New Analysis Calls for Increased Integration of Reproductive Health and HIV Prevention Services

Current Efforts Miss Opportunities to Help Contain Global Pandemic

Providers of reproductive health services are in a strategic position to make significant contributions to closing the global HIV prevention gap, according to a new analysis published jointly by The Alan Guttmacher Institute (AGI) and the Joint United Nations Programme on AIDS (UNAIDS) with the collaboration of the UNFPA (United Nations Population Fund) and the International Planned Parenthood Federation (IPPF). "The Role of Reproductive Health Providers in Preventing HIV" calls for greater attention to the benefits that would accrue from integrating HIV-related activities into the reproductive health service set. Reproductive health providers already offer a wide range of services to millions of women who are now at the center of the global HIV pandemic and are increasingly expanding their outreach to adolescents and to men. Yet their current and potential role as front-line providers of HIV prevention services is largely untapped.

Reproductive health providers are a major source of preventive health care and are important entry points for HIV prevention for millions of individuals who are at high risk of contracting the virus, including:

  • reproductive age women--who account for nearly half of adults living with HIV worldwide;
  • young people between 15 and 24--who account for half of all new cases of HIV and more than 13 million unwanted births each year; and
  • expectant and new mothers--who account for 630,000 infants worldwide infected with HIV during their mother’s pregnancy, labor and delivery.

According to Heather Boonstra of AGI, "HIV is largely a sexually transmitted infection, and because reproductive health providers by definition serve people who are sexually active, we miss an opportunity if we don’t help these providers integrate HIV prevention activities into their work."

In addition to their ability to reach out to women, and increasingly to adolescents and men, reproductive health providers have the knowledge and skills upon which stepped-up interventions for HIV prevention could be built. Adequate resources are key to increasing the ability of these providers to offer three key HIV prevention services:

  • HIV counseling and testing and condom promotion in a setting where many women and adolescents, in particular, are already comfortable;
  • prevention, diagnosis and treatment of sexually transmitted infections that would otherwise increase the risk of HIV transmission; and
  • assistance to HIV-positive women for the prevention of unwanted pregnancies, thus reducing the chances of transmission to infants.

The analysis calls for overcoming financial shortfalls and resistance to public acknowledgement of women’s and adolescents’ sexuality in order to help reproductive health providers reach their full potential in closing the gap in HIV prevention through greater integration. It also points out that integration is a two-way street: Especially with increasing numbers of HIV-positive people living longer, integrating reproductive health into HIV treatment services would help these people achieve their sexual and reproductive health goals, and would help contain the spread of HIV infection.

"Integrating HIV and other reproductive health services seems obvious, but is often not recognized at the program and policy level," said Dr. Purnima Mane, UNAIDS Director for Social Mobilization and Information. "Policymakers and program managers need to work together to find ways to deliver these inherently interrelated services more efficiently, more effectively--and in a more coordinated manner--to address the increasing global threat of HIV to women."

This Issues in Brief is available on AGI’s Web site, UNAIDS’s Web site and on UNFPA’s Web site. A version with full citations is also available here.

The Alan Guttmacher Institute--www.guttmacher.org--is a not-for-profit corporation for sexual and reproductive health research, policy analysis and public education, with offices in New York and Washington, D.C.

The Joint United Nations Programme on HIV/AIDS, UNAIDS, is the main advocate for global action on the epidemic. It leads, strengthens and supports an expanded response aimed at preventing transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS, and alleviating the impact of the epidemic.

UNFPA, a UNAIDS cosponsor and the largest global funder of reproductive health and population programs, supports efforts to integrate HIV prevention into reproductive health programming around the world.

IPPF is the world’s largest provider of sexual and reproductive health information and services, reaching more than 24 million people through 40,000 clinical outlets.

Media Contacts:

UNAIDS - Dominique De Santis:
+41 22 791 4509

UNFPA - William A. Ryan:
212-297-5279

IPPF - Claire Hoffman:
+44 207 487 7906

Media Contact