PRB

(August 2011) Many studies have recommended integrating reproductive health and HIV services because sexually active individuals have overlapping needs: They are at risk of both unintended pregnancies and HIV infection. A 2009 World Health Organization review of the studies on this issue found that integrating family planning and HIV services leads to higher-quality and better-used services and is cost-effective. However, linking the services, whether in one integrated facility or through referrals, faces political as well as programmatic challenges.

Key Facts

• More than 80 percent of new HIV infections are sexually transmitted.¹ 
• More than 200 million women want to delay or stop having children but are not using contraception.² 
• Providing family planning at HIV care treatment centers has been estimated to save almost US$25 for every US$1 spent.³
• In developing countries, an estimated 1.4 million pregnant women are living with HIV, and about half of them receive antiretroviral drugs to prevent transmission of the virus to their babies.⁴ 
• In eastern and southern Africa, where HIV is most prevalent, about half of pregnant women are tested for HIV, and an estimated 68 percent of pregnant women living with HIV receive antiretroviral treatment to prevent transmission of the virus to their babies.⁵

Benefits of Integrating Family Planning and HIV Services

• Clients receive more comprehensive services for overlapping health needs.
• Clients save travel expense and time when they can get multiple services in one location.
• Clients are less likely to experience the stigma associated with freestanding HIV clinics.
• A growing body of research shows that linking services leads to better access to and use of services.
• Health systems can use limited resources more efficiently and improve financial sustainability.
• Women living with HIV can receive services that prevent mother-to-child transmission of HIV and reduce the number of children born with HIV, and they can receive contraceptive services and counseling if they prefer not to become pregnant right away or at all.

Challenges to Integration

• Funding for reproductive health services often comes separately from funding for HIV services.
• Health care workers need training in multiple disciplines.

References

1. UNAIDS, “Sexual Transmission of HIV,” accessed at www.unaids.org/en/strategygoalsby2015/sexualtransmissionofhiv/, on Aug. 1, 2011.
2. Susheela Singh et al., Adding It Up: The Costs and Benefits of Investing in Family Planning and Maternal and Newborn Health (New York: Guttmacher Institute and United Nations Population Fund, 2009).
3. John Stover, Leanne Dougherty, and Margaret Hamilton, Are Cost Savings Incurred by Offering Family Planning at Emergency Plan HIV/AIDS Care and Treatment Facilities? (Washington, DC: The Futures Group/POLICY Project, 2006): 9-10, accessed at www.policyproject.com/pubs/generalreport/FP-HIV%20Integration%20Costs%20and%20Savings%20Final.pdf, on July 25, 2011.
4. WHO, UNAIDS, and UNICEF, Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector – Progress Report 2010 (Geneva: WHO, 2010).
5. WHO, UNAIDS, and UNICEF, Towards Universal Access.