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1.
Reprod Health Matters ; 24(48): 79-89, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28024682

RESUMO

This paper is a sequel to a 2004 article that reviewed South Africa's introduction of new sexual and reproductive health (SRH) and rights laws, policies and programmes, a decade into democracy. Similarly to the previous article, this paper focuses on key areas of women's SRH: contraception and fertility, abortion, maternal health, HIV, cervical and breast cancer and sexual violence. In the last decade, South Africa has retained and expanded its sexual and reproductive health and rights (SRHR) policies in the areas of abortion, contraception, youth and HIV treatment (with the largest antiretroviral treatment programme in the world). These are positive examples within the SRHR policy arena. These improvements include fewer unsafe abortions, AIDS deaths and vertical HIV transmission, as well as the public provision of a human papillomavirus vaccine to prevent cervical cancer. However, persistent socio-economic inequities and gender inequality continue to profoundly affect South African women's SRHR. The state shows mixed success over the past two decades in advancing measurable SRH social justice outcomes, and in confronting and ameliorating social norms that undermine SRHR.


Assuntos
Política de Saúde , Saúde Reprodutiva , Direitos Sexuais e Reprodutivos , Saúde da Mulher , Direitos da Mulher/métodos , Aborto Induzido , Antirretrovirais/uso terapêutico , Neoplasias da Mama/prevenção & controle , Anticoncepção , Feminino , Infecções por HIV/tratamento farmacológico , Disparidades em Assistência à Saúde , Humanos , Serviços de Saúde Materna , Gravidez , Saúde Reprodutiva/legislação & jurisprudência , Delitos Sexuais , Justiça Social , África do Sul , Neoplasias do Colo do Útero/prevenção & controle , Saúde da Mulher/legislação & jurisprudência , Direitos da Mulher/legislação & jurisprudência
2.
Afr J AIDS Res ; 15(2): 123-40, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27399042

RESUMO

Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural and social interventions to alleviate the socio-structural determinants of HIV infection. There is growing evidence that social protection has the potential to reduce the risk of HIV infection among children and adolescents. This research combined expert consultations with a rigorous review of academic and policy literature on the effectiveness of social protection for HIV prevention among children and adolescents, including prevention for those already HIV-positive. The study had three goals: (i) assess the evidence on the effectiveness of social protection for HIV prevention, (ii) consider key challenges to implementing social protection programmes that promote HIV prevention, and (iii) identify critical research gaps in social protection and HIV prevention, in Eastern and Southern Africa. Causal pathways of inequality, poverty, gender and HIV risk require flexible and responsive social protection mechanisms. Results confirmed that HIV-inclusive child-and adolescent-sensitive social protection has the potential to interrupt risk pathways to HIV infection and foster resilience. In particular, empirical evidence (literature and expert feedback) detailed the effectiveness of combination social protection particularly cash/in-kind components combined with "care" and "capability" among children and adolescents. Social protection programmes should be dynamic and flexible, and consider age, gender, HIV-related stigma, and context, including cultural norms, which offer opportunities to improve programmatic coverage, reach and uptake. Effective HIV prevention also requires integrated social protection policies, developed through strong national government ownership and leadership. Future research should explore which combinations of social protection work for sub-groups of children and adolescents, particularly those living with HIV.


Assuntos
Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição/estatística & dados numéricos , Serviços Preventivos de Saúde/estatística & dados numéricos , Política Pública , Assunção de Riscos , Adolescente , África Oriental/epidemiologia , África Austral/epidemiologia , Criança , Aconselhamento , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pobreza , Profilaxia Pré-Exposição/economia , Profilaxia Pré-Exposição/métodos , Serviços Preventivos de Saúde/economia , Comportamento Sexual/psicologia , Fatores Socioeconômicos
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