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Full-Text Articles in Demography, Population, and Ecology
Associations Between Fgm/C And Hiv In Ethiopia, The Gambia, Kenya, And Sierra Leone: A Limited Analysis Of Demographic And Health Survey Data, Yetunde A. Noah Pinheiro, Zhuzhi Moore, David Gathara
Associations Between Fgm/C And Hiv In Ethiopia, The Gambia, Kenya, And Sierra Leone: A Limited Analysis Of Demographic And Health Survey Data, Yetunde A. Noah Pinheiro, Zhuzhi Moore, David Gathara
Reproductive Health
Studies investigating the association between male circumcision and HIV have demonstrated the protective effect of male circumcision. In some settings, FGM/C and male circumcision are considered “equivalent” procedures. This working paper presents findings of a study that investigates the effect of FGM/C on the likelihood of HIV infection for women in practicing communities in Ethiopia, Gambia, Kenya, and Sierra Leone.
Female Sex Workers Living With Hiv In Tanzania Have Both A Need For Contraception And A Desire To Have Children In The Future, Project Soar
Female Sex Workers Living With Hiv In Tanzania Have Both A Need For Contraception And A Desire To Have Children In The Future, Project Soar
HIV and AIDS
HIV-positive women often have critical family planning (FP) needs in addition to HIV-related care, treatment, and prevention concerns. In sub-Saharan Africa, unintended pregnancy is common among HIV-positive women. At the same time, many women living with HIV want to have children some day, and there are various “safer conception” strategies available to help HIV-affected individuals and couples get pregnant while minimizing the risk of HIV transmission to seronegative partners and the baby. This brief describes the fertility-related needs and desires of female sex workers living with HIV in Tanzania, highlighting results indicating that health services should help women meet both …
Adolescent Girls And Young Women’S Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council
Adolescent Girls And Young Women’S Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council
HIV and AIDS
The Population Council, in collaboration with the National AIDS Control Programme and CSK Research Solutions Ltd., conducted implementation science research in Tanzania to identify key considerations for introducing pre-exposure prophylaxis (PrEP) antiretroviral medication to adolescent girls and young women (AGYW) at substantial risk of HIV infection. This brief presents results from qualitative in-depth interviews and focus group discussions with AGYWs. Based on the findings, the brief recommends including sensitization and education of communities, parents, and male partners of AGYWs in demand-creation activities; training providers to deliver adequate education about PrEP to avoid misperceptions about its intended use, side effects, and …
Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar
Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar
HIV and AIDS
In Malawi, and other resourced-constrained, sub-Saharan African countries with a high HIV burden, several service delivery models have emerged to increase prevention of mother-to-child transmission care retention by strengthening connections between health facilities and their surrounding communities. Yet there has been little documentation of the unique characteristics of each model and their comparative impact on mother-infant pair (MIP) care retention and other health outcomes. This brief describes how Project SOAR is responding to these knowledge gaps by conducting research to identify components of community-based MIP support that are associated with maternal care retention and infant HIV-free survival. This research will …
Stakeholder Considerations For Prep Introduction To Adolescent Girls And Young Women: Laying The Groundwork For Research Utilization In Tanzania, Population Council
Stakeholder Considerations For Prep Introduction To Adolescent Girls And Young Women: Laying The Groundwork For Research Utilization In Tanzania, Population Council
HIV and AIDS
In collaboration with the Tanzania National AIDS Control Programme and CSK Research Solutions Ltd., the Population Council is conducting an implementation science research study in that country to build needed evidence to inform decisionmaking around oral pre-exposure prophylaxis (PrEP) introduction to adolescent girls and young women (AGYW) aged 15–24. The study uses quantitative and qualitative methods to gather data from AGYW, policymakers and other stakeholders, health providers, and AGYW’s parents and male partners to: assess their knowledge and attitudes toward oral PrEP; determine opportunities and approaches for providing PrEP; and identify potential facilitators and barriers to PrEP introduction and use. …
Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Zambia, Population Council
Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Zambia, Population Council
HIV and AIDS
The Population Council is conducting implementation research to build needed evidence to inform decisionmaking around effective implementation of community-based, girl-centered interventions and to assess their effectiveness in reducing HIV vulnerability among adolescent girls and young women (AGYW)—a population in which AIDS is the leading cause of death in the region. Learnings from this study in Zambia and similar ones in Kenya and Malawi will be valuable for informing each country and the region how to implement AGYW programming that goes beyond the health sector to reduce AGYW's vulnerability to HIV.
