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Open Access Highly Accessed Research article

Women and HIV in a moderate prevalence setting: an integrative review

Michelle L Redman-MacLaren1*, Jane Mills2, Rachael Tommbe3, David J MacLaren1, Richard Speare4 and William JH McBride1

Author affiliations

1 School of Medicine and Dentistry, James Cook University, McGregor Rd, Smithfield, Cairns, Australia

2 School of Nursing, Midwifery and Nutrition, James Cook University, Cairns, Australia

3 School of Health Sciences, Pacific Adventist University, Port Moresby, National Capital District, Papua New Guinea

4 Anton Breinl Centre for Public Health and Tropical Medicine, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia

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Citation and License

BMC Public Health 2013, 13:552  doi:10.1186/1471-2458-13-552

Published: 6 June 2013

Abstract

Background

Almost 32,000 people are living with human immunodeficiency virus (HIV) in Papua New Guinea (PNG). The primary route of transmission in this moderate prevalence setting is through heterosexual sex. Thus a gendered understanding of HIV is required to inform HIV prevention, treatment and care options. The aim of this review is to investigate understandings specifically about women and HIV in PNG and to identify gaps in the literature to inform future HIV research.

Methods

An integrative review of literature about women, HIV and PNG was conducted using a systematic search of online databases, including book chapters and grey literature. Prior to inclusion, literature was assessed using inclusion and exclusion criteria, and the Critical Appraisal Skills Programme (CASP) appraisal tool. Selected articles, book chapters and reports were coded and a constant comparative method of analysis used to construct a series of themes.

Results

The 26 articles, book chapters and reports included in the review were predominantly descriptive, original research (23/26 pieces of literature). Six themes were identified in the literature: economic, social and cultural factors (including mobility); gender issues (including violence against women); knowledge about HIV (including perception of risk of HIV); religious beliefs about HIV; women perceived as responsible for HIV transmission; and prevention of HIV. Literature about women and HIV in PNG is predominantly focussed upon women who sell sex, women as mothers or young women. Women are usually represented as either victims of HIV or responsible for transmitting HIV. Anthropological and social research has described the economic, social and cultural context along with the lived experience of HIV in PNG, but there is limited operations research or implementation research available.

Conclusions

The literature reviewed has highlighted the importance of a gendered analysis of HIV prevention, care and treatment in PNG. There is an opportunity for operations, implementation and health systems research about HIV in PNG to shift research from description to action.

Keywords:
Women; Gender; HIV; Papua New Guinea; Integrative review; Moderate prevalence setting