Gender-responsiveness of HIV services
Export Indicator
Progress towards ensuring HIV services acknowledge and take specific actions to respond to the gender norms, roles and inequalities that impede HIV services.
Gender-responsive approaches acknowledge and take specific actions to respond to the gender norms, roles and inequalities that impede HIV services.
In the context of HIV, gender-responsive approaches take into account gender-related drivers of HIV risk (e.g. harmful gender norms, unequal power dynamics, fear and risk of violence) and gender-related barriers to HIV services (e.g. decision-making power, differing service and support needs, gender-related discrimination) in their design, implementation and evaluation to ensure HIV services reach people of all genders.
Gender-responsive approaches do not seek to transform the social contexts (e.g. societal norms around gender) and structural contexts (e.g. discriminatory legal frameworks, inequitable hiring practices within institutions) that fuel gender inequalities.
Gender-responsive HIV services have been demonstrated to increase HIV testing, male engagement in HIV prevention services such as prevention of mother-to-child transmission, youth engagement in HIV services, and adherence to treatment. This indicator will provide feedback to the country and facilities surveyed on where improvements are needed.
Number of health facilities providing gender-responsive HIV services.
Total number of health facilities providing HIV services surveyed.
Numerator/denominator.
Checklist to assess the gender-responsiveness of HIV services completed by health facilities providing HIV prevention, treatment or care services. See the technical brief for this survey for additional information on survey implementation, including sampling.
Health facilities are considered to be providing gender-responsive HIV services if they reach a score of 75–100 on the checklist using the following scale:
0–25: limited gender-responsiveness.
26–50: working towards gender-responsiveness.
51–74: mostly gender-responsive.
75–100: gender-responsive.
Every 2 years.
None
None
This indicator directly assesses the gender-responsiveness of HIV services from the perspective of health facilities. Gender-responsive approaches can support more equitable access to services. The checklist used to construct this indicator was developed based on literature review, with input from technical experts. The questions to construct the indicator assess agreement with various statements on services provided rather than measuring specific events. Social desirability bias may occur, leading to overreporting of gender-responsiveness of HIV services.
This indicator provides general information on the gender-responsiveness of HIV services, but it does not reflect how this may vary for different groups of clients, such as people from key populations. It is recommended that this indicator is analysed in conjunction with data on user perspectives or client feedback collected through other tools, which can be complementary and provide information to better understand how experiences may differ for people of different genders and gender identities, including people from key populations.
Analysis of data disaggregated by various facility characteristics, such as geographical location, type of facility (public/private), services (e.g. prevention, treatment, care and support, sexual and reproductive health), may provide further insights to inform programmes and policies.
Dovel K, Dworkin SL, Cornell M, Coates TJ, Yeatman S. Gendered health institutions: examining the organization of health services and men’s use of HIV testing in Malawi. J Int AIDS Soc. 2020;23(Suppl 2):e25517.
Gupta GR, Oomman N, Grown C, Conn K, Hawkes S, Shawar YR, et al. Gender equality and gender norms: framing the opportunities for health. Lancet. 2019;393(10190):2550–2562.
Pettifor A, Lippman SA, Gottert A, Suchindran CM, Selin A, Peacock D, et al. Community mobilization to modify harmful gender norms and reduce HIV risk: results from a community cluster randomized trial in South Africa. J Int AIDS Soc. 2018;21(7):e25134.
Remme M, Siapka M, Vassall A, Heise L, Jacobi J, Ahumada C, et al. The cost and cost-effectiveness of gender-responsive interventions for HIV: a systematic review. J Int AIDS Soc. 2014;17(1):19228.
Basic steps in gender-responsive programming: integrating gender into HIV/AIDS programmes in the health sector. Geneva: World Health Organization; 2009 (https://www.ncbi.nlm.nih.gov/books/NBK143050/, accessed 7 November).