Characteristics Associated With Hiv And Hsv-2 Among Adolescents In Malawi, Barbara Mensch, Erica Soler-Hampejsek
Characteristics Associated With Hiv And Hsv-2 Among Adolescents In Malawi, Barbara Mensch, Erica Soler-Hampejsek
HIV and AIDS
The DREAMS (Determined, Resilient, Empowered AIDS-free, Mentored, and Safe) partnership aims to significantly reduce new HIV infections in adolescent girls and young women (AGYW) in Malawi and other sub-Saharan African countries. To better understand the epidemiological context for the DREAMS programming, Project SOAR analyzed previously collected quantitative cohort data from the Population Council’s Malawi Schooling and Adolescent Study to identify the factors associated with the prevalence and incidence of HIV and the herpes simplex virus, commonly referred to as genital herpes. SOAR’s analysis provides a deeper understanding of the epidemiological and gendered context of the HIV epidemic in Malawi. This …
Considerations For Prep Introduction To Adolescent Girls And Young Women: Implementation Science Research In Tanzania, Population Council
Considerations For Prep Introduction To Adolescent Girls And Young Women: Implementation Science Research In Tanzania, Population Council
HIV and AIDS
In collaboration with the National AIDS Control Programme and CSK Research Solutions Ltd., a Tanzania-based research organization, the Population Council is conducting implementation science research in Tanzania to build needed evidence to inform decisionmaking around the introduction of oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW), ages 15–24. This research will actively engage key stakeholders throughout the study, including gaining their insights on key study questions, interpreting the findings, crafting initial programming recommendations based on findings, and supporting their adoption in Tanzania and beyond. Findings from this study and other observational studies and demonstration trials in progress …
Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In South Africa, Population Council
Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In South Africa, Population Council
HIV and AIDS
The Population Council is conducting implementation research in South Africa, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in Uganda, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in South Africa and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.
Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Hiv Services: Implementation Science Research In Swaziland, Population Council
Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Hiv Services: Implementation Science Research In Swaziland, Population Council
HIV and AIDS
The Population Council is conducting implementation research in Swaziland, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in South Africa, Uganda, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in Swaziland and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.
Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Uganda, Population Council
Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Uganda, Population Council
HIV and AIDS
The Population Council is conducting implementation research in Uganda, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in South Africa, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in Uganda and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.
Introducing Oral Pre-Exposure Prophylaxis To Adolescent Girls And Young Women In Tanzania: Overview Of Findings From Implementation Science Research, Population Council
Introducing Oral Pre-Exposure Prophylaxis To Adolescent Girls And Young Women In Tanzania: Overview Of Findings From Implementation Science Research, Population Council
HIV and AIDS
The Population Council in collaboration with Tanzania’s National AIDS Control Program and CSK Research Solutions Limited conducted implementation science research in one urban district and one rural district in the country, to provide needed evidence for informing decisionmaking on whether and how to introduce oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW) in Tanzania. The aims of the research were to: assess the acceptability of PrEP among AGYW, their male partners, their parents/guardians, healthcare providers, and policymakers; determine the feasibility of and opportunities for providing PrEP to AGYW; and identify key facilitators and barriers to PrEP introduction …
Parents' And Guardians' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council
Parents' And Guardians' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council
HIV and AIDS
The Population Council, in collaboration with the National AIDS Control Programme (NACP) and CSK Research Solutions Ltd., conducted implementation science research in two research sites in Tanzania to identify key considerations for introducing oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW). The NACP and members of the study’s research utilization committee recognized the importance of learning about parents’ and guardians’ attitudes and perceptions of PrEP use by their adolescent and young adult daughters and peers to inform the PrEP implementation process in Tanzania. Moreover, existing research in Tanzania finds that parents communicate with their children about sexual …
Rates Of Hiv And Hsv-2 Among Young People In Machinga, Malawi, Barbara Mensch, Erica Soler-Hampejsek
Rates Of Hiv And Hsv-2 Among Young People In Machinga, Malawi, Barbara Mensch, Erica Soler-Hampejsek
HIV and AIDS
To better understand the epidemiological context for the DREAMS programming, Project SOAR analyzed previously collected quantitative cohort data from the Population Council’s Malawi Schooling and Adolescent Study (MSAS) to identify the prevalence and incidence of HIV and the herpes simplex virus, commonly referred to as genital herpes. SOAR’s analysis provides a deeper understanding of the changing epidemiological and gendered context of the HIV epidemic in Machinga. The youth cohort data from the MSAS provide accurate estimates of HIV prevalence over time and HIV incidence, thereby filling important data gaps.
Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar
Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar
HIV and AIDS
Project SOAR is conducting implementation science research in Malawi to build needed evidence to inform decisionmaking about effective programming to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. Specifically, SOAR is: examining approaches to identify the most at-risk girls, particularly those out of school, and enroll and retain them in DREAMS programming; assessing HIV-risk and health-seeking behaviors before and after AGYW’s engagement in DREAMS interventions; exploring how to reach AGYW’s male sexual partners and increase their uptake of HIV services; and assessing facilitators and barriers to HIV service uptake by men living with HIV. …
Understanding Married Women's Vulnerability To Hiv Infection In Egypt: An Exploratory Study, Doaa Oraby, Nahla G. Abdel-Tawab
Understanding Married Women's Vulnerability To Hiv Infection In Egypt: An Exploratory Study, Doaa Oraby, Nahla G. Abdel-Tawab
Reproductive Health
This study examines the behavioral, sociocultural, economic, programmatic, and legal factors that aggravate Egyptian women’s vulnerabilities to HIV/AIDS. The study concludes that in low-prevalence settings like Egypt, targeted interventions are the most strategic and cost-effective: for example, HIV awareness-raising with a special focus on the preventive role of consistent, correct condom use, and creating a cadre of peers that could provide psychosocial support and HIV counseling to migrant workers. Furthermore, premarital and antenatal care programs should include HIV awareness-raising and provider-initiated counseling and testing after screening of women to identify those at risk for HIV infection. Concurrently, efforts should be …
Addressing Intimate Partner Violence And Power In Relationships In Hiv Testing Services: Results Of An Intervention Piloted In Nairobi, Kenya, Nicole Haberland, Charity Ndwiga, Katharine Mccarthy, Margaret Makanyengo, Rose Kosgei, Cecilia Choi, Julie Pulerwitz, Sam Kalibala
Addressing Intimate Partner Violence And Power In Relationships In Hiv Testing Services: Results Of An Intervention Piloted In Nairobi, Kenya, Nicole Haberland, Charity Ndwiga, Katharine Mccarthy, Margaret Makanyengo, Rose Kosgei, Cecilia Choi, Julie Pulerwitz, Sam Kalibala
HIV and AIDS
The overarching goal of this study was to pilot an approach to HIV testing services (HTS) that addresses intimate partner violence (IPV) and sexual relationship power (SRP) inequalities, and explores the intervention’s potential for improving uptake and retention of antiretroviral therapy and prevention of mother-to-child transmission services. The project was implemented in Kenyatta National Hospital’s (KNH) antenatal care (ANC) clinic, and examined intermediate indicators of effect, as well as operational issues around incorporating attention to IPV in hospital procedures, especially in high-volume, high-need settings like KNH’s. The findings from this study suggest that providing some minimal IPV/SRP counseling to all …
Peer Mentoring: An Effective Strategy For Integrating Hiv And Srh Services, Integra Initiative
Peer Mentoring: An Effective Strategy For Integrating Hiv And Srh Services, Integra Initiative
Reproductive Health
Mentoring is an innovative approach to improving provider skills without compromising service delivery by harnessing the potential of existing providers. In Kenya, a peer-mentorship approach was designed and tested to improve service providers’ skills, knowledge, and capacity to provide high-quality integrated HIV and SRH services. A central component was to understand providers’ opinions on mentoring, so as to build a practical and sustainable mentorship model. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London …
Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative
Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative
Reproductive Health
At the end of 2013, an estimated 35 million people were living with HIV, and sub-Saharan Africa was disproportionately affected. With major efforts directed at expanding access to life-saving antiretroviral therapy in sub-Saharan Africa, many people are living longer with HIV, leading productive and sexually active lives. Unintended pregnancies and the potential of vertical transmission are some of the challenges faced by women living with HIV. Understanding the fertility preferences and reproductive decisions of these women is vital for informing efforts to enable them to achieve these desires effectively and safely. The “Steps to Integration” series provides a guide on …
