Tools and Curricula

Strategic Considerations for Strengthening the Linkages between Family Planning and HIV/AIDS Policies, Programs, and Services

World Health Organization, U.S. Agency for International Development, and Family Health International (2009).

This document is designed to help program planners, implementers, and managers, including government officials and other country-level stakeholders, make appropriate decisions about whether to pursue the integration of family planning and HIV services. It also explains how to approach integration in a strategic and systematic manner to achieve maximum public health benefit. Links to resources that support implementation, such as facility assessment tools, training curricula, and job aids, are provided.

A Practical Guide to Integrating Reproductive Health and HIV/AIDS into Grant Proposals to the Global Fund

Hardee, K., Gay, J., and Dunn-Georgiou, E. (2009).

This document was developed to help countries and organizations integrate reproductive health, including family planning and HIV, in proposals submitted to the Global Fund for AIDS, Tuberculosis and Malaria. Grounded in the research, programmatic, and policy literature on linkages and integration, this document asks and answers the following questions: 1) What is integration? 2) Given a country's context, what policies and programs could be linked and integrated? 3) What are the integration implementation challenges to be aware of when writing a proposal? and 4) How can integration be monitored and evaluated? In addition to providing evidence that integration improves HIV and AIDS outcomes, it provides examples from country programs and the integration components of successful Round 8 proposals.

Making the Case for Interventions Linking Sexual and Reproductive Health and HIV in Proposals to the Global Fund to Fight AIDS, Tuberculosis and Malaria

World Health Organization (2010).

This report offers a rationale for seven HIV program interventions that can make good programs better through a holistic approach to HIV. Among these interventions is "PMTCT-Plus," which includes integrating family planning into services to prevent mother-to-child transmission of HIV.

The Case for Integrating Family Planning and HIV/AIDS Services: Evidence, Policy Support, and Programmatic Experience

FHI 360 (2010).

Eight short policy briefs summarize the state of integration between the family planning and HIV. These briefs highlight developments in the integration of family planning and HIV, including changes in the policy environment, new programmatic examples, and findings from operations research. Some include links to additional key tools and resources.

Technical Issue Brief: Drug Interactions Between Hormonal Contraceptive Methods and Anti-Retroviral Medications Used to Treat HIV

U.S. Agency for International Development, U.S. President's Emergency Plan for AIDS Relief, Department of Health and Human Services, and Centers for Disease Control and Prevention (2014). 

This collaboratively produced brief is aimed at key decision makers working in HIV and AIDS and family planning: national policymakers, U.S. government program managers, and implementing partners, practitioners, researchers and professional societies. It outlines the current state of knowledge about whether specific antiretrovirals (ARVs) interact with specific hormonal contraceptive methods, including any decreases in efficacy, or increased toxicities or side effects. This information is timely, since some ARVs that have raised concern about potential drug interactions are being used more widely. The brief describes the types of hormonal contraceptives, the types of ARVs, and commonly used antiretroviral regimens. It summarizes reasons for uncertainty around potential drug interactions and describes available evidence, including a table specifying what is known about the possible effects of specific ARVs on the efficacy of hormonal contraceptive methods. The brief outlines programmatic implications; identifies areas for further research; and refers readers to several additional resources.  

Technical Brief: Hormonal Contraception and HIV

U.S. Agency for International Development, U.S. President's Emergency Plan for AIDS Relief, Department of Health and Human Services, and Centers for Disease Control and Prevention (USAID and PEPFAR September 2013).

This collaboratively developed brief summarizes current epidemiological evidence on the use of hormonal contraception (HC) and specific issues associated with HIV acquisition and transmission. It addresses several specific questions with respect to the risk of: HIV acquisition by women using HC; HIV transmission from women living with HIV who use HC to male partners; faster disease progression among women living with HIV who use HC; and any drug interactions between HC and antiretroviral therapy for women who are using both drugs. The brief is aimed at several key groups of decision makers working in HIV and AIDS and family planning: national policymakers, U.S. government program managers, and implementing partners. Drawing on available evidence, the brief summarizes both what is known and key unanswered questions and areas where the evidence is lacking or inconclusive. It recommends that national programs consider expanding access to HIV testing and counseling within family planning programs, using recently updated WHO guidelines to update national guidelines, and expanding the contraceptive method mix, including male and female condoms and messaging to reinforce dual method use. The brief also lays out what the evidence means for policymakers and providers serving HIV-negative women, and those serving HIV-positive women. Finally, it includes a list of resources and references. 

