon" is an electronic news capsule from the Horizons Program.
Horizons (<http://www.popcouncil.org/horizons/horizons.html>) is a global
operations research program designed to:
1) Identify and test potential strategies to improve HIV/AIDS prevention,
care, and support programs and service delivery.
2) Disseminate research findings and promote their utilization with the aim
of replicating and scaling up successful interventions.
Sex work-related publications
Horizons Report May 2002
New Approaches to Sex Work and HIV/AIDS
Feature Stories:
"Can Solidarity and Government Policy Reduce HIV Risk in Sex Work?"
Dominican program increases condom use and lowers STI prevalence.
"From Health Promotion to Community Development" Sex work studies in Brazil
and India find significant associations between social capital and safer
sex.
"Petals and Thorns Show The Risks and Benefits" Researchers develop
innovative informed consent procedure for sex workers in Cambodia.
Studies in Brief:
"Study Examines Efforts to Promote Female Condom to Sex Workers" Campinas,
Brazil
"Researchers Assess Integration of HIV Services and Maternal-Child Care"
Nairobi, Kenya
"Combining STI Management Strategies May Be Cost-effective" Antananarivo,
Madagascar
Text (available in html and pdf):
<http://www.popcouncil.org/horizons/newsletter/horizons_report.html>
Estimating the Cost and Effectiveness of Different STI Management Strategies
for Sex Workers in Madagascar
In Madagascar, the prevalence of sexually transmitted infections (STIs) is a
serious public health problem, particularly among sex worker populations.
Horizons study investigators conducted an assessment of STI management
practices in health facilities in two urban areas of Madagascar. They found
that health practitioners were using a syndromic approach to manage STIs
which is less appropriate for sex workers who may have multiple, often
asymptomatic infections, many of which may not be captured through this
method of diagnosis. If practitioners were to diagnose STIs with laboratory
tests, however, the cost of the medical visits would become prohibitively
expensive and time-consuming. For a more precise yet cost-effective
diagnostic approach, researchers developed a risk profile for various STIs
based on age, number of partners, symptoms, and so on.
This summary presents a cost-effectiveness analysis of different strategies
to manage STIs among sex workers in Madagascar.
Full Summary (HTML and PDF):
<http://www.popcouncil.org/horizons/ressum/swmad/swmad.html>
Acceptability of the Female Condom after a Social Marketing Campaign in
Campinas, Brazil
The female condom is intended to serve the dual role of protecting against
unwanted pregnancy and sexually transmitted infections (STIs). Information
is lacking about its continued use, particularly among women at high risk of
HIV and other STIs. This report summarizes the findings from a Horizons
study that examined the role of the female condom as a method of protection
against HIV/STIs among female sex workers in Campinas, Brazil, who were
provided with increased access to the product and information about it
through an educational and social marketing intervention.
Full Summary (HTML and PDF):
<http://www.popcouncil.org/horizons/ressum/fcbrazil/fcbrazil.html>
Stigma and Discrimination-related publications
HIV/AIDS-related Stigma and Discrimination: A Conceptual Framework and an
Agenda for Action
Despite international efforts to tackle HIV/AIDS, stigma and discrimination
(S&D) remain among the most poorly understood aspects of the epidemic. This
is due in part to the complexity and diversity of S&D, but also in part to
limitations in current thinking within the field and the inadequacy of
available theoretical and methodological tools. The purpose of this paper is
to propose a new conceptual framework to help inform thinking about the
processes of S&D, about the way these processes relate to HIV/AIDS, and
about potential interventions to address S&D and minimize their impact. To
do this, the paper:
1) Analyzes the sources of S&D, the forms that HIV/AIDS-related S&D take,
and the contexts in which HIV/AIDS-related S&D take place.
2) Highlights the limitations of current thinking and argues that S&D need
to be understood as social rather than individual processes.
3) Identifies an agenda for research and intervention.
Full Report (PDF only):
<http://www.popcouncil.org/pdfs/horizons/sdcncptlfrmwrk.pdf>
Greater Involvement of PLHA in NGO Service Delivery: Findings from a
Four-country Study
Despite growing recognition of its importance, there has been little
research that examines the involvement of people living with HIV/AIDS (PLHA)
in the delivery of prevention, care, and support services in developing
countries and its effects on PLHA, others affected by HIV/AIDS, and
nongovernmental organizations (NGOs). To address this gap, the Horizons
Program and the International HIV/AIDS Alliance conducted a study of PLHA
involvement in 17 NGOs in Burkina Faso, Ecuador, Zambia and Maharashtra
State, India, between October 1998 and August 2001. The goal of the study
was to identify the conditions that foster PLHA involvement and the
strategies that organizations can use to achieve meaningful involvement of
PLHA.
Full Summary (HTML and PDF):
http://www.popcouncil.org/horizons/ressum/plha4cntry/plha4cntry.html
<http://www.popcouncil.org/pdfs/horizons/accesstotreatment.pdf>
Meeting the Sexual Health Needs of Men Who Have Sex with Men in Senegal
Research conducted in many countries has highlighted the vulnerability of
men who have sex with men (MSM) to HIV and other STIs. Yet in Africa, they
receive little attention in HIV/AIDS programming and service delivery
because of widespread denial and stigmatization of homosexual behavior. In
Senegal, a study conducted by researchers from the National AIDS Control
Program (PNLS), Cheikh Anta Diop University, and the Horizons Program has
provided valuable information about the needs, behaviors, knowledge, and
attitudes of MSM that has important implications for program managers and
policymakers working to stem the spread of HIV/AIDS.
Full Summary (HTML and PDF):
http://www.popcouncil.org/horizons/ressum/msmsenegal/msmsenegal.html
<http://www.popcouncil.org/pdfs/horizons/accesstotreatment.pdf>
Mitigation-related publications
Microfinance and Households Coping with HIV/AIDS in Zimbabwe: An Exploratory
Study
The widespread prevalence of HIV/AIDS in sub-Saharan Africa adversely
affects millions of households. In recent years, microfinance has been
proposed as a strategy to help the households of microentrepreneurs respond
to the negative economic impacts of HIV/AIDS. This study, conducted in
Zimbabwe, sought to better understand the relationship between a
microfinance program, Zambuko Trust, and how microentrepreneurs' households
cope with the impact of HIV/AIDS. The study also examined how HIV/AIDS is
affecting Zambuko's operations and what microfinance institutions (MFIs) can
do to lessen the impact of HIV/AIDS on their clients and operations.
Full Summary (HTML and PDF):
http://www.popcouncil.org/horizons/ressum/microfinzimb/microfinzimb.html
<http://www.popcouncil.org/pdfs/horizons/accesstotreatment.pdf>
Horizons is implemented by the Population Council in partnership with the
International Center for Research on Women, the International HIV/AIDS
Alliance, the Program for Appropriate Technology in Health, Tulane
University, Family Health International, and Johns Hopkins University. This
announcement and the publications listed above were made possible through
support provided by the Global Bureau of Health/HIV-AIDS, U.S. Agency for
International Development (USAID), under terms of Award No.
HRN-A-00-97-00012-00. The opinions expressed herein are those of the
author(s) and do not necessarily reflect the views of USAID.
Copyright © 2002 The Population Council, Inc.
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