Yemen is a country with a low-level HIV epidemic. The main model used for VCT in Yemen involves a "client-initiated" approach. This approach is not ideal for promoting access to VCT.
Different approaches should be used to Fuck yemeni access such as provider-initiated, mobile and web-based interventions. Home Publications Conferences Register Contact. Guidelines Upcoming Special Issues. Research Article Open Access. December 27, Accepted: January 27, Published: January 30, Citation: J Infect Dis Ther 4: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Agri and Aquaculture Journals Dr. Related article at PubmedScholar Google. Voluntary counselling and testing VCT is considered a gateway to Fuck yemeni, treatment, care and support. Although the availability and utilization of VCT services are continuing to increase worldwide and by were reported to be available in countries [ 2 ].
Despite increasing the number of facilities providing VCT in Yemen, the number of people being tested remains below targets [ 4 ]. The objective of this study is to explore factors that may affect access to VCT services for female sex workers FSW and men who Fuck yemeni sex with men MSM in Yemen in order to find feasible approaches to increase access. Yemen is considered a country Fuck yemeni a low-level HIV epidemic.
Inthe estimated overall prevalence of HIV was 0. However, there is no available data about the cumulative number of HIV related deaths and orphans. Inthe annual number of newly registered HIV cases was Insentinel surveillance showed an HIV prevalence among tuberculosis TB patients and pregnant women of 0.
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HIV surveillance is still weak and incomplete especially among populations at higher risk [ 6 ]. It needs to be borne in mind that the data presented here mainly reflects reported cases and is subjected to sampling and reporting bias.
The Fuck yemeni is still scant for Fuck yemeni drug users, prisoners, and mobile populations refugees, internally displaced persons and migrants. A HIV and AIDS situation analysis in Yemen among 2, participants general population, marginalized minority group, Yemenis returning from extended work abroad and refugees found that the main factors facilitating the spread of HIV infection included poverty, socio-cultural variations among these groups, low HIV-risk perception and population movements, especially Fuck yemeni workers [ 12 ].
Sex work in Yemen is illegal and mainly reflects poverty.
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Low incomes, high rates of dowry and unemployment might have pushed some men to have sex with men as Fuck yemeni for women [ 13 ]. Some men practice sex with other men for financial gain. For example a small study conducted in the Aden Governorate by El- Karouaoui [ 14 ] found Fuck yemeni about 32 Participants had no information about protected sex such as using condoms and lubricants.
Due to stigma and taboo, MSM are largely invisible in the community and they have reduced opportunities to seek care which might lead to higher risk of spreading HIV.
They are less likely to use condoms and to seek Fuck yemeni assistance for Fuck yemeni, which make them more vulnerable to HIV [ 9 ]. Regarding IDU, there is no evidence concerning the HIV epidemic among this group in Yemen, and all the studies conducted till now did not show that they have HIV prevalence higher than the wider population.
However such studies among the IDU are limited in Yemen, the available data from the assessment that was conducted in Sana'a and Aden showed that most IDU identified are immigrants and foreigners, and there are Fuck yemeni reported HIV cases among them [ 15 ].
Moreover, given the geographical position and trading history of Yemen, it may well be that IDU is being greatly underestimate by the authorities. The social stigma and laws make them invisible. The NAP has undertaken studies since to analyze the situation of the populations at higher risk in Yemen. FSW in Yemen are engaged in sex work largely because of poverty and they are forced to sell sex mostly at low price [ 13 ] at hotels, night clubs, streets and illegal brothels [ 12 ].
The social status of FSW ranges from Fuck yemeni, married, singles and widows [ 9 ]. The population size estimate of FSW conducted in showed that the ages of FSW ranged from years with the majority between years. The estimated total number of FSW in 5 main governorates as shown in annex 2 was about and in Yemen as a whole is 60, [ 16 ]. The clients of FSW are drown from different categories of men in Yemen and mostly among those who have good income, security forces, sailors, truck drivers, migrant workers and tourists from Gulf Fuck yemeni 12 ].
Many MSM in Yemen captured in the surveys to date, first engaged in homosexual practices when they were young for financial gain or gifts exchange and some of them live as couples. Homosexuality was reported in a study conducted by Busulwa [ 12 ] to occur in all categories of people: The majority of MSM who were identified by EL Karouaoui in Aden [ 14 ] was single and has low income and they sell Fuck yemeni in hotels, night clubs, on the beach, malls, Fuck yemeni market or by renting apartments.
The findings of the population size estimate of MSM in showed that the age group of MSM ranged from years and the highest number was between years. The estimated total number of MSM in 5 main governorates as shown in annex 2 was about and in Yemen as a whole is 44, [ 16 ].
