HIV is a sexual and reproductive health issue, both because sexual transmission is the greatest cause of new infections, and because women living with HIV have urgent reproductive health needs, including the need to avoid unwanted pregnancy or prevent HIV transmission to any children they wish to bear. By failing to require strong linkages among maternal health, family planning and HIV interventions, PEPFAR has missed countless opportunities to improve the health and save lives.
 
U.S. global AIDS policy should promote full integration of HIV/AIDS and sexual and reproductive health services. User-based integration of these services is paramount because:

• Integration addresses the needs of women and girls who are at high risk of both HIV infection and unwanted pregnancy.

• Bringing related services together under one roof reduces the burden for those seeking care, greatly increasing the likelihood that they will get the care they need.

• Where co-location of services is impractical, designing seamless referral systems ensures that users find appropriate care with minimal effort and cost.

• Integrating services can reduce costs for governments and donors by avoiding duplication of infrastructure and overhead.

• Thinking about people as whole human beings who have a range of sexual and reproductive health needs just makes sense.

Until recently, despite recommendations from the World Health Organization (WHO), U.S.-funded operational research, and even the Office of the Global AIDS Coordinator (OGAC),  decision makers have not fully recognized the importance of strengthening and linking health services that provide multiple benefits – including sexual and reproductive health services and HIV prevention.

However, the U.S. government is beginning to shift toward an integrated approach. The Obama administration’s Global Health Initiative frames a robust HIV/AIDS response within the larger global health context, promising an approach that integrates HIV/AIDS within sexual and reproductive health. Moreover, on December 1, 2009, Ambassador Goosby released PEPFAR’s 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. Most recently, in September 2011, PEPFAR, in partnership with George W. Bush Institute, Susan G. Komen for the Cure, and UNAIDS, launched the global Pink Ribbon Red Ribbon campaign, an initiative that integrates cervical and breast cancer education, screening, and treatment with HIV services. Evidence indicates that integrating family planning as well is the logical next step, but there is no movement in that direction as of yet.

Anna Inguru, International Community of Women Living With HIV –Global, on integrating HIV and sexual and reproductive health services:

"We need to embrace sexual health, education, rights, and services, especially girls, so they are empowered to know themselves, to know what would happen, and in the eventuality, what services are available, and of course we do need to advocate for provision of services." Read more

Additional resources:

What Does Family Planning Have to do With HIV? Everything. (CHANGE)

The U.S. Global Health Initiative and Sexual and Reproductive Rights: Integration (CHANGE)

Family Planning–Integrated HIV Services: A Framework for Integrating Family Planning and Antiretroviral Therapy Services (USAID)