This EngenderHealth resource offers guidance and recommendations for creating programmes that protect and promote the sexual and reproductive health (SRH) and rights of women and girls living with HIV and AIDS. Based on experiences in Brazil, the resource offers recommendations in four key areas involving creating a political and social environment for promotion of sexual and reproductive rights; strengthening health systems to improve the availability of comprehensive sexual and reproductive health; ensuring participation of adolescent girls and women living with HIV and AIDS in public policies and rights initiatives; and strengthening support available to them.

Three dimensions of vulnerability of this population of people living with HIV (PLHIV) were analysed: the individual dimension of vulnerability; social vulnerability; and the programmatic or institutional dimension of vulnerability.

Among the recommendations are the following communication-based aspects of providing for the right to sexual and reproductive health for women and girls living with HIV:

• "Creating a political and social environment that respects, protects and promotes sexual and reproductive rights;
1. Guarantee the adoption of a cross-disciplinary, equitable approach to SRH care for women and adolescent girls living with HIV and AIDS that includes access to accurate information couched in suitable language...
2. Ensure the participation of women and adolescent girls living with HIV and AIDS in the planning, implementation, monitoring, and evaluation stages of National Policies on Integral Health Care for Women and on Integral Health Care for Adolescents and Young People...

• Strengthening health systems to improve the availability of comprehensive sexual and reproductive health;
1. Integrate into the curricula of graduate courses in human sciences and health sciences the themes of human rights, sexual rights, reproductive rights, ethnic/racial relations, gender relations, and diversity, in addition to questions related to overcoming stigma and discrimination associated with living with HIV and AIDS.
2. Foster the inclusion of the theme "social determinants of health conditions" in all permanent education activities for health workers..., [including correlating] the process leading to poor health and socioeconomic, regional, ethnic, racial, gender, and age-related disparities and other factors (like gender violence against women, stigma and discrimination associated with living with HIV, and other human rights violations)...
3. Guarantee that the themes of human rights and living with HIV and AIDS and rights are addressed in the programs of permanent education and ongoing training for health workers and community health agents...
4. Broaden opportunities to update health workers’ knowledge about and skills on the SRH of HIV-positive women and girls through training and certification...
5. Create opportunities for sharing and exchanging experiences and lessons learned in the promotion, defense, and enforcement of the rights of PLHIV...
6. Guarantee the development of strategies to broaden participation and engagement of the male partners of women and adolescent girls living with HIV and AIDS, particularly in counseling...
7. ...develop communications and information strategies to promote the rights of PLHIV, especially their sexual rights and reproductive rights and the prevention of vertical transmission of HIV and syphilis, among others, by guaranteeing the broad dissemination of communications products directed at health workers, health managers, health service users, and society at large.
8. Widely disseminate the booklets Users’ Rights and Health Service Users among women and adolescent girls living with HIV.

• Ensuring their meaningful participation in monitoring public policies and rights initiatives;
1. Strengthen the participation of women and adolescent girls living with HIV and AIDS as political participants...
2. Foster and encourage qualification and permanent education processes for monitoring, and evaluation of public policies for PLHIV...
3. Stimulate and foster civil society initiatives to develop communications strategies and the production and dissemination of audiovisual materials, materials for radio and television, printed matter, and electronic media products adapted to the differing realities and needs of the target audience and aimed at raising awareness about the feminization of the epidemics of AIDS and other STDs [sexually transmitted diseases], about positive prevention, about the rights of PLHIV (including their sexual rights and reproductive rights), about facing up to stigma, discrimination, and violence, and about other relevant themes...

• Strengthening support for personal development, expressions of sexuality, and reproductive choices among adolescent girls and young women living with HIV and AIDS.
1. Organize health and social services in such a way that they attract young people by offering them a welcoming, friendly atmosphere and the possibility to construct shared solidarity...
2. Train and certify [health and social services] staff in health, education, and other areas to work with adolescents and young people, by adopting democratic and respectful postures..."
3. Promote permanent education and qualification in... sexual rights and reproductive rights and the prevention of gender-based violence, for young people and adolescents, using peer education methodologies.
4. Stimulate... training for professionals responsible for the care, education, culture, leisure, sport, and the promotion and protection of the rights of adolescents and young people with legal problems, who are incarcerated,... [and] [f]acilitate access to counseling services..."


Developed with support from the Packard Foundation, EngenderHealth’s coalition of local partners includes: the United Nations Population Fund (UNFPA)-Brazil, Movimento Nacional Cidadas PositHIVas-National Movement of PositHIVe Women Citizens, Brasilian Chapter of the International Community of Women Living with HIV and AIDS, National Network of People Living with HIV and AIDS (RNP+), United Nations General Assembly Special Session (UNGASS) Forum-Brazil, Grupo de Incentivo a Vida (GIV), GESTOS (Seropositivity, Communication, and Gender), and the Joint United Nations Program on HIV and AIDS (UNAIDS).

Posting from Sharone Beatty to The CORE Group listserv [6] on May 21 2009.