A framework for comprehensive approaches to sexual and reproductive health and rights, including HIV/AIDS
S. Sippel, M.B. Hastings, K. Whipkey
Center for Health and Gender Equity (CHANGE), Washington, United States
Issues: The importance of comprehensive sexual and reproductive health and rights (SRHR), which includes HIV/AIDS, has been reaffirmed by the international community, from the International Conference on Population and Development to the Millennium Development Goals. However, a user-based framework for comprehensive SRHR that is not a mere listing of services has not been fully explored.
Description: Researchers studied the benefits of and challenges to comprehensive, rights-based SRH care in the Dominican Republic, Botswana, and Ethiopia. Researchers paid particular attention to the SRH needs of women living with HIV. Based upon field interviews and literature consultations, CHANGE developed a framework for achieving comprehensive SRHR that examines the combination of services, programs, referral systems, and set of rights protections that people need to achieve optimum sexual and reproductive health.
Lessons learned: CHANGE's framework for achieving comprehensive SRHR incorporates three essential components: family planning; sexual health, including HIV/AIDS; and maternal health. Services should be promoted within programs that are user-centered and participatory; provide services free from judgment and stigma, especially for PLWHA; promote informed choice about all available prevention, treatment, and care methods; avoid coercion; ensure equal access regardless of age, race, class, gender, sexuality, HIV status, profession; offer high-quality care; and integrate care in one location or through seamless referral. This framework also assumes a life-cycle approach where providers understand and accept that the same individual who seeks family planning at one moment in life may seek maternal care or HIV testing at another moment.
Next steps: This framework has been distributed via CHANGE's report “Investing in Reproductive Justice for All: Toward a U.S. Foreign Policy on Comprehensive Sexual and Reproductive Health and Rights.” Researchers, however, are soliciting feedback on the framework from international stakeholders and will use this information to present recommendations to the Obama Administration for its Global Health Initiative.
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