Experiences With Pregnancy Among Female Sex Workers In Ethiopia: A Link Up Exploratory Study, Population Council, Miz-Hasab Research Center, Organization For Social Services For Aids
Experiences With Pregnancy Among Female Sex Workers In Ethiopia: A Link Up Exploratory Study, Population Council, Miz-Hasab Research Center, Organization For Social Services For Aids
HIV and AIDS
In Ethiopia, it is illegal to operate a brothel or procure sex workers as a commercial activity, but the sale of sex by women is not prohibited by law. Research suggests that the number of Ethiopian female sex workers is growing, with younger women and girls increasingly entering the sex trade. Public health programs and policies typically have emphasized HIV prevention in this vulnerable population. A 2014 study of 3,882 Ethiopian female sex workers found that HIV prevalence in the 10 study sites ranged from 15–33 percent, compared to national prevalence of 1.9 percent among women. Furthermore, since most female …
Integration Of Sexual And Reproductive Health And Hiv Services, Integra Initiative
Integration Of Sexual And Reproductive Health And Hiv Services, Integra Initiative
Reproductive Health
In sub-Saharan Africa, there is a high rate of unintended pregnancy, particularly among HIV-positive women, and the majority of HIV infections are sexually transmitted or transmitted as a result of pregnancy, childbirth, and breastfeeding. Yet many health facilities do not provide integrated HIV and SRH services. Integration has the potential to increase access and uptake of health services, increase job satisfaction among providers, more effectively distribute facility workloads, and reduce facility costs. The Integra Initiative represents an effort to respond to the need for high-quality evidence on the feasibility, effectiveness, cost, and impact of different models for delivering integrated HIV …
Cost And Technical Efficiency Of Integrated Hiv And Srh Services In Kenya And Swaziland, Integra Initiative
Cost And Technical Efficiency Of Integrated Hiv And Srh Services In Kenya And Swaziland, Integra Initiative
Reproductive Health
Policymakers and researchers have long hypothesized the potential benefits of integrating HIV prevention, treatment, and care with sexual and reproductive health (SRH) services in settings with generalized HIV epidemics. In addition to improving health and social outcomes, integration of services holds the promise of increasing efficiency of service delivery and maximizing health care resources. Economic theory suggests several potential efficiency advantages at the service and programmatic levels. However, evidence on the unit cost and efficiency gains associated with integration remains scarce. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings …
The Effect Of Integrating Hiv Services On Quality Of Postnatal Care, Integra Initiative
The Effect Of Integrating Hiv Services On Quality Of Postnatal Care, Integra Initiative
Reproductive Health
Addressing the postnatal needs of new mothers is a neglected area of care throughout sub-Saharan Africa. Unintended pregnancies during the first 12 months following delivery, and vertical transmission of HIV during labor and delivery, are some of the challenges faced by women during the extended postpartum period. Many women want to delay or avoid another pregnancy, but are not using a modern contraceptive method. Few developing countries ensure that mothers and newborns are assessed early and monitored during the initial six-week period as recommended by WHO, which contributes to discontinuity of services received during pregnancy and delivery and limits linkages …
Srh And Hiv Service Integration And Stigma, Integra Initiative
Srh And Hiv Service Integration And Stigma, Integra Initiative
Reproductive Health
Stigma is frequently faced by people living with HIV and those who they are associated with, and is frequently followed by discrimination. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London School of Hygiene & Tropical Medicine and the Population Council. Issue 3 of the series explores the experience of stigma among clients living with HIV in a variety of settings, both service-based (when seeking family planning, antenatal, and postnatal care services) and facility-based …
Learning From Women About Hiv Risk, Hiv Testing Behaviors, And Prevention Practices In Mpumalanga, South Africa: A Descriptive Study To Inform Microbicides Introduction, Martha Brady, Saiqa Mullick, Barbara Friedland, Marlena Gehret Plagianos, Linda Du Plessis, Thabiso Mango
Learning From Women About Hiv Risk, Hiv Testing Behaviors, And Prevention Practices In Mpumalanga, South Africa: A Descriptive Study To Inform Microbicides Introduction, Martha Brady, Saiqa Mullick, Barbara Friedland, Marlena Gehret Plagianos, Linda Du Plessis, Thabiso Mango
