In 2019, the results from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Study highlighted that women want and need choices for both contraception and HIV prevention. The study also revealed astoundingly high rates of HIV incidence across participants, elevating a long-standing call for the integration of services for HIV, sexually transmitted infections (STIs) and pregnancy prevention.
A year after ECHO, we are learning more about promising models for integration, where gaps persist in service delivery, and what strategies can address them — but there is still much to be done to fully realize the integration of sexual and reproductive health (SRH), defined here as the integration of HIV care, treatment and prevention; STI treatment and prevention; family planning; and cervical cancer services.
The need for SRH integration is urgent, even as countries grapple with overwhelmed health systems. The global COVID-19 pandemic is exacerbating barriers to critical health services across the board. Without action from stakeholders to maintain momentum, integration will stall and the detrimental impact on women's and girls' health will be irreversible. As an initial response to this crisis, the World Health Organization (WHO) has affirmed that SRH services, including those provided during pregnancy and childbirth, must be a priority for health systems during the acute phase of the COVID-19 pandemic. However, we must all work together to make this a reality — not only now, but into the future.
What does successful HIV/SRH integration require?
We posed this question to experts from around the world. Here are their responses:
What Does Successful Integration Require?
AVAC/FP2020 SRH Integration Overview
Dr. Natasha Salifyanji Kaoma
Copper Rose Zambia
International Treatment Preparedness Coalition (ITPC)
Dr. Rachel Baggaley
World Health Organization
Dr. Nyaradzo Mgodi
University of Zimbabwe College of Health Sciences Clinical Trials Research Centre
Dr. Ann Biddlecom
Center for Health and Gender Equity (CHANGE)
Treatment Advocacy and Literacy Campaign (TALC)
TogetHER for Health
ECHO Global Community Advisory Group
International Community of Women Living with HIV Eastern Africa (ICWEA)
Advocacy for Prevention of HIV and AIDS (APHA)
Kenya Medical Research Institute (KEMRI)