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1. Introduction to the SHE programme
1. SHE programme slide kit
An introduction to the objectives and activities of
the SHE programme
Date of preparation: June 2012Mercury No: VIEMEA12NP026
SHE is a European programme
addressing specific challenges facing
women with HIV, by educating healthcare
providers in their care and treatment, and by supporting
women to feel empowered in all
situations of their life
Its objective is to improve the care and
quality of life of women living with
HIV
The SHE programme
What is SHE?What is the SHE
programme’s objective?
The SHE programme is being developed
by two multidisciplinary
faculties, including women personally
affected by HIV and healthcare
professionals involved in their care
Who is developing the SHE
programme?
Why was the SHE programme developed?
• The number of women living with HIV is on the rise: in Europe alone, women represent one third of new diagnoses of HIV (29.1%)
ECDC/WHO. HIV/AIDS Surveillance in Europe, 2010, available online: http://www.ecdc.europa.eu/ [accessed December 2011]
2004 2005 2006 2007 2008 2009 20100
10,000
20,000
30,000
40,000
50,000
60,000
27,117 28,917 31,162 34,193 35,418 36,458 36,019
15,103 15,51216,188
16,64618,654 19,129 18,180
Men Women
Year
Nu
mb
er
of n
ew
ly-d
iag
no
sed
HIV
in
fect
ion
in E
uro
pe
Why was the SHE programme developed?
• Women living with HIV have urgent unmet medical needs• Women are particularly
vulnerable to HIV• Managing women living
with HIV is challenging for physicians
• Women may face barriers to accessing or maintaining HIV treatment
• Educational HIV and AIDS programmes are needed
Challenges facing women living with HIV
Biology
Lifetime hormonal changes
Differences in response to ART
Limited gender-specific data
Lack of specific guidelines
Stigma, fear of disclosure
Social, economic, legal
and cultural issues
World Health Organisation: “Gender inequalities and HIV.” 2011. Available at http://www.who.int/gender/hiv_aids/en/
SHE: An integrated programme
Strong
HIV positiv
e
Empowered women
Strong
HIV positive women
Educational programme
A community facultyPeer support programme for
women living with HIV
A scient
ific committee
Medical educati
onal programme
for HCP
An integrated local approach, building a European SHE network
Explore the situation of women with HIV
Identify knowledge gaps
Develop best practices and bridge the knowledge gap between
physicians and women with HIV
Empower women with HIV
Facilitate patient–physician dialogue
Bridge the knowledge gap between physicians and women
with HIV
2010 2011 2012
APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB
Review of available data
First faculty meeting: Defining the five SHE topics
Second faculty meeting: Developing the programme
Preparation of scientific materials Update of materials
First scientific standalone:Exploring the story of women
living with HIV in Europe
Second scientific standalone:Caring for women
living with HIV in Europe
Developing the SHE programme
First advisory committee meeting
Development of peer support toolkit
Second advisory committee meeting
Third advisory committee meeting
Launch of peer support toolkit at IAS 2011
Community programme
Scientific programme
Translation and adaptation of peer support toolkit into French, German, Spanish,
Italian, Polish and Portuguese
Define topics and review available
data
Development of the
medical toolkit
Community ad board meeting
Launch of SHE website www.shetoshe.org
Key elements of the SHE programme
SHE medical education
SHE peer support
SHE units
The SHE network
Scientific programme Community programme
Key elements of the SHE programme
SHE medical education
SHE peer support
SHE units
The SHE network
Scientific programme Community programme
Introduction of the SHE medical toolkit
1. SHE programme slide kit
An introduction to the objectives and activities of
the SHE programme 2. SHE topic slide kits
A summary of scientific data in five key topics relevant to
the care of women living with HIV
3. SHE data gap slide kit
A summary of urgent clinical questions identified as data gaps by delegates
at European SHE meetings, highlighting European
priorities, what is currently known and what actions
could be taken
5. SHE awareness poster
A poster suitable for display in hospitals or clinics to raise awareness of the
objectives and key elements of the SHE
programme4. Suggestions for SHE meetings
Proposals and helpful tips for running local educational and interactive meetings using the materials in the SHE unit box
6.SHE key facts summary
A short printable summary of key data on the five SHE
topics
SHE medical education: 5 key topics addressing challenges of women at all ages
SHE medical education topic slide kits
• A survey of recently published literature and congress presentations• To be updated after major congresses
2. SHE topic slide kits
A summary of scientific data in five key topics relevant to
the care of women living with HIV
The SHE data gaps for the five key topics
Standardised analysis of incidence of HIV by gender across European countries
Standardised surveillance of HIV transmission to
women
Standardised surveillance of women who are
migrants
Standardised surveillance of women involved in sex
work
Intersectional analyses of situations affecting women
with HIV
Up to date survey of current HIV testing
strategies targeted at women in Europe
Analysis of success factors affecting testing strategies
targeted at women in Europe
Studies of HIV testing strategies in new settings
Survey of links between healthcare and immigration
services across Europe
Literature review of barriers to testing women with HIV
in Europe
Data on access to antiretroviral treatment for
women in different European countries
Guidelines for the management of women
with HIV
More gender-specific clinical data are needed
Pharmacokinetic and pharmacodynamic studies
by gender
Treatment adherence among women with HIV;
and the effect of depression and other social
factors
Guidance on the use of contraceptive drugs by
women with HIV
Data on the number of women with HIV using oral
contraceptives, and the number who would like to
do so
Increased support for and coordination of European
country registries of ART in pregnant women
More up-to-date guidance on the management of
pregnant women with HIV
Data on infant drug levels and their effects in
breastfeeding women with HIV
European gender-specific data on response to ART in
older people
Contribution of the social & physiological challenges of
HIV to the experience of aging in women
Role of hormone replacement therapy in older women with HIV
Pharmacokinetics and long-term consequences of
ART
Data on polypharmacy in older women with HIV
What do we know about the situation of women with HIV in Europe?
