Addressing the sexual and reproductive health needs of people living with HIV in Zambia : challenges and opportunities
Document type: mthesis
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Abstract:
OBJECTIVE: With increased access to treatment, people living with HIV (PLWHA) in Zambia have better health status and live longer. This study aims to identify the challenges and opportunities of addressing their sexual and reproductive health (SRH) needs within the health system. METHODS: This thesis is a literature review of selected studies to explore the supply and demand-side barriers that PLWHA encounter in accessing SRH services. The Andersen-Newman Behaviour model is used to analyse the literature. RESULTS: PLWHA have a number of SRH needs that are not uncommon. These include: desire to have children; fertility regulation services; treatment for sexually transmitted and reproductive infections and pleasurable sexual relationships. The challenges faced in fulfilling these needs include: negative health staff attitudes; inadequate social support; cost of accessing services and socio-cultural norms that discourage health-seeking behaviour. In practice, the supply and demand-side factors are found to be interrelated. Discrimination within the community and the health care facilities limit service uptake. Restrictive policies, laws and provider beliefs further limit the supply of SRH services to subpopulations including adolescent and prisoners living with HIV. PLWHA have some specific SRH needs that require special attention. CONCLUSION: Gender roles, health beliefs and structural weaknesses in the health care system have to be addressed to improve the fit between SRH needs and services. A supportive and non-discriminatory legal and policy framework can facilitate informed sexual and reproductive health choices by PLWHA. More evidence is needed on the preferred and feasible packaging of integrated HIV and SRH services.
Authors:
Mangani, F.D.
Country:
Zambia
Category:
Research
Department:
Development Policy & Practice
Institute:
KIT (Royal Tropical Institute)
Keywords:
HIV and AIDS
,
reproductive health
,
health services
Language:
eng
Organization:
KIT - Royal Tropical Institute
PAGE:
vii, 53
Year:
2009
Region:
East Africa
Right:
© 2009 Mangani
Subject:
Health and Nutrition
Title:
Addressing the sexual and reproductive health needs of people living with HIV in Zambia : challenges and opportunities
Training:
Master of Public Health / International Course in Health Development (ICHD)