The HIV epidemic is integrally linked to sexual and reproductive health: The majority of HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. Both HIV/AIDS and poor sexual and reproductive health are driven by common root causes, including poverty, gender inequality and social marginalization of key populations. Responses to both health issues should be closely linked and mutually reinforcing.
UNFPA, along with the rest of the international community, strongly advocates for closer linkages between HIV/AIDS interventions and sexual and reproductive health care. This makes sense in terms of public health benefits, economic efficiency and human rights. Integration of services is called for in a major UNAIDS policy position paper. The idea was reaffirmed by the 2011 General Assembly political declaration on HIV/AIDS which called for integration of HIV and with broader health and development efforts, including on sexual and reproductive health.
The Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive has two bold targets: reduce the number of new HIV infections among children by 90%; and reduce the number of AIDS-related maternal deaths by 50%. These targets cannot be achieved without delivering the full range related interventions integrated with SRH, particularly addressing maternal, new-born, and child health, family planning, sexual transmitted infections and gender based violence.
Stronger linkages between sexual and reproductive health and AIDS programmes should lead to a number of important public health benefits:
Improved access to, and uptake of key services
Better access of people living with HIV to services tailored to their needs
Reduced AIDS-related stigma and discrimination
Improved coverage of underserved and marginalized populations, such as injecting drug users, sex workers or men who have sex with men
Greater support for triple protection against unintended pregnancy, HIV, and other sexually transmitted infections for those in need, especially young people
Improved quality of care
Enhanced programme effectiveness and efficiency
Early findings from an EU/SIDA-funded Joint UNFPA/UNAIDS regional project on Linking SRHR and HIV in Southern Africa suggest this integrated approach is resulting in increased uptake of antiretroviral therapy, increased utilization of family planning services, reduced workload and better patient flow, and increased involvement of men in antenatal clinic visits.