Integration - HIV/AIDS

HIV epidemic, family planning needs are linked, and demand an integrated approach

Originally posted on Science Speaks

With the conclusion of the international London Summit on Family Planning earlier this month, the global health community has shifted its focus to the International AIDS Conference in Washington, D.C.

It is exciting to see tangible global action around these health issues, and each warrants dedicated focus with political and financial commitments. But having these two separate conferences – on two different continents within two weeks of one another – obscures an important reality: family planning and HIV are inextricably linked, especially for HIV-positive women who are pregnant or may become pregnant.

Approximately 17 million women worldwide are currently living with HIV, with more than a million new infections in women of reproductive age each year. And while addressing unmet family planning needs is essential for all women, family planning services are particularly critical for HIV-positive women who want to postpone pregnancy due to HIV-related illness, or want to access medicines and services that will allow them to give birth to an HIV-negative child.

While conferences like the ones being held in London and Washington help marshal political will and focus public attention on family planning and HIV as important global health issues, we must also ask the question: couldn’t we be accomplishing more with an integrated approach?

Many organizations like ours specialize in a particular public health area, but the women we serve have diverse needs. For example, Esnart, a 32-year-old woman in Zambia, must take a day off of work each month to access HIV treatment. She leaves before dawn traveling two hours on two different buses, just to line up to receive her medication. If she needs any other health services, such as family planning, she must join another line.

As she says, “It is not like it is integrated where you access it at the same point…When you’re done with one service, then you move on to another [line]. People get there as early as four in the morning just to queue up.”

integrated clinicThis is just one example on the ground of how women’s health services can be divided, to the detriment of the women who need them. These divisions are often present all the way up to health policy planning and funding decisions. By bridging this artificial divide between HIV and family planning, we have an opportunity to accelerate progress on both fronts by delivering life-saving services together, and learning from each others’ stumbles and successes.

In her speech to the delegates at AIDS 2012 yesterday, Secretary of State Hillary Clinton said, “Women want to protect themselves from HIV and they want access to adequate health care. And we need to answer their call.”

We must not repeat the mistakes of the past by discussing women’s health in a fragmented way. Global health organizations should be committed to ensuring that these issues are discussed and acted upon in a more integrated manner. This means looking for opportunities at all levels to effectively deliver comprehensive care to women and their families, especially those affected by HIV/AIDS.

Although it often occurs outside the public spotlight, the real promise of global meetings like the Family Planning Summit and International AIDS Conference is fulfilled after people leave the conference halls and return to their countries to act on the priorities set forth – one hopes helping women like Esnart access these services more efficiently.

Both the science and the experience of women all over the world show that reproductive health and HIV are interrelated. It is our hope that those leaving London and Washington, D.C. this July can join forces to support the programs, policies, and funding needed to make meaningful progress on both of these issues.

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