Instinctively, the link between HIV and Sexual and Reproductive Health Services appears obvious; the most common route of HIV transmission is through sexual contact and the leading cause of death among women of a reproductive age remains AIDS. But sexual and reproductive health services are not always ‘HIV sensitive’ and high level political commitments fail to address the structural causes which contribute to limited effectiveness when it comes to translating policy into practice. Gender inequality is a prominent societal barrier regarding access to HIV treatment because it deprives women of their rights to information and freedom of choice, reflecting the disempowerment of women in many communities. By limiting the decision making capacities of women and girls, it increases the chances of women being involved in abusive relationships which, in turn, increases their vulnerability in contracting HIV.
Marginalised groups such as men who have sex with men and drug takers are increasingly vulnerable to the risk of HIV infection and failing to combat the discrimination these group face, heightens the stigma surrounding the disease. Integrating HIV testing into family planning services can reach a larger proportion of individuals who may be unaware of their status. Considering over half of all infections go unreported, it is of urgent importance that testing levels improve.
A larger presence of family planning services has the potential to improve the care of HIV positive clients but centres must be embedded in the wider context of human rights with appropriately trained health workers. This includes recognition of human rights legislation and also the upholding of the principles of confidentiality which are central to rights of bodily integrity. Coerced sterilisations and the use of ARTs as contraceptives are still a prevalent form of practice in many clinics and this ignorance regarding the rights of the mother further drives underground the importance of recognising reproductive rights as human rights. Alongside the community ownership of interventions, the promises of international donors cannot also be allowed to be broken because gaps in international funding starve local programmes of funding which has a devastating effect on the care of HIV positive individuals.