At a recent briefing by the folks at the Office of the Global AIDS Coordinator, Ambassador Jimmy Kolker asked about whether any PEPFAR funded programs were going to focus on providing the HPV vaccine to adolescents, given that this would also build capacity for rolling out other vaccines in the future. Kolker's response was a bit of an admonition to remember that this is the President's Emergency Plan for AIDS Relief (emphasis on AIDS). He said that OGAC is interested in integrating HIV/AIDS services into reproductive health services, but they won't be working to integrate reproductive health services into HIV/AIDS services. Hmmm.
Stronger integration – both ways – of reproductive health and HIV prevention service is a logical step to meet the US government goal of preventing 7 million infections. More problems are being created than solved when funding for reproductive health programs is being reduced even if HIV/AIDS prevention funding is growing. More infections will occur if the health services that people use are not providing them information and services to protect against HIV. As people are thankfully living longer with HIV, they need services to ensure that they are safely sexually active.
HIV is primarily a sexually transmitted disease. And STD prevention is HIV prevention. There is plenty of biological evidence that the presence of other STDs increases the likelihood of both transmitting and acquiring HIV. Even if OGAC doesn't think that PEPFAR money should be spent on sexual and reproductive health services, it would have been constructive to respond to the question that they will continue to look for ways to strengthen and partner with other sources of reproductive health services. But probably the question couldn't be answered in that way because they are not yet programming with these basic linkages in mind.