Integrating HIV and Sexual and Reproductive Health Services

"We must take AIDS out of isolation and provide young girls with opportunities to negotiate their sexual relationships and receive sexuality education so that they can protect themselves from infection... If we don't do this, our vision of zero new infections will remain a dream."--UNAIDS Executive Director Michel Sidibé at the 2011 Commission on the Status of Women.

HIV was responsible for approximately 60,000 maternal deaths in 2008, is among the leading causes of death of women of reproductive age, and sexual transmission remains the leading cause of infection. Despite this overlap of HIV/AIDS issues with reproductive rights and maternal health concerns, U.S. global AIDS programs continue to operate largely independently of family planning and other sexual and reproductive health programs.

Integrated sexual and reproductive health services--HIV prevention, treatment, and care; cancer screening and treatment; maternal health care; and family planning services – are essential in the fight against the HIV pandemic. Lack of integration results in critical healthcare gaps that limit the effectiveness of U.S. global AIDS programs and compromise women's health: Women living with HIV may go untreated because their family planning provider does not test for HIV. Others may receive treatment at an HIV clinic, yet face stigma if they seek prenatal care. Girls facing unintended pregnancy may receive prenatal and maternity care, yet no information on contraceptive methods. 

In the last few years, some – including officials at USAID and the Office of the Global AIDS Coordinator (OGAC) – have made an effort to promote integration of HIV/AIDS and reproductive health programs. In September 2011, the President's Emergency Plan for AIDS Relief (PEPFAR), in partnership with George W. Bush Institute, Susan G. Komen for the Cure, and UNAIDS, launched the global Pink Ribbon Red Ribbon campaign, an initiative that integrates cervical and breast cancer education, screening, and treatment with HIV services. Evidence indicates that integrating family planning as well is the logical next step, yet U.S. global AIDS programs continue to operate from a non-integrated starting point, i.e. "Where does it make sense to integrate efforts?" as opposed to "Where does it makes sense to separate?"

Resources:
The U.S. Global Health Initiative and Sexual and Reproductive Rights: Integration (CHANGE)

What Does Family Planning Have to do With HIV? Everything. (CHANGE)

Family Planning–Integrated HIV Services: A Framework for Integrating Family Planning and Antiretroviral Therapy Services (USAID)