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Purpose of This Module
What Is Integration?Integration of STI/HIV prevention and care in reproductive health programs and services encompasses a broad range of activities. The term “integration” itself can have various meanings and connotations. Integration can mean the addition of a few new STI/HIV-related activities to family planning services, or it can mean an entire restructuring of services or overall shift in approach to programs and services. It can also involve integrating the issues of reproductive health and STIs/HIV outside of the clinical setting within community educational or outreach programs, media campaigns, or advocacy programs. Services can be integrated at the structural level by, for example, administratively and programmatically combining major public health programs within ministries of health, or they can be integrated at a lower level within the point of service. What constitutes “integrated” and what does not is a matter of interpretation. For example, if an STI clinic is added within the same building as a family planning clinic, some might consider the services integrated. But if the purpose of that clinic is income generation, if the clinic serves different clients than the family planning clinic, and/or if no linkages or internal referral mechanisms exist between the two clinics, perhaps it is not integrated. If the providers in the family planning clinic are not trained to assess risk, recognize signs and symptoms of STIs, and make referrals for diagnosis and treatment, the location of the STI clinic may have no bearing whatsoever upon the service that a family planning client receives. What constitutes “integrated” when it comes to prevention can also be unclear. For example, if a counselor gives a general talk on HIV and STIs in the waiting room of a family planning clinic, that may be considered integrated services. But, if the health care provider does not address HIV and STIs when the client receives services, and HIV/STI risks are not taken into account as part of the process of informed method choice, are those services integrated?
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This
module discusses issues related to integrating HIV-prevention activities
and interventions into reproductive health and other health services.