...involvement outcome of integration activities can build consensus, ownership, and acceptance of the process.

* Research to provide evidence of the benefits of such integration is needed.

As efforts begin to shift toward integrating family planning into HIV/AIDS services, voluntary counseling and testing (VCT) centers are emerging as primary targets for integration. Research from Africa and the Caribbean shows that such integration is feasible and acceptable, and large-scale integration efforts are being launched and expanded there.

VCT services have become one of the most common means of preventing, detecting, and improving access to care and support for HIV/AIDS. And VCT services are likely to greatly expand with support from the five-year U.S. President's Emergency Plan for AIDS Relief (PEPFAR), which focuses on fighting the HIV/AIDS epidemic in 15 resource-poor countries, mostly in Africa and the Caribbean.

In terms of family planning, VCT centers offer rare opportunity to reach many people with contraceptive needs who may not normally visit a family planning clinic. Women are the primary clients of family planning clinics, but VCT centers attract large numbers of women, men, and couples. At the centers, provision of or referral for contraceptive services can help prevent pregnancies among uninfected women who wish to postpone or space childbirth. And among HIV-infected women or women who may be at risk of infection, pregnancy prevention can ultimately help in the prevention of mother-to-child transmission (PMTCT) of HIV (see article, page 21). For male clients and couples, especially those whose HIV serostatus is discordant, counseling and provision of condoms alone or in combination with other, more effective contraceptives can provide dual protection against unintended pregnancy and HIV transmission.

Implementing change

These potential benefits of integrating family planning services into VCT services are apparent, and international support for such integration is growing. A recent analysis of family planning content in 12 international VCT and PMTCT guidelines produced between 1997 and 2003 found that all but one explicitly address family planning, with the focus on providing information about contraceptives or referring clients to family planning services. (1)

Despite this progress, the idea of such integration is still relatively new, and, generally, implementation is just beginning. The potential for its success is illustrated by the...

NOTE: All illustrations and photos have been removed from this article.



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Averting HIV-infected births: integrating family planning services can..., March 22, 2004
Involving men: impact of integrated services depends on male cooperati..., March 22, 2004
Uganda: integrating family planning into VCT.(Case Studies)(HIV volunt..., March 22, 2004

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