HIV/AIDS and Sexual and Reproductive Health, Finding Common Ground: Risk or Reality?

Wednesday 16 August

Background:

The need for integrating HIV/AIDS with sexual and reproductive health (SRH) services is increasingly gaining momentum – at both a policy and programme level. This is based on the fact that nearly 75–80% of HIV transmission in Africa and most parts of the world is through sexual intercourse, while an additional 10% is through mother-to-child transmission – all areas dealt with in sexual and reproductive health. Secondly, in countries with generalised epidemics, groups most infected or affected with HIV/AIDS are the same as those carrying most of the burden of SRH: young people and women of reproductive age. Many are current or potential clients for SRH as well as HIV/AIDS services, presenting under-utilised opportunities for integrated services. Provision of vertical HIV/AIDS and SRH services to such groups is very costly and time consuming, since they have to seek different services from a variety of service providers. In resource-poor settings with few trained personnel, vertical services also mean that staff leave one programme or services setting and join the other; weakening the health care delivery system as a whole.

Global declarations and statements of commitment towards integrating HIV/AIDS with SRH (and vice versa) such as the ICPD (1994); the Glion Call to Action and New York Call to Commitment are positive developments. However, this call to integrate HIV/AIDS with SRH has not been effectively translated into appropriate policies, programmes and services at national and local health care delivery levels to the benefit of the client. Integration efforts have, of late, been largely spearheaded by the SRH community, but it is imperative that the HIV community also embraces the ethos and spirit of integration. Many factors could be responsible for this separation at policy and institutional level (including funding mechanisms and national strategies) and at a programme and service delivery level (including infrastructure, programme and services delivery models, skills, etc.). There are also many research questions regarding integration that remain unanswered including: cost effectiveness, impact on services, and stigma reduction.

The aim of ‘Finding Common Ground: Risk or Reality?’ aims is to explore the synergies between the HIV and SRH communities to better understand current models being used and to explore the gaps and challenges of integration at policy, programmes & services delivery and research levels. The ‘reality’ of integration is that in predominantly generalised epidemics the traditional clients in need of SRH and HIV services are similar; but the ‘risk’ of integration is that both the cost and attitude of service providers may prove to be an insurmountable hurdle.

Workshop Objectives:

  • To share experiences of bi- directional integration of HIV/AIDS and SRH (and vice versa)
  • To identify challenges to integration at policy, programmes, services delivery and research levels
  • To identify broad strategic responses in addressing the integration of HIV/AIDS and SRH.
Expected output:

A short ‘process report’ highlighting the following:

  1. Current models for integrating HIV/AIDS and SRH
  2. Barriers to effective integration of HIV/AIDS and SRH at policy, programmes and services delivery levels
  3. Areas for research on integration of HIV/AIDS and SRH
  4. Recommendations for action at policy, programmes, service delivery and in research.
Session Methodology/format: The workshop is planned as a controversy and common ground session to bring practical experiences from the field on integrating HIV/AIDS and SRH. The session will bring representatives of the UN and government together with CSOs and PLWAS. Experts from the HIV community will come together with SRH experts to confront the issue of integration, identify gaps and map out a common direction. The session is broken into three parts, moderated by the Session Chair, who will also summarise key issues and recommendations.

Session Chair: World Health Organization (Dr Izabelle de Soyza)

Part I: will begin with three presentations, each lasting 10 minutes. The focus of the presentations will be on finding common ground and points of divergence for integrating HIV/AIDS with SRH.

Presenters:

  • Fertility Desires of People Living with HIV (Ms. Dorothy Odhiambo – Network of African People Living with HIV/AIDS – NAP+)
  • Integrating HIV/AIDS into Sexual and Reproductive Health Programmes & Services (Dr. Nono Simelela – International Planned Parenthood Federation, IPPF)
  • Integrating Sexual and Reproductive Health into HIV/AIDS (Javier Hourcade – International HIV/AIDS Alliance)

Part II: This will be three focused discussions of the papers presented to analyse the implications of integration at policy, programmes and services delivery levels and for research. Each will last 10 minutes.

Discussants:

  • Structural and Policy (including funding & funding mechanisms) implications for integration of HIV/AIDS with SRH (UNFPA): Dr Lynn Collins
  • Research implication for integration (Dr. Naomi Rutenberg - Population Council)

Part III: This will be open discussion and comments from the floor, lasting 25 - 30 minutes.

Target Audience: The meeting will specifically be of interest to government officials from HIV/AIDS Control Programmes and SRH Divisions; as well as other policy makers, programme managers and implementers, researchers, PLWAs and the general conference participants.