Implementation of Global Health Initiative: Consultation Document

Global Health Initiative and U.S. Agency for International Development (2012).

The Obama administration wishes to strengthen global health around the world. This 2012 document outlined goals for HIV and AIDS, malaria, tuberculosis, neglected tropical diseases, maternal and child health, family planning and reproductive health, and nutrition. The new model for the U.S. Government global health assistance program, which dedicated an unprecedented $63 billion over six years, began in 2010. One of its goals is to move from an emergency response to sustainable, country-owned efforts. An emphasis on women- and girls-centered services is a guiding principle. Other principles include increasing impact through strategic coordination and integration; strengthening and leveraging key multilateral organizations, global health partnerships, and private sector engagement; encouraging country ownership and investing in country-led plans; building sustainability through health systems strengthening; improving metrics, monitoring, and evaluation; and promoting research and innovation. 

Family Planning and HIV Services Integration Toolkit

USAID, FHI 360, Johns Hopkins, Marie Stopes International (2015).

This toolkit, provided by K4Health, is aimed at diverse audiences including policymakers, program managers, service providers, and advocates. Through an interactive website, it provides information on the rationale for integrating family planning and HIV services, along with detailed resources for research, policy, training, service delivery, program management, communication and advocacy, and understanding country experiences. The tool compiles and organizes numerous substantive technical resources including specific technical training materials and guidelines, job aids, rapid assessment tools for services and facilities, materials for advocacy and communications, and guides for procurement, logistics, and decision making. A separate section includes considerations and technical issues related to serving young people; and country case studies provide reflections and lessons from program implementation experience. 

Integrating Family Planning into HIV Programs: Evidence-Based Practices

U.S. Agency for International Development, FHI 360, and Preventive Technologies Agreement (2013).

This document summarizes and synthesizes the expanding evidence base for integration of family planning HIV services. It draws from research, program experience, and technical guidance to make recommendations for initiating and scaling up integrated services. It emphasizes practical steps to help program managers, policymakers, and funders advance this integration. The document outlines the compelling rationale for and impact of integrating the two services. Benefits of integration include program efficiency; considerations include helping clients who wish to delay, space, or limit pregnancies; and ensuring healthy pregnancies and deliveries among those who wish to have a child. The document also highlights key factors that may facilitate or hamper program and service integration, and provides a table summarizing different practical levels for providing contraceptive information, counseling, and methods at HIV service delivery points. It also includes an annotated list of key tools and resources to support integrated programming, and a comprehensive list of references. 

Update to CDC’s U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: Revised Recommendations for the Use of Hormonal Contraception Among Women at High Risk for HIV Infection or Infected with HIV

U.S. Centers for Disease Control and Prevention (June 2012).

These revised recommendations by the U.S. Centers for Disease Control and Prevention (CDC) affirm previous guidance stating that there is no definitive link between hormonal contraceptives and an increase of HIV infection among women, and that all women who use contraceptive methods other than condoms should be counseled on condom use and prevention of sexually transmitted infections. This report follows a thorough review by the CDC of recent studies examining this link. The CDC concludes, as does the World Health Organization, that women at of HIV infection or HIV-positive women can continue to use all hormonal contraceptive methods without restriction. This revision does include a clarification for women at high risk for HIV infection who use progestin-only injectables on the inconclusive nature of the evidence on the association between use of injectables and HIV acquisition. It also stresses the importance of condom use and other HIV prevention measures; outlines various contraceptive methods; and recommends the use of a contraceptive method mix.


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