Strategies for gender-equitable HIV services in rural India.

Strategies for gender-equitable HIV services in rural India.
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印度农村性别平等艾滋病毒服务战略。

DOI:
10.1093/heapol/czp004
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发表时间:
2009
影响因子:
3.2
通讯作者:
Bollinger,RobertC
Bollinger,RobertC
中科院分区:
医学3区
文献类型:
--
作者:
Sinha,Gita;Peters,DavidH;Bollinger,RobertC

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印度农村地区艾滋病毒的出现有可能加剧性别不平等,因为妇女已经遭受了巨大的健康差距。印度最近的卫生政策为确定和实施性别平等的农村艾滋病毒服务提供了新的机会。在本次综述中,我们采用莫斯利和陈的健康概念框架来概述艾滋病毒卫生服务利用和结果的决定因素。我们从性别角度审视该框架,对印度农村地区艾滋病毒临床服务中与性别相关的差距进行了全面的文献综述,重点关注患者的获取和结果、提供者的做法和机构伙伴关系。将印度农村地区的调查结果与更广泛的国际文献结合起来,我们描述了印度农村地区性别平等艾滋病毒服务的潜在策略,作为对以下三个问题的回答:(1) 性别平等的艾滋病毒检测和护理应满足哪些特定性别患者的需求? (2) 卫生保健提供者需要什么才能提供性别平等的艾滋病毒服务? (3) 机构应如何执行和维持性别平等的艾滋病毒服务?早期阶段的数据表明,印度农村地区的艾滋病毒服务存在巨大的性别差异,反映了普遍的性别规范。包括针对特定性别的艾滋病毒检测和护理服务在内的策略将直接满足当前针对特定性别的患者的需求。农村护理提供者迫切需要性别敏感性以及艾滋病毒相关沟通和临床技能方面的培训。为了加强和维持性别平等,多部门机构必须建立性别平等的医疗工作场所、跨学科艾滋病毒服务伙伴关系和监督方法,包括对按性别分类的数据进行分析。印度农村地区快速发展的艾滋病毒服务项目采用性别平等的方法可以成为整个医疗保健系统中性别平等的基础。
The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt Mosley and Chen's conceptual framework of health to outline determinants for HIV health services utilization and outcomes. Examining the framework through a gender lens, we conduct a comprehensive literature review for gender-related gaps in HIV clinical services in rural India, focusing on patient access and outcomes, provider practices, and institutional partnerships. Contextualizing findings from rural India in the broader international literature, we describe potential strategies for gender-equitable HIV services in rural India, as responses to the following three questions: (1) What gender-specific patient needs should be addressed for gender-equitable HIV testing and care? (2) What do health care providers need to deliver HIV services with gender equity? (3) How should institutions enforce and sustain gender-equitable HIV services? Data at this early stage indicate substantial gender-related differences in HIV services in rural India, reflecting prevailing gender norms. Strategies including gender-specific HIV testing and care services would directly address current gender-specific patient needs. Rural care providers urgently need training in gender sensitivity and HIV-related communication and clinical skills. To enforce and sustain gender equity, multi-sectoral institutions must establish gender-equitable medical workplaces, interdisciplinary HIV services partnerships, and oversight methods, including analysis of gender-disaggregated data. A gender-equitable approach to rural India's rapidly evolving HIV services programmes could serve as a foundation for gender equity in the overall health care system.
尼泊尔农村地区诊断延迟和寻求医疗保健行为的性别差异。
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发表时间: 2003-04-01
影响因子: 3.6
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