HIV prevention among women in low- and middle-income countries: Intervening upon contexts of heightened HIV risk

Abstract

Women's vulnerability to HIV infection is influenced by contextual factors in the risk environment that operate at multiple levels (i.e., physical, social, economic, policy). We present three case studies that illustrate combination approaches to HIV prevention among women who are at heightened risk for infection, especially sex workers, in low- and middle-income countries (LMICs). Lessons learned from these case studies are consistent with international literature promoting interventions that combine sexual risk reduction, condom promotion, and improved access to sexually transmitted infection (STI) treatment in the context of structural interventions, including policy change and empowerment of sex workers to reduce their vulnerability to HIV/STIs. We suggest avenues for future research and new intervention targets as well as a more nuanced approach to understanding the structural and social vulnerability of women to HIV infection in these settings.