Integrating Family Planning and HIV Services

Overview

Integration improves health outcomes by offering comprehensive sexual and reproductive services to women and couples who are affected by HIV and at risk for unintended pregnancy. Delivering these services separately results in a missed opportunity that may weaken their effectiveness and quality and stall progress toward achieving key health outcomes and safeguarding human rights.

Continue reading to learn about the benefits of integrating family planning and HIV services:

Meets client desires and demand. Integration allows for a one-stop, comprehensive health care service where clients can receive family planning services at the same place where they access HIV services.

Supports clients to achieve their fertility intentions. Integrating family planning services and HIV services can increase access to contraception among clients of HIV services who wish to delay, space, or limit their pregnancies. Integration can also help to ensure a safe and healthy pregnancy and delivery for those who wish to have a child.

Improves HIV prevention. For women living with HIV who do not wish to become pregnant, family planning is an evidence-based, cost-effective strategy for preventing unintended pregnancies and for reducing new pediatric HIV infections.

Protects human rights. By increasing access to care and enabling women and couples to achieve their fertility intentions, high-quality and comprehensive integration of these services protects human rights and fosters gender equality.

Click through the menu below to explore messages, research, and educational resources related to this topic.

  • Countries with the greatest burden of HIV also have high levels of unmet need for family planning. Both are driven by poverty, poor access to health care, gender inequality, and social marginalization of vulnerable populations.
  • Integrating family planning and HIV services can both prevent unintended pregnancies and reduce new HIV infections.
  • Evidence suggests that linking family planning with HIV services is feasible, beneficial, and cost-effective.

Integration: The joining together of different types of health services in order to expand access to care and improve health outcomes.

Linkages: The bi-directional synergies between sexual and reproductive health and HIV in policy, programs, services, and advocacy. Service integration is just one component of this broad human rights-based approach. 

Family Planning and HIV Service Integration: This course will explain the benefits of integrating family planning (FP) into HIV services and provide guidance on how to establish and sustain the delivery of integrated FP/HIV services. 

Additional eLearning courses that address the intersection of family planning and HIV services include the following:

Below is a selection of peer-reviewed articles on contraceptive technology innovations and related topics.

Strengthening the Integration of Family Planning and HIV Services at the Community Level in Kenya (Evidence Project, 2018; PDF, 1.52MB) offers evidence of the feasibility, quality of care, and acceptability of using community health volunteers to integrate family planning into HIV/AIDS services for women living with HIV in Kenya.

Integrating Family Planning into HIV Programs: Evidence-based Practices (FHI 360, 2013; PDF, 485KB) This brief offers practical recommendations for institutionalizing and scaling up integrated family planning and HIV services.

Delivery of Integrated Family Planning and HIV Testing and Counseling Services by Village Health Teams (FHI 360, 2014; PDF, 605KB) This brief shares findings from an evaluation of an innovative integration model pilot tested in Uganda.

AIDS Supplement: Family Planning and HIV (International AIDS Society, 2013) The 2013 AIDS supplement on integrating family planning and HIV services highlights research, programs, and policy regarding how the fields of family planning and HIV are interrelated and shares strategies and best practices for implementation. 

The Role of Family Planning in Achieving Safe Pregnancy for Serodiscordant Couples: Commentary from the United States Government’s Interagency Task Force on Family Planning and HIV Service Integration (Mason, J. et al. Journal of the International AIDS Society, 2017, 20(Suppl 1):21312). People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely.

Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review (Haberlen, S. A., Narasimhan, M., Beres, L. K. and Kennedy, C. E. Studies in Family Planning. 2017). This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Integration efforts, particularly in contexts where contraceptive use is low, must address community-wide and HIV-specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care.

Integration of Family Planning Services into HIV Care Clinics: Results One Year After a Cluster Randomized Controlled Trial in Kenya (Cohen CR, Grossman D, Onono M, Blat C, Newmann SJ, et al. (2017) PLOS ONE 12(3): e0172992). This study sought to determine if integration of family planning (FP) and HIV services led to increased use of more effective contraception and decreased pregnancy rates. Integration of FP services into HIV clinics led to a sustained increase in the use of more effective contraceptives and decrease in pregnancy incidence 24 months following implementation of the integrated service model.

Placing Contraception at the Centre of the HIV Prevention Agenda (Crankshaw TL; Smit JA; Beksinska ME. African Journal of AIDS Research. 2016 Jul; 15(2):157-62.) The authors apply a SRHR lens to HIV prevention by highlighting the critical relationship between unintended pregnancy and HIV, and seek to expand on earlier debates that prevention of HIV and prevention of unintended pregnancy are inextricably linked, complementary activities with interrelated and common goals. They discuss the intersecting pathways between HIV prevention and unintended pregnancy prevention and build a case for contraception to be placed at the center of the HIV prevention agenda.

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