Introduction
the importance of linking SrH
and Hiv and aidS is now widely
recognised. the majority of Hiv
infections are sexually transmitted
or are associated with pregnancy,
childbirth and breast-feeding.
the risk of Hiv transmission and
acquisition can be further increased
due to the presence of certain Stis.
in addition, sexual and reproductive
ill-health and Hiv share root
causes, including poverty, limited
access to appropriate information,
gender inequality, cultural norms
and social marginalisation of the
most vulnerable populations. the
international community agrees
that the Millennium development
goals will not be achieved
without ensuring access to SrH
services and an effective global
response to the Hiv epidemic.
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linkages between core Hiv services
(prevention, treatment, care and
support) and core SrH services
(fp, MnH, the prevention and
management of Stis, rtis, promotion
of sexual health, prevention and
management of gender-based
violence, prevention of unsafe
abortion and management of
post-abortion care) in national
programmes are thought to generate
important public health benefits. in
addition, perspectives on linkages
need to be broad-based addressing
not only the health sector and the
direct impact on health, but also the
structural and social determinants
affecting both Hiv and SrH.
there is international consensus
around the need for effective linkages
between responses to Hiv and SrH
including recommendations for
specific actions at the levels of policy,
systems, and services. these include:
·
glion call to action on family
planning and Hiv/aidS in Women
and children (May 2004)
·
new York call to commitment:
linking Hiv/aidS and Sexual and
reproductive Health (June 2004)
·
unaidS policy position
paper `intensifying Hiv
prevention' (June 2005)
·
World Summit outcome
(September 2005)
·
call to action: towards an
Hiv-free and aidS-free
generation (december 2005)
·
ungaSS political declaration
on Hiv/aidS (June 2006)
·
consensus Statement:
achieving universal access to
comprehensive prevention of
Mother-to-child transmission
Services (november 2007)
Benefits
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Much remains unknown about
which linkages will have the
greatest impact, and how best
to strengthen selected linkages
in different programme settings.
However, stronger bi-directional
linkages between SrH and Hiv-
related programmes could lead
to a number of important public
health, socioeconomic and
individual benefits, such as:
·
improved access to and uptake
of key Hiv and SrH services
·
better access of plHiv to SrH
services tailored to their needs
·
reduction in Hiv-related
stigma and discrimination
·
improved coverage of underserved/
vulnerable/key populations
·
greater support for dual protection
·
improved quality of care
·
decreased duplication of
efforts and competition
for scarce resources
·
better understanding and
protection of individuals' rights
·
mutually reinforcing
complementarities in legal
and policy frameworks
·
enhanced programme
effectiveness and efficiency and,
·
better utilization of scarce
human resources for health.
Rapid Assessment Tool for Sexual & Reproductive
Health and HIV Linkages: A Generic Guide