In early August, the International Planned Parenthood Federation (IPPF) published a five-year research project looking into the cost, quality, health benefits and stigma reduction of integrating HIV programs and sexual and reproductive health service programs in Kenya, Malawi, and Swaziland. Named The Integra Initiative, the study, supported by the Bill and Melinda Gates Foundation, and carried out in partnership with the London School of Hygiene and Tropical Medicine and the Population Council, provides “evidence to support the integration of HIV counseling and testing into mainstream family planning and maternal health services.”
Researchers found that integration can improve service delivery and increase the number of people receiving HIV counselling and testing. For clients, integrated services save them time and money, allow them to develop trusting relationships with their providers, and give them the opportunity to meet other clients living with HIV. IPPF’s Director General, Tewodros Melesse, said, “We know that there is a clear and obvious link between sexual and reproductive health and HIV so providing [sexual, reproductive,] and HIV services in the same place and at the same time makes good sense.” While the results are promising, more investment in research is needed.
These results are in line with a key goal of the US President’s Emergency Plan for AIDS Relief (PEPFAR) to expand service integration–although the program is not currently meeting this goal. In Ms. Magazine’s Summer 2013 issue, Jeanne Clark writes in “Unholy Alliance” about how PEPFAR-funded abstinence-only programs and conservative religious organizations affect prevention efforts.
Clark writes, “Even though current PEPFAR guidance has shifted to support comprehensive reproductive and sexual-health programs, the abstinence programs still have a lingering effect, leading some providers to de-emphasize condom education and other comprehensive prevention strategies. On Dec. 1, 2009, PEPFAR released its five-year strategy, which indicated that a key goal is to expand integration of HIV prevention, care, support and treatment services with family planning and other reproductive-health services. Yet the Fiscal Year 2013 Country Operational Plan Guidance states in no uncertain terms that ‘PEPFAR funds may not be used to purchase family-planning commodities.’ That means that women cannot get contraceptives at the same site where they receive HIV/AIDS testing, counseling, treatment and care.”