by Jay Gribble, vice president, International Programs
Given the sustained attention to the HIV/AIDS pandemic, one could wonder why it is necessary for family planning to share the stage at ICFP 2011 with the issues of HIV/AIDS. Yet given how family planning, reproductive health, and HIV/AIDS are intrinsically linked, the ICFP 2011 is taking advantage of the opportunity to talk about the need for comprehensive sexual and reproductive health—a topic that is broader than the more focused issue of family planning. And given the recent research finding that use of injectable contraception may increase the risk of HIV infection, the relationship between these two issues has received increased attention. So it is both appropriate and responsible to turn attention to the links between FP and HIV. And as the Honorable Stephen O’Brien observed, the commonalities between efforts to address women’s and men’s FP/RH and HIV needs further reinforce the importance of considering these two issues jointly :
- Both require a comprehensive approach that responds to the need for high-quality information, services, and supplies that allow women and men to make informed choices about their sexual and reproductive lives.
- There is a need to expand integrated services so that people can address their needs for sexual and reproductive health needs together with those related to HIV/AIDS prevention and treatment.
- Programs that respond to the reproductive health and HIV need to be tailored to the needs of vulnerable populations—youth, sex workers, the poor, men, men who have sex with men—among others.
Given the inherent relationship between HIV and reproductive health, it is critical that these two program areas work together. And efforts are advancing to that end. Attempts to integrate services are expanding. In Senegal, host country of ICFP 2011, the Director of the Reproductive Health program within the Ministry of Health has talked about their beginning to offer HIV testing through family planning services, as well as family planning counseling and services to people seeking HIV services. Similar efforts have existed for many years and are slowly but surely getting traction. It is encouraging to hear that more and more Ministries of Health are recognizing the need to offer comprehensive services that address the real, complex needs of people.
In addition to providing services together, there are ongoing research efforts to develop new products –multipurpose preventive strategies (MPTs)—that help women avoid pregnancy, HIV, and other sexually transmitted infections, including HPV and HSV-2 (herpes). Some of the emerging technologies provide long-acting prevention through intravaginal rings that can be inserted and left in place for a defined amount of time. Other approaches can be used on demand and have effectiveness for up to 24 hours after intercourse: the new SILCS diaphragm (one size fits most women) used together with a Tenafevir gel (non-hormonal-based approach); and another topical gel (used without a barrier method) that prevents pregnancy, HIV, and HSV-2.
The ongoing attempt to integrate family planning and HIV/AIDS services—and prevention products—provides important reasons to be optimistic about helping women and men live healthy lives. Given the high levels of unmet need for family planning and the ongoing threat of HIV/AIDS that face men and women—especially young women—give us important reasons to redouble effort to support policies and programs that allow people to get the services they need in a comprehensive, integrated way that responds to their particular needs. Integrated FP/RH and HIV services are possible, as PRB outlined in its 2009 policy brief, they can ultimately save scarce resources and better serve people’s needs. World AIDS Day at IFPC 2011—progress is possible!