Health  Vol.6 No.11 , May 2014
Gender Sensitive STIs/HIV/AIDS Prevention Policies: A Qualitative Study
ABSTRACT
Background: The global incidence of STIs is rising. It is estimated that 499 million new cases of curable STIs occur every year. The existence of more than one million reported cases of STIs annually in Iran shows that addressing this issue must be a priority for Iranian health authorities. While recognition of the importance of gender issues to reproductive health (RH) programs has grown significantly in the past several years, major challenges remain in implementing gender-sensitive programs. Gender mainstreaming in Iranian reproductive health program is a relatively new issue, so this study aims to explore gender sensitive STIs/HIV/AIDS prevention policies. Method: This study employed a qualitative research design. Participants were health managers, health policy makers and reproductive health providers. They were selected purposefully and then continued by snowball sampling method. 43 semi-structured in-depth interviews with 37 key informants were done. All the interviews were recorded and transcribed. The data were analyzed by content analysis method. Trustworthiness of the data was achieved by using credibility, trans-ferability and conformability. Results: Key informants clearly explained the gender sensitive STIs/ HIV/AIDS prevention policies in three main categories: 1) advocacy, 2) collaboration between different sectors and 3) community empowerment to gender sensitive STIs/HIV/AIDS prevention programs. Conclusion: Changing gender neural STIs/HIV/AIDS prevention policy to more complete gender sensitive policy needs advocacy, collaboration of sectors and community empowerment.

Cite this paper
Rahmanian, F. , Simbar, M. , Ramezankhani, A. and Zayeri, F. (2014) Gender Sensitive STIs/HIV/AIDS Prevention Policies: A Qualitative Study. Health, 6, 1246-1254. doi: 10.4236/health.2014.611153.
References
[1]   Miners, A., Llewellyn, C., Pollard, A., Lagarde, M., Richardson, D., Cairns, J., Fisher, M. and Smith, H. (2012) Assessing User Preferences for Sexually Transmitted Infection Testing Services: A Discrete Choice Experiment. Sexually Transmitted Infections, 88, 510-516.
http://dx.doi.org/10.1136/sextrans-2011-050215

[2]   Surveillance of STIs (2005) A Report by the Sexually Transmitted Infections Subcommittee for the Scientific Advisory Committee of the Health Protection Surveillance Centre. Health Protection Surveillance Centre, Dublin.

[3]   Mayaud, P. and Mabey, D. (2004) Approaches to the Control of Sexually Transmitted Infections in Developing Countries: Old Problems and Modern Challenges. Sexually Transmitted Infections, 80, 174-182.
http://dx.doi.org/10.1136/sti.2002.004101

[4]   Lazaro, N. (2010) Management of Sexually Transmitted Infections in Non-Specialist Settings: Practical Issues. Medicine, 38, 322-327.
http://dx.doi.org/10.1016/j.mpmed.2010.02.004

[5]   Sexually Transmitted Infections (STIs) (2013) The Importance of a Renewed Commitment to STI Prevention and Control in Achieving Global Sexual and Reproductive Health. WHO, Geneva.

[6]   World Health Organization (WHO), UNAIDS and UNICEF (2011) Global HIV/AIDS Response: Epidemic Update and Health Sector Progress towards Universal Access: Progress Report 2011. WHO, Geneva.

[7]   HIV/AIDS Surveillance (2003) Centers for Disease Control, National Center for Infectious Diseases, Division of HIV/AIDS. US Department of Health and Human Services, Washington DC.

[8]   Ministry of Health and Medical Education (MOHME) and HIV/STI Office (2008) Situation Analysis of Sexually Transmitted Infections in the Islamic Republic of Iran.

[9]   Ministry of Health and Medical Education (MOHME) and National AIDS Committee Secretariat (2012) Islamic Republic of Iran AIDS Progress Report.

[10]   UNAIDS (2003) Aids Epidemic Update: 2003. World Health Organization, Geneva.

[11]   Uwe, E.A., Ekuri, E.E. and Asuquo, P.N. (2006) African Women and Vulnerability to HIV/AIDS: Implications for Female Related Cultural Practices. International Quarterly of Community Health Education, 27, 87-94.
http://dx.doi.org/10.2190/IQ.27.1.g

[12]   Maman, S., Campbell, J., Sweat, M.D. and Gielen, A.C. (2000) The Intersections of HIV and Violence: Directions for Future Research and Interventions. Social Science & Medicine, 50, 459-478.
http://dx.doi.org/10.1016/S0277-9536(99)00270-1

[13]   Sciarra, J.J. (2009) Global Issues in Women’s Health. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 104, 77-79.

[14]   Peacock, D., Stemple, L., Sawires, S. and Coates, T.J. (2009) Men, HIV/AIDS, and Human Rights. Journal of Acquired Immune Deficiency Syndromes, 51, S119-S125.