What are the challenges of testing for HIV in women?
What do we know about antiretroviral treatment of HIV in women?
How does HIV affect the choices of women of childbearing age?
What are the long-term considerations for women living with HIV?
3. SHE data gap slide kit
A summary of urgent clinical questions identified as data gaps by
delegates at European SHE meetings, highlighting European priorities, what is currently known and what actions could be taken
Key elements of the SHE programme
SHE medical education
SHE peer support
SHE units
The SHE network
Scientific programme Community programme
Peer support can benefit both clinicians and women with HIV
1. Positively UK. Peer Support Model. 2010.2. Broadhead et al. Soc Sci Med 2002;55:235–46.
PreparedBe prepared for the formal
consultation with the doctor1
ConfidentIncrease confidence and
self-esteem1
Healthier Help improve physical, mental
and social health1
More knowledgeableEnhance understanding of HIV and related issues, increasing knowledge of treatments
and adherence to them2
EmpoweredCreate an enabling environment to become empowered and take better control of lives1
Peer support can help
women living with HIV to be:
EngagedHelp overcome isolation, find a
voice and be heard, with a stronger voice as part of a group1
The SHE peer support toolkit
• A comprehensive and practical toolkit to support women living with HIV to become peer support counsellors in a clinical setting
• The toolkit is currently available in the UK, and is being translated and adapted for France, Germany, Italy, Poland, Portugal, and Spain
Printed toolkit www.shetoshe.org USB stick
Components of the peer support tool kit
Diagnosis
• Coming to terms• Self-esteem• Disclosure
Accessing and using healthcare services
• Discussion of services• Partnership with
healthcare providers
Sex and relationships
• Talking about sex• Pleasure and
prevention
Physical, sexual and reproductive health
• Improving health• Making plans• STIs• Older women with HIV• Younger women with
HIV
Living well with HIV
• Impact of HIV on daily living
• Managing anxiety and depression
• Self-esteem and confidence
Introduction
• What is the SHE programme?
• Who is this toolkit for?• Getting started as a
SHE programme facilitator
• What is peer support?
Women, HIV and human rights
• Introducing human rights
• What human rights mean to us
Women and HIV treatment
• Living with HIV treatment
• Taking HIV medication• Symptoms and side
effects
Why peer support is good (for healthcare professionals)
• Why use peer support for women in the clinic
• How SHE could be run
Key elements of the SHE programme
SHE medical education
SHE peer support
SHE units
The SHE network
Scientific programme Community programme
The SHE unit: a multidisciplinary team caring for women living with HIV
THE SHE FACULTY
THE SHE UNIT
Meetings Materials
THE SHE NETWORK
Evaluation Feedback
HIV physicians and peer support workers, nurses, psychologists,
paediatricians, pharmacists, gynaecologists, social workers, lawyers,
nutritionists
• Based in a specific clinic
• Working to improve practice and empower women living with HIV
• Drawing on expertise and experience from the SHE programme
• Adapted to local needs
The SHE unit:materials and the SHE unit box
THE SHE UNIT BOXProvided to all SHE units
PEER SUPPORT TOOLKIT
THE SHE BOOK
HOW TO SET UP A SHE UNIT
MEDICAL TOOLKIT
Available in English on www.shetoshe.org
Available in English on www.physz.com
Please contact your local BMS country medical department for a copy of the SHE unit box
Key elements of the SHE programme
SHE medical education
SHE peer support
SHE units
The SHE network
Scientific programme Community programme
Developing the SHE network
NATIONAL SHE FACULTY
ADAPTED SHE UNITS ACROSS THE COUNTRYHealthcare providers and peer support workers
EUROPEAN SHE FACULTY
Local advisory
board
Train the trainers
Community workshops
Hospital-based
meetings
Medical workshops
SHE unit meetingsSHE at local congresses
Media and on-line communications
Hea
lthca
re p
rovi
ders
Peer support w
orkers
Expanding the SHE network:an integrated approach
Peersupport
Medicaleducation
SHE units andthe SHE network
THE SHE FACULTY
THE SHE UNIT
Meetings Materials
THE SHE NETWORK
Evaluation Feedback
www.SHEtoSHE.org
www.physz.com
Latest SHE milestones
400 visitors
200 individuals wanted to receive more information about the SHE programme
50 new members of the SHE lab in Physz
EACS scientific committee interested in the SHE programme
Very positive feedback!
