Linking Sexual and Reproductive Health and HIV Services

Linking sexual and reproductive health and HIV is of critical importance. Worldwide, more than 80 per cent of HIV infections are sexually transmitted. In addition, poor sexual and reproductive health and HIV are fueled by similar causes, including poverty, limited access to services, a lack of correct information, gender inequality and social marginalization.

On 8 June, during a side event at this week’s United Nations High Level Meeting on AIDS in New York, participants explored the question of how to better integrate HIV and sexual and reproductive health interventions. The event was sponsored by UNFPA, the Joint UN Programme on HIV/AIDS (UNAIDS), the UN Educational, Scientific and Cultural Organization (UNESCO), the World Health Organization (WHO), and the International Planned Parenthood Federation (IPPF).

The highly interactive session looked at the issue through the prism of five key thematic areas: cost-effectiveness and cost savings of linkages; prevention of mother to child transmission though a sexual and reproductive health platform; comprehensive sexuality education for young people; gender based violence; and human rights of people living with HIV.

In opening remarks, Dr. Babatunde Osotimehin, UNFPA Executive Director, explained how the integration of sexual and reproductive health and HIV services makes ‘people-sense’. These services include testing for HIV and other sexually transmitted infections (STIs), prevention of mother-to-child transmission, support for fertility decisions, and increased access to condoms, contraception and correct information.  He went on to emphasize wider policy and human rights implications.

“Linking sexual and reproductive health and HIV goes beyond integrating health services,” he said. “It demands from us that we fortify the human rights platform – ending stigma, violence and discrimination.”

Human rights and the right to health are at the core of integrated services. A broader human rights agenda can also be promoted that goes beyond service delivery and tackles legal reforms, such as those relating to the right to information and freedom from violence, abuse and coercion.

The participants shared ideas and experiences of how those working in the fields of HIV and sexual and reproductive health have combined their efforts to make interventions more effective in creative and innovative ways, including strategies to strengthen treatment as a prevention option.

Mother- and child-centred care can improve both sexual and reproductive health and HIV outcomes. For many women, pregnancy is the first point of access to the health system and they can benefit from a range of interventions, including HIV prevention and treatment integrated into routine maternal health care; family planning; prevention and treatment of sexually transmitted infections; and information and support on gender-based violence.

The discussion also showed that when comprehensive sexuality education is effectively implemented on a national scale, there is potential for averting HIV infections, other STIs and unintended pregnancies. 

Participants examined how men can benefit from greater integration. For instance, in countries where voluntary male circumcision is being implemented for HIV prevention, the number of men accessing other sexual and reproductive health services, such as prevention of mother-to-child transmission and treatment of STIs, has increased.

The meeting closed with agreement that linking sexual and reproductive health and the HIV response, especially in a climate of austerity, is a gateway to strengthening the human rights agenda and health systems.