[15]   Sayles, J.N., Pettifor, A., Wong, M.D., MacPhail, C., Lee, S.J., Hendriksen, E., Rees, H.V. and Coates, T. (2006) Factors Associated with Self-Efficacy for Condom Use and Sexual Negotiation among South African Youth. Journal of Acquired Immune Deficiency Syndromes, 43, 226-233.

[16]   Baiden, P. and Rajulton, F. (2011) Factors Influencing Condom Use among Women in Ghana: An HIV/AIDS Perspective. Journal of Social Aspects of HIV/AIDS Research Alliance/SAHARA, 8, 46-54.

[17]   USAID (2011) A Summary Report of New Evidence That Gender Perspectives Improve Reproductive Health Outcomes.
http://www.prb.org/igwg_media/summary-report-gender-perspectives.pdf

[18]   Maganja, R.K., Maman, S., Groves, A. and Mbwambo, J.K. (2007) Skinning the Goat and Pulling the Load: Transactional Sex among Youth in Dar es Salaam, Tanzania. AIDS Care, 19, 974-981.
http://dx.doi.org/10.1080/09540120701294286

[19]   Jewkes, R., Nduna, M., Levin, J., Jama, N., Dunkle, K., Khuzwayo, N., Koss, M., Puren, A., Wood, K. and Duvvury, N. (2006) A Cluster Randomized-Controlled Trial to Determine the Effectiveness of Stepping Stones in Preventing HIV Infections and Promoting Safer Sexual Behaviour amongst Youth in the Rural Eastern Cape, South Africa: Trial Design, Methods and Baseline Findings. Tropical Medicine & International Health, 11, 3-16.
http://dx.doi.org/10.1111/j.1365-3156.2005.01530.x

[20]   Lotfi, R., Tehrani, F.R., Yaghmaei, F. and Hajizadeh, E. (2012) Barriers to Condom Use among Women at Risk of HIV/AIDS: A Qualitative Study from Iran. BMC Women’s Health, 12, 13.
http://dx.doi.org/10.1186/1472-6874-12-13

[21]   Corbin, J. and Strauss, A. (1990) Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Sage, Thousand Oaks.

[22]   Agampodi, S.B., Agampodi, T.C. and Ukd, P. (2008) Adolescents Perception of Reproductive Health Care Services in Sri Lanka. BMC Health Services Research, 8, 98.
http://dx.doi.org/10.1186/1472-6874-12-13

[23]   Collins, C., Alagiri, P., Summers, T. and Morin, S. (2002) Abstinence Only vs. Comprehensive Sex Education: What Are the Arguments? What Is the Evidence?
http://www.ebooksoneverything.com/youth/abstinencevssexeducation.pdf

[24]   Trelle, S., Shang, A., Nartey, L., Cassell, J.A. and Low, N. (2007) Improved Effectiveness of Partner Notification for Patients with Sexually Transmitted Infections: Systematic Review. BMJ: British Medical Journal, 334, 354.

[25]   Cohen, D.A., Wu, S.Y. and Farley, T.A. (2004) Comparing the Cost-Effectiveness of HIV Prevention Interventions. Journal of Acquired Immune Deficiency Syndromes, 37, 1404-1414.

[26]   Radcliffe, K. and Clarke, J. (1998) Contact Tracing—Where Do We Go from Here? Sexually Transmitted Infections, 74, 313-315.

[27]   Shapiro, D., Meekers, D. and Tambashe, B. (2003) Exposure to the “SIDA dans la Cité” AIDS Prevention Television Series in C?te’ d’Ivoire, Sexual Risk Behaviour and Condom Use. AIDS Care, 15, 303-314.
http://dx.doi.org/10.1080/0954012031000105360

[28]   Vaughan, P.W., Rogers, E.M., Singhal, A. and Swalehe, R.M. (2000) Entertainment-Education and HIV/AIDS Prevention: A Field Experiment in Tanzania. Journal of Health Communication, 5, 81-100.
http://dx.doi.org/10.1080/10810730050019573

[29]   Lim, M.S., Hocking, J.S., Hellard, M.E. and Aitken, C.K. (2008) SMS STI: A Review of the Uses of Mobile Phone Text Messaging in Sexual Health. International Journal of STD & AIDS, 19, 287-290.
http://dx.doi.org/10.1258/ijsa.2007.007264

[30]   Swendeman, D. and Rotheram-Borus, M.J. (2010) Innovation in Sexually Transmitted Disease and HIV Prevention: Internet and Mobile Phone Delivery Vehicles for Global Diffusion. Current Opinion in Psychiatry, 23, 139-144.
http://dx.doi.org/10.1097/YCO.0b013e328336656a

