Sexual and Reproductive Health Framework - UNFPA

Diego Goldberg/Pixel Press/UNFPAmother-to-child transmission of HIV; and saferdelivery practices, including safe blood transfusionand antiretroviral provision. Antiretroviraltreatment services and SRH services should alsomake cross-referrals, when needed, to ensure accessto SRH services for people living with HIV/AIDS(PLWHA).99. Integrating STI prevention, diagnosis and treatmentis essential to the SRH package. STIs are oftenineffectively diagnosed and treated by healthpractitioners, pharmacists, informal drug sellersand traditional healers. Various attempts havebeen made to reach women by integrating themanagement of STIs into existing maternal andchild health and/or family planning services, withlimited success. Nonetheless, experience showsthat the integration of STI prevention into familyplanning services, especially through counsellingon sexual health and partner relationships, hasincreased service utilization and improved thequality of care. These approaches can be improved toexpand coverage and outreach to sex workers, men,youth and other groups not previously targetedthrough family planning. In addition, presumptivetreatment in high-risk groups and comprehensive,community-based programmes to control STIscould greatly contribute to the reduction of HIVtransmission rates.100. STI-prevention strategies range from promotingcondom usage to delaying the age at firstsexual encounter and reducing the numberof sexual contacts. Other strategies includeperiodic presumptive treatment (targeting atriskpopulations); social marketing of condoms;user-friendly services for adolescents; and maleinvolvement, male motivation and services formen. These strategies need to involve the privatesector and NGOs and to include strong educationaland information components. Barrier methods(male and female condoms) continue to be thebest options to prevent STI transmission for thoseat risk. Ongoing research may identify effectivemicrobicides to be used either on their own or inaddition to condoms and diaphragms.101. Behavior change continues to be a complex issue;given the social-economic and cultural contextin which this behavior takes place. It is at thevery heart of preventing STIs, including HIV.Despite cultural, social, political and religiousbarriers to comprehensive social behaviourchange programmes, multisectoral approachesin various countries have met with success. Fieldresearch demonstrates the need to focus on specificpopulations, consult with them extensively andinvolve them in the design, implementation andevaluation of programme interventions.102. Evidence collected worldwide confirms that qualityeducation, including relevant content and life skillsrelated to SRH, and better understanding of thesocio-cultural determinants that oppose or facilitateSRH, is strongly predictive of better knowledge andawareness, safer behaviour and reduced risk andvulnerability to STIs and the HIV/AIDS epidemic,especially among girls and women. UNFPA will buildon past experiences and comparative advantagesin order to strengthen harmonized programmingand implementation mechanisms, linking SRHand HIV/AIDS/STI issues. UNFPA will advancecoordinated HIV/AIDS responses in both formal andnon-formal education at the country level throughthe partnership strategies and mechanisms in thecontext of United Nations reform and the UNFPAstrategic pan 2008-2011.103. In addition, there is a need to constantly raiseawareness and adapt and adjust national policiesaccording to recent research findings in SRH,e.g., human papilloma virus (HPV) vaccines andinternationally agreed strategies.26MAKING REPRODUCTIVE RIGHTS AND SEXUAL AND REPRODUCTIVE HEALTH A REALITY FOR ALL