HIV and AIDS
The provision of any new prevention product in clinical trial settings is often vastly different from implementation in “real life” public sector settings. In addition, use of antiretrovirals (ARV), such as tenofovir gel, for pre-exposure prophylaxis requires regular HIV testing to ensure users are uninfected before initiating and continuing product use. Therefore, before any ARV-based prevention product can be introduced to women, information is needed on HIV testing practices, how best to integrate products into existing primary health care systems, and women’s risk perception and health-seeking behaviors. The Population Council, in partnership with Solutions IPPT, conducted a study to learn …
Sexual And Reproductive Health Among Young Female Sex Workers In Bangladesh Brothels—Baseline Findings From Link Up, Population Council
Sexual And Reproductive Health Among Young Female Sex Workers In Bangladesh Brothels—Baseline Findings From Link Up, Population Council
HIV and AIDS
Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. Consortium members PIACT Bangladesh and Marie Stopes Bangladesh implemented a brothel-based program for female sex workers to address sexual and reproductive health and rights. Working in eight brothels in seven districts, trained female sex worker peer educators provided face-to-face education, including referrals to on-site and off-site health care …
Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida
Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida
HIV and AIDS
Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. At a workshop held in Burundi, 3–5 June 2014, the Population Council, Alliance Burundaise contre le SIDA, and local partners in Burundi identified successful activities, highlighted important challenges and best practices, and found innovative ways to improve Link Up programming. This document contains a selection of the most …
Sexual And Reproductive Health Of Women Living With Hiv In Egypt: Unmet Needs And Unfulfilled Dreams, Doaa Oraby, Nahla G. Abdel-Tawab
Sexual And Reproductive Health Of Women Living With Hiv In Egypt: Unmet Needs And Unfulfilled Dreams, Doaa Oraby, Nahla G. Abdel-Tawab
Reproductive Health
The gender profile of the HIV/AIDS epidemic has changed since it emerged 30 years ago when infections were concentrated in key populations of men such as injecting drug users and men who have sex with men. In 2012, women accounted for nearly 50 percent of the estimated 35.3 million people living with HIV/AIDS globally. In the Middle East and North Africa, 44 percent of infected adults are women. The past 30 years have also witnessed remarkable improvements in access to high-quality information and medical services, including services for prevention of mother-to-child transmission of the virus. With care and treatment for …
Policy And Programme Considerations For Arv-Based Prevention For Women: Insights From Key Opinion Leaders In Zimbabwe About Tenofovir Gel, Samukeliso Dube, Barbara Friedland, Saiqa Mullick, Martha Brady, C. Elizabeth Mcgrory
Policy And Programme Considerations For Arv-Based Prevention For Women: Insights From Key Opinion Leaders In Zimbabwe About Tenofovir Gel, Samukeliso Dube, Barbara Friedland, Saiqa Mullick, Martha Brady, C. Elizabeth Mcgrory
HIV and AIDS
Zimbabwe has seen a tremendous shift in the HIV landscape in the last decade, particularly regarding prevalence. Yet many people, especially women, are still at high risk and efforts to identify and implement additional HIV-prevention options remain critical. After nearly 20 years of microbicides research, 1 percent tenofovir gel is the first vaginal microbicide to show promise. Since 2011, Zimbabwe has been scaling up use of tenofovir-based regimens as first-line therapy for adults infected with HIV. A randomized, placebo-controlled, double-blind trial demonstrated that women assigned to use 1 percent tenofovir gel had a 39 percent lower risk of HIV infection …
Program And Policy Considerations For Tenofovir Gel In India: An Overview, Population Council
Program And Policy Considerations For Tenofovir Gel In India: An Overview, Population Council
HIV and AIDS
The 2011 National Sentinel Surveillance estimated that 1.9 million people in India aged 15 and older were living with HIV. An estimated 39 percent are women. Given the urgent need for HIV-prevention options for women, a number of efforts are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a guide to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The guide includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. The …