[31]   Semrau, K., Kuhn, L., Vwalika, C., Kasonde, P., Sinkala, M., Kankasa, C., Shutes, E., Aldrovandi, G. and Thea, D.M. (2005) Women in Couples Antenatal HIV Counseling and Testing Are Not More Likely to Report Adverse Social Events. AIDS, 19, 603-609.
http://dx.doi.org/10.1097/01.aids.0000163937.07026.a0

[32]   Homsy, J., Kalamya, J.N., Obonyo, J., Ojwang, J., Mugumya, R., Opio, C. and Mermin, J. (2006) Routine Intrapartum HIV Counseling and Testing for Prevention of Mother-to-Child Transmission of HIV in a Rural Ugandan Hospital. Journal of Acquired Immune Deficiency Syndromes, 42, 149-154.

[33]   Pulerwitz, J., Michaelis, A., Verma, R. and Weiss, E. (2010) Addressing Gender Dynamics and Engaging Men in HIV Programs: Lessons Learned from Horizons Research. Public Health Reports, 125, 282-292.

[34]   Waddell, E.N. and Messeri, P.A. (2006) Social Support, Disclosure, and Use of Antiretroviral Therapy. AIDS and Behavior, 10, 263-272.
http://dx.doi.org/10.1007/s10461-005-9042-x

[35]   Uddin, M.J. and Choudhury, A.M. (2008) Reproductive Health Awareness among Adolescent Girls in Rural Bangladesh. Asia-Pacific Journal of Public Health, 20, 117-128.

[36]   Borgia, P., Marinacci, C., Schifano, P. and Perucci, C.A. (2005) Is Peer Education the Best Approach for HIV Prevention in Schools? Findings from a Randomized Controlled Trial. The Journal of Adolescent Health, 36, 508-516.

[37]   Cornman, D.H., Schmiege, S.J., Bryan, A., Benziger, T.J. and Fisher, J.D. (2007) An Information-Motivation-Behavioral Skills (IMB) Model-Based HIV Prevention Intervention for Truck Drivers in India. Social Science & Medicine, 64, 1572-1584.

[38]   Witte, K., Cameron, K.A., Lapinski, M.K. and Nzyuko, S. (1998) A Theoretically Based Evaluation of HIV/AIDS Prevention Campaigns along the Trans-Africa Highway in Kenya. Journal of Health Communication, 3, 345-363.
http://dx.doi.org/10.1080/108107398127157

[39]   Tao, G., Irwin, K.L. and Kassler, W.J. (2000) Missed Opportunities to Assess Sexually Transmitted Diseases in US Adults during Routine Medical Checkups. American Journal of Preventive Medicine, 18, 109-114.
http://dx.doi.org/10.1016/S0749-3797(99)00139-7

[40]   Coates, T.J., Richter, L. and Caceres, C. (2008) Behavioural Strategies to Reduce HIV Transmission: How to Make Them Work Better. Lancet, 372, 669-684.
http://dx.doi.org/10.1016/S0140-6736(08)60886-7

[41]   Crosby, R.A., DiClemente, R.J., Wingood, G.M., Cobb, B.K., Harrington, K., Davies, S.L., Hook 3rd, E.W. and Oh, M.K. (2001) HIV/STD-Protective Benefits of Living with Mothers in Perceived Supportive Families: A Study of High-Risk African American Female Teens. Preventive Medicine, 33, 175-178.
http://dx.doi.org/10.1016/S0140-6736(08)60886-7

[42]   Henrich, C.C., Brookmeyer, K.A., Shrier, L.A. and Shahar, G. (2006) Supportive Relationships and Sexual Risk Behavior in Adolescence: An Ecological-Transactional Approach. Journal of Pediatric Psychology, 31, 286-297.
http://dx.doi.org/10.1093/jpepsy/jsj024

[43]   McNeely, C., Shew, M.L., Beuhring, T., Sieving, R., Miller, B.C. and Blum, R.W. (2002) Mothers’ Influence on the Timing of First Sex among 14- and 15-Year-Olds. The Journal of Adolescent Health, 31, 256-265.

[44]   Wight, D., Williamson, L. and Henderson, M. (2006) Parental Influences on Young People’s Sexual Behaviour: A Longitudinal Analysis. Journal of Adolescence, 29, 473-494.
http://dx.doi.org/10.1016/j.adolescence.2005.08.007

[45]   Voisin, D.R. (2002) Family Ecology and HIV Sexual Risk Behaviors among African American and Puerto Rican Adolescent Males. The American Journal of Orthopsychiatry, 72, 294-302.
http://dx.doi.org/10.1037/0002-9432.72.2.294

[46]   UNICEF (2002) HIV/AIDS Education: A Gender Perspective, Tips and Tools. UNICEF, New York.

 
 
Top