A Prevention Agenda for Women

July 21, 2014

Thirty-plus years into the epidemic, there is extensive evidence that integrating family planning services and HIV prevention and treatment isn’t just a good idea, it is the only effective approach to women’s health. The notion that a woman should choose a family planning method in one clinic, and then go someplace else for a conversation about her HIV risk or status and related needs is unsustainable. And yet, there’s extensive work to be done to create a world where the same clinic or conversation encompasses sexual health, pleasure, family planning decisions, HIV risk and/or treatment—as well as gender-based violence, which is rampant and left out of both family planning and HIV conversations.

This week, in Melbourne, women are continuing to carry forward this work—including raising many of the issues highlighted in this report. These conversations are infused with mourning and urgency after the loss of several champions of an effective response to the epidemic and to women’s needs on the Malaysia air flight that was shot down just before the conference began. You can read women’s voices—including AVAC program director Emily Bass and a call to action on microbicide research from Zena Stein and Ida Susser—in the first issue of Mujeres Adalantes, the newsletter of the Women’s Networking Zone at the conference. And you can hear long-time advocate Lydia Mungherera deliver her impassioned and eloquent plenary in the webcasts section of the IAC official website.

Shortly before the conference in Melbourne began, CHANGE released the report from a meeting, cosponsored with AVAC, on “coordinated global advocacy” on family planning and HIV. This report summarizes the key recommendations related to integration of HIV and family planning services, how to best move forward in the context of uncertainty about whether some hormonal contraceptives (HC) increase HIV risk, and how to advance “method mix”—a wider array of contraceptive choices for women everywhere.

In the year since the meeting, advocates have been working to put many of these recommendations into action. An ad-hoc group of HIV and sexual and reproductive health advocates, led by African women’s groups, continues to push for clarity from the family planning community, normative agencies and researchers on how questions about HC and HIV will be addressed. There’s been a lot of activity, if not a lot of clarity. The proposed ECHO trial which would evaluate the impact of several hormonal contraceptive options on HIV risk scaled back its design from four arms to three after failing to raise the funds for the original design. Coordinated outreach by several members of the ad-hoc coalition to members of the FP2020 Rights and Empowerment Working Group has opened up a channel for discussing these issues with an entity that has an international profile and convening power. We will be watching and waiting to see how these types of conversations unfolds in Melbourne and beyond.