PROMOTING INTIGRATION OF HIV/AIDS AND SEXUAL REPRODUCTIVE HEALTH SERVICES

Examples of integration of HIV/AIDS and family planning (FP) Service delivery elements that comprise the minimum essential package of integrated FP/HIV services are in purple in the table below.
Integration of HIV services into FP services		Integration of FP services into HIV services
HIV services that can be integrated into the FP service include: If HIV status is unknown: HIV/STI prevention education including risk-reduction counseling, condom demonstration and promotion, and counseling on dual protection and dual method use* Assessment of HIV status and counseling on the benefits of knowing one's status* Screening for risk of HIV infection * Referrals to counseling and testing (CT) services for clients at risk for HIV infection* HIV counseling and testing (provider- or client-initiated) If HIV+ status is known: Counseling on reproductive choices and contraceptive options for women and couples with HIV* Referrals to HIV care and treatment services* Referrals to care and support programs for people living with HIV* For HIV+ clients desiring pregnancy, referrals to PMTCT services* For HIV+ clients desiring pregnancy, provision of information on the risk of transmission to children and uninfected partners, assessment of health status as it relates to pregnancy, and counseling on safe pregnancy and infant feeding options Couple counseling on risk reduction for sero-concordant and sero-discordant couples Counseling on disclosure strategies for people diagnosed with HIV/AIDS and referrals for their partners for counseling and testing Specific HIV information and services for key populations, such as youth, MSM, sex workers, and infection drug users Psycho-social support for people living with HIV Referrals to other HIV services not offered on-site		FP services that can be integrated into the HIV service include: Screening client for risk of unintended pregnancy* Referrals to FP services for clients at risk of unintended pregnancy. If no reliable FP services exist in the area, the facility and its provider should strive to provide some methods, such as condoms, pills  and injectables, on-site* For HIV+ clients desiring pregnancy, referrals to PMTCT services* Promotion and provision of condom use for dual protection and condom demonstration* Informed choice counseling on the full range of available FP methods and where to access them, including discussion of method effectiveness, side effects, and non-contraceptive benefits; potential drug interactions with hormonal contraceptives if client is on ARVs; capacity of FP methods to prevent STI/HIV infection ; dual method use For HIV+ clients desiring pregnancy, provision of information on the risk of transmission to children and uninfected partners, assessment of health status as it relates to pregnancy, and counseling on safer pregnancy and infant feeding options Counseling on healthy timing and spacing of pregnancy, fertility return, LAM, and exclusive breastfeeding through six months Provision of oral contraceptive pills, injectable hormonal contraceptives, intrauterine device (IUD), and/or hormonal implants with instructions for use, and male and female condoms Provision of method re-supply and follow-up care, as necessary Provision of tubal litigation and vasectomy Referral for methods not offered on-site, preferably through a referral mechanism that guarantees same-day uptake of method

* Minimum essential package

Founded in 1972 by an uneducated Ethiopian farmer, Zumra Nuru, as a better alternative to mainstream Ethiopian society, Awra Amba is a community where gender equality is crucial, where organized religion is banished, and where work and development are of the upmost importance.

The elderly and the young enjoy rights that aren't accorded outside the village. The village is run by way of committees where 50-percent-plus-one vote majorities decide all bylaws and decisions concerning the community.

Down a dirt track from the paved road, about a nine-hour drive northwest of the capital, Addis Ababa, lies Awra Amba - a clutch of wattle and daub houses and shared buildings, including weaving and textile workshops, a grinding mill, a tourist hostel, a school and a library. Most of the village's labor force works communally, so money is ploughed back into the village and the profits are split evenly.

Ethiopian utopian village goes against the grain

This way of doing things has helped lift the village out of poverty and now, some 40 years after its founding, family income, literacy levels, life expectancy, gender equality and economic growth are far exceeding the national average.

Awra Amba on BBC World News