The Gender Differences in Access to ARV Therapy

In this article, Le Couer et al. report the procedure and findings of their study that aimed to associate the gender differences in access to ARV therapy with the causes and timing of HIV testing in the framework of the individual life-course and the growing AIDS pandemic in the country. The study made use of a life-event history survey to collect data from all beneficiaries of the ARV therapy in four hospitals located in the suburban Chiang Mai Province.

The data were collected through an interview that lasted between 25 and 132 minutes. The analysis of the data was done using multiple statistical tests including Stata version 9, Pearson’s chi-square test, Fisher’s exact test, student t-test, and Kruskal-Wallis test. The scholars found that access to ARV therapy was significantly higher among women than among men. This is despite the disproportionately higher number of men suffering from AIDS than women in Thailand. This differential result is attributed to the priorities given to mothers for HIV testing and treatment. The study showed that men sought testing services and therapeutic assistance when the illness was at an advanced stage thereby limiting their access to the ARV therapy.

One limitation of the study involved the sensitivity of the data which forced some of the potential participants to be treated in hospitals outside their residential areas and therefore they could not participate in the study. Despite this limitation, the study had a high response rate of 89%. The findings of this study can be used to implement more effective HIV/AIDS testing and treatment programs for men given that men are globally discriminated against in the fight against HIV and AIDS.

In this document, the Department of Health provides advice to commissioners working with alcoholics concerning potential and actual harm caused by alcohol in local communities. The document aims to equip these professionals with adequate information that can be used to institute and implement effective intervention mechanisms for minimizing alcohol harm. The significance of the study is based on the grave harm that alcohol poses in terms of disease and injuries. The Department of Health (2009) states that excessive drinking is a major cause of disease and injury, accounting worldwide for 9.2% of disability-adjusted life years with only tobacco smoking and high blood pressure as higher risk factors,” (p.6).

The main goals of the intervention measures include reduction of alcohol intake, reduction in alcohol reliance, reduction in alcohol-related health issues, reduction in alcohol-related social ills, and overall enhancement in health and social functioning. The Department of Health also identifies four major High Impact Changes that it hopes the document will bring about. These changes include enhancement of the success and ability of specialist treatment; appointment of Alcohol Health Workers; provision of additional assistance to people to consume less alcohol; and intensification of nationwide social marketing priorities.

To ensure the desired outcomes, the document outlines four actions that should be taken by the professionals. The first action involves strategic planning based on the level of alcohol harm and its potential impact on their local communities. Specification of service outcomes and procuring services is the second action that needs to be taken. The third and last action involves managing demand and performance through strategies such as regular supervision and early intervention.

Reference List

Department of Health. (2009). Signs for improvement – commissioning interventions to reduce alcohol-related harm. London: Department of Health.

Le Couer, S., Collins, I.J., Pannetier, J., and Lelievre, E. (2009). Gender and access to HIV testing and antiretroviral treatments in Thailand: Why do women have more and earlier access? Social Science & Medicine 69, 846-853.