Time for action on sexual health and HIV integration

Copper Rose Zambia, one of the largest youth-led and youth-focused organisations in Zambia, has released a roadmap to help advocates and others take action so that everyone can access sexual and reproductive health (SRH) services. 

What is the report about? 

How advocates, civil society organisations, healthcare providers, policymakers and funders can integrate SRH services with services for related issues, like HIV, maternal and child health and gender equality. 

To guide this work, Copper Rose Zambia, a member of the Coalition to Accelerate and Support Prevention Research, has worked with AVAC and partners to produce the Sexual and Reproductive Health Integration Advocacy Roadmap. It is based on current evidence, stakeholder interviews, focus group discussions and a workshop held at the 2023 International Conference on AIDS and STIs in Africa. 

Why is this report important? 

UNAIDS’ current strategy highlights the importance of combining HIV and SRH services. The two issues are closely linked. So combining SRH services with HIV services (and services for other related issues) can be more convenient and effective for people, and more cost-effective for providers. 

The new roadmap aims to reignite action on SRH integration. Health practitioners and educators can use it to understand how to deliver high-quality, integrated SRH services. Advocates can use it to develop strategies to show decision makers why integration makes sense. 

What does it say? 

Advocacy is needed to drive political will, mobilise resources and ensure accountability for SRH integration. Campaigns and other activities should put the people most affected by a lack of SRH services, such as young people, at the centre. One young woman from Uganda, who contributed to the roadmap, said: “As young people …we are not part of the table as contributors but on the menu. If integration is going to be effective we need to do away with ageism in programme design.’’  

The roadmap outlines how four areas can help to achieve SRH integration. These areas are communities, services, systems (such as funders, international and regional organisations and the private sector) and policy.  

1. Communities   

Harmful social, religious and cultural views and beliefs are hindering SRH integration. Local communities are key to overcoming this. Grassroots advocacy to demand integrated SRH services is essential.  

The roadmap outlines actions to take in relation to local communities. These include: 

• Advocating for SRH education that is accessible, culturally sensitive and age-appropriate. This should address the views and beliefs that prevent SRH integration. 

• Advocating for SRH to be included in existing community programmes and schools so that people, including young people, have accurate SRH information. 

• Establishing SRH committees that bring together community members, leaders and local organisations to promote SRH integration.  

2. Services 

There is a need for stigma-free, quality, integrated SRH services. Priority actions for services include: 

• Analysing laws and regulations that affect which SRH services are available to which people, then advocating for barriers to be removed. For instance, is there age of consent in relation to SRH services?  

• Assessing how SRH services are currently delivered to identify strengths and weaknesses and what is stopping different groups from accessing services.  

• Working with decision makers to develop or update SRH integration guidelines, and developing a strategy to deliver integrated SRH services. This strategy could define the key services to include and the most effective ways to provide them to different groups, for example.  

• Strengthening healthcare providers’ capacity to provide SRH services. Actions around this include advocating for, and developing, SRH training programmes that meet the needs of different groups, mentoring and assisting healthcare providers to deliver stigma-free SRH services, and monitoring service quality. 

To see systems and policy recommendations, read the full roadmap. 

What does this mean for HIV services? 

Integrating SRH services means getting many different stakeholders together. This includes the people most in need of SRH services, local community members and leaders, civil society organisations, healthcare providers, policymakers and donors. Mapping out the key players, their roles and how they could work together is an essential first step. 

In the roadmap, its authors conclude: “By working together, mapping the landscape, aligning processes and programmes and advocating for change, we can make significant strides in integrating SRH and realising the vision of universal access to sexual and reproductive health for all. The time for action is now. Let’s get to work.” 

For more on integrating HIV and SRH services, visit our best practice section.