English version launched in October
By April 2012, there have been more than 15,000 visitors
Local SHE portals (France, Germany, Italy, Poland, Portugal and Spain) will launch in early 2012
Very positive feedback!
140 attendees
Development of the SHE unit model
Very interactive workshops
SHE units model very well received
Very positive feedback – 75% of delegates felt the educational content was ‘excellent’ or ‘very good’
– 92% felt the medical toolkit will be useful for clinical practice
Presented at a plenary session
Presentation included the development of the SHE programme, including its key elements and current activities
Well received, especially from American and Canadian delegates!
Oct 2011SHE booth at EACS
Oct 2011Launch of the “SHEtoSHE”
website
Jan 2012Presentation of the SHE
abstract
Nov 2011Second SHE meeting
• Oral presentation of SHE at the 2nd IWHW 2012• Summary of the SHE programme• Report of activities so far
• Planned: submission of SHE abstract to IAS 2012 – value of the peer support model
• Planned: submission of SHE abstract to HIV11 (2012) – the SHE unit model
• Planned: submissions to national congresses
Communicating the SHE programme
SHE supplement in development
SHE abstracts and presentations
• Summaries of research into the five SHE topics
• Discussion of SHE data gap prioritisation from the Lisbon and Madrid SHE meetings
SHE programme communications plan for 2012
2012JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
• Four levels of communication planned:• Short SHE programme newsletter for European faculty (scientific & community)
every quarter• Comprehensive SHE report for all SHE network members every 6 months• SHE scientific update slide set after major congresses (approx. every 4 months)• SHE European faculty updates by email/TC/WebEx as required
SHE faculty updates as required
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The SHE community faculty in 2012
Community programme co-ChairsCelia Miralles (Spain)
Annette Piecha (Germany)
Helene Freundlich (France)Karine Lacombe (France)Annette Haberl (Germany)
Margherita Errico (Italy)Antonella d’Arminio Monforte (Italy)
Isabel Nunes (Portugal) TBC
Magdalena Ankiersztejn-Bartczak (Poland)
María José Fuster Ruiz de Apodaca (Spain)
Silvia Petretti (UK)Jane Anderson (UK)
2 Pan-European nursing and policy members Nicky Perry and Peggy Maguire
Consulting groups/consultantsJuliet Bennett / Robert Fieldhouse / Thandi Haruperi / Alice
Welbourn / Brian West
The SHE scientific faculty
Scientific programme co-ChairsAnnette Haberl (Germany)
Margaret Johnson (UK)
Larissa Afonina (Russia)Jane Anderson (UK)
Teresa Branco (Portugal)Stephanie Dominguez (France)María Jesús Pérez Elías (Spain)
Leo Flamholc (Sweden)María José Galindo (Spain)Thandi Haruperi (pan-EU)
Phillip Hay (UK)Christine Katlama (France)Karine Lacombe (France)
Anne-Mette Kjaer Lebech (Denmark)Mariana Mardarescu (Romania)
Celia Miralles (Spain)Antonella D'Arminio Monforte (Italy)
Cristina Mussini (Italy)Anita Olczak (Poland)
Ophelia Orum-Haanyama (Sweden)Anke Reitter (Germany)Katja Römer (Germany)
Lorraine Sherr (UK)
The SHE community faculty in 2011
Community programme co-ChairsJane Anderson (UK)Silvia Petretti (UK)
Magdalena Ankiersztejn-Bartczak(Poland)
Juliet Bennett (UK)Stefania Doglioli (Italy)Robert Fieldhouse (UK)
Hélène Freundlich (France)María José Fuster Ruiz de Apodaca
(Spain)Annette Haberl (Germany)
Thandi Haruperi (pan-EU)Karine Lacombe (France)Peggy Maguire (pan-EU)
Celia Miralles (Spain)Antonella D'Arminio Monforte (Italy)
Nicky Perry (UK)Annette Piecha (Germany)Alice Welbourn (pan-EU)
Brian West (UK)