The strategy was the result of a participatory process involving different sectors including private for profit and nonprofit stakeholders and it addresses the political commitment towards HIV and AIDS; promotes prevention including condom use and harm reduction programmes; calls for action to improve access to VCT, PMTCT and ART services; and aims to reach populations at higher risk by studies and research [ 6 ].
Prevention activities were the main focus of the initial efforts and this continues to the Fuck yemeni day. Currently there are 20 sites in the country providing VCT in 8 governorates: There are 5 public hospitals providing ART Fuck yemeni 5 governorates and 4 antenatal care clinics in 3 governorates providing prevention of mother Fuck yemeni child transmission PMTCT services 3 of them public and one of them an NGO [ 5 ].
Male condoms are distributed through reproductive health service providers. However, there are some initiatives on social marketing of male condoms and their availability in the market [ 6 ]. Such campaigns include the production and distribution of printed materials, travelling theatre, lectures and seminars. However, NAP has begun to engage some in awareness Fuck yemeni activities and advocacy meetings that address different methods for reaching populations at higher risk [ 5 ].
The strategies that are used to increase access to services in other similar situations were also revised.
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The KIT library was used to review materials related to the topic. English and Fuck yemeni Arabic articles, full texts and some important national reports were included in the study within a time limit of the last 10 years.
Some additional literature outside this time frame was included if relevant. The conceptual framework used in this study is shown in Figure 2. This framework was used to describe the factors affecting access to health services.
The study was based on a literature review within a limited period of time. The information was not based on a primary data collection but relies on secondary data. The data presented in this study mainly reflects Fuck yemeni cases and is subject to sampling and reporting bias.
Relevant literature from other countries that have similar characteristics of their HIV epidemics and related cultural issues were reviewed. However, inference has to be made on their relevance to the situation in Yemen. This review could serve as the basis for future studies to be carried out among key populations at higher risk of HIV infection Fuck yemeni Yemen.
InVCT services were established for the first time at 14 sites in Yemen. The main model adopted for VCT services in Yemen is clientinitiated visits.
The VCT policy emphasizes voluntary testing, confidentiality, anonymity and the informed consent of the client [ 4 ]. The process of testing and counselling includes pre-test counselling, testing and post-test counselling. Inthe total number of Fuck yemeni who have received pre-test counselling was 3, distributed over 8 governorates. Fuck yemeni is no data about the number of clients who actually received post-test counselling and who were given their HIV status.
The number of VCT sites in the Aden Governorate is proportionality more than in other governorates as shown in annex 4. It is therefore not surprising that the Fuck yemeni number of clients who accessed the VCT services in was in Aden as shown in Figure 3 [ 6 ]. There is no information on the selection and the distribution of VCT services in those governorates.
The data reveals that the number of people who accessed and utilized VCT was low in comparison to mandatory HIV testing. Fuck yemeni majority of PLHIV in Yemen who know their HIV status learned it through mandatory HIV testing as a prerequisite for migration, surgery, employment for certain private Fuck yemeni, donation of blood or residency renewal as shown in Figure 4 [ 4 ]. Clearly the available data is the result of sampling patterns and possibly also influenced by reporting bias.
Homosexuality and sex work are illegal in Yemen and punishable under the law [ 6 ].
Prostitutes, brothel owners and some hotel owners where sex workers are available are subject to imprisonment [ 14 ]. Priority area number 10 states that identifying populations at higher risk and initiating interventions to change their behaviours should be achieved by the end of It also mentions that these groups should be involved in the design, implementation and evaluation of any interventions targeting them, including VCT Fuck yemeni 6 ].
The national plan and initiatives from some NGOs targeting populations at higher risk are considered good opportunities that have helped to reach these populations [ 6 ]. This helped to reduce the waiting time for Fuck yemeni results [ 4 ]. Age and sex play an important role in access to VCT services. The older people are, the less likely they are to use VCT [ 18 ]. The male to female ratio was 1. This may be Fuck yemeni young accessed VCT more readily.
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Female clients were less likely to access VCT services. This may reflect socio-cultural barriers such as inability of female to access VCT alone or may be due to the presence of male counsellors at VCT sites that prevents them from accepting the services. It has been argued that people who have lower education are more likely to be in denial regarding their HIV status Fuck yemeni 18 ] and less likely to have access to HIV information. Fuck yemeni data collected from the VCT sites for the period July-December revealed that the total number of clients who accessed and utilized Fuck yemeni was 1, To put these Figures into perspective, it should be noted that These findings suggest that illiteracy is playing a role in accessing VCT services and increasing vulnerability to HIV infection and this possibility needs to be studied further.
Both sides have harassed, threatened, and attacked Yemeni activists and The Saudi-led coalition's restrictions on imports to Yemen have. People Born with Atypical Sex Characteristics Battle For Informed Consent.
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