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Key HIV/SRH Materials and Findings

AVAC developed the following resources to advance the use of evidence-based methods for integration in programs and policies.

Key Findings on Policies

  • Policies on age of consent for HIV and SRH services in many high-burden countries are inconsistent and lack clarity, particularly for oral PrEP, and should be aligned to facilitate integrated services.
  • While family planning policies allow tasks to be performed across cadres of providers, that’s not the case in HIV services. Many countries require doctors or ART/PrEP-certified nurses to prescribe PrEP. Policies that permit task-shifting are critical to reduce barriers to integrated service delivery.
  • The Global Gag Rule, a US foreign policy, has constrained the provision of HIV prevention and SRH services globally. Evidence-based policies and stable funding support comprehensive service delivery.

Key Findings on End Users

  • Adolescent girls and young women (AGYW) are more receptive to messaging around pregnancy prevention, making family planning a point-of-entry for conversations on HIV prevention.
  • AGYW tend to attribute side effects to oral PrEP when also using contraception or STI treatment. Approaches such as peer support groups with early PrEP adopters, counseling on continuation, and highlighting similarities with contraceptive side effects have been well-received by new PrEP users.
  • AGYW respond to consistency in health facility staff, rapport, privacy and respect. HIV/SRH integration can increase trust and confidentiality for clients.

Key Findings on Providers

  • Non-clinical staff, i.e. “health systems navigators” and “mentors,” can be responsible for outreach, education, counseling and referrals. This lightens the burden on providers when services are integrated.
  • Integration “champions” can motivate other providers with similar backgrounds (i.e. age, cultural upbringing) to promote all services.
  • Mentorship and peer outreach via SMS/WhatsApp are instrumental to reinforce provider skills and encourage continued learning.

Key Findings on Service Delivery

  • Investing in provider training on values and attitudes promotes empathetic and people-centered care.
  • Synchronizing refills of PrEP and contraception encourages continued use of both products among AGYW clients.
  • Accompanied referral, fast-tracking youth, and youth-friendly centers are low-cost models for integration that fit young people’s needs and lifestyles.

Key Findings on Health Systems

  • Non-traditional settings, outside the clinic, may be preferable to many AGYW seeking health services.
  • Expanding PrEP training to reproductive, maternal, neonatal, and child health (RMNCH) providers and other nurses will help alleviate pressures on over-burdened health systems.
  • Integration of monitoring and evaluation (M&E) tools and registers can enhance planning, accountability, and client monitoring.