PREVENTING HIV AND UNINTENDED PREGNANCIES ... - UNFPA

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Table 4: Prong 2 Package of Essential ServicesDescription of serviceSTI screening andmanagementGender-based violenceprevention and impactmitigationStigma anddiscriminationeradicationHow it contributes toprevention of unintendedpregnanciesn Preventing and managingSTIs, especially ulcerativeand inflammatory, ones areimportant to protect health,including fertilityn For people living with HIVsome STIs, such as herpes,can be more severe with lowCD4 countsn Syphilis infection in personsliving with HIV can increaseHIV viral load and decreaseCD4 cell counts 65n Maternal syphilisinfection has also beenassociated with increasedrisk of mother-to-childtransmission. 66 In addition,syphilis during pregnancycauses 750,000 neonataland foetal deaths each yearin developing countries.Prevention and controlof syphilis in pregnancyis therefore an importantcomponent of efforts toattain improved MCHoutcomes.n Gender-based violence is apre-eminent human rightsviolationn Women living with HIVmay experience additionalviolence based on HIV-statusn Violence or even fear ofviolence may interfere withaccess to health, social, andlegal services, and exercisingreproductive rights.See Section 9 Key Strategiesand Actions, Strategy 5Key actions*n Screening for and recognition and possiblemanagement of STIs: 25, 30, 31, 47, 71, 72, 76> Conduct syphilis screening at first ANC and otherSRH visit(s), and provide immediate treatment ifpositive to client and sexual partner(s) 25, 31, 71,72, 76> Intensify use of syndromic case management ofSTIs where other methods are not available (e.g.,genital ulcer, vaginal discharge) 72, 76> Provide counselling on STI prevention (includinginformation on recognition of symptoms, when andwhere to access services and relevant transmissioninformation) 22, 25, 31, 47, 52, 66, 72, 76> Screening for cancer of the cervix and of the breast15, 71, 72> Offer treatment for partners of women diagnosedwith a STI. 25, 30, 72, 76n Screening for and management of signs/symptoms ofdomestic violence and sexual assault: 19, 58, 60, 61> Take history and assess risk of violence, includingby intimate partners, and ways to avoid it 19, 58, 60,61> Provide counselling and psychosocial support, aswell as emergency contraception and HIV and STIpost-exposure prophylaxis for women, men andadolescents who have experienced sexual violence19, 58, 60, 61> Refer people who have experienced or areexperiencing violence to appropriate services,including legal and psychological support services19, 60, 61> Provide information on services and organizationsspecializing in gender-based violence. 19, 60, 61See Section 9 Key Strategies and Actions, Strategy 5Text in orange refers to interventions outlined in the package of key effective interventions for family planning for communityand/or facility levels in developing countries (see Table 3). 6733 Preventing HIV and Unintended Pregnancies: Strategic Framework 2011–2015
7Entry points:Service deliverysettingsPreventing HIV and Unintended Pregnancies: Strategic Framework 2011–2015 34
Page 1 and 2: Preventing HIV andunintended pregna
Page 3 and 4: About thisframeworkThis framework s
Page 5 and 6: ContentsAbout this frameworkNote on
Page 7: ExecutivesummaryWe are at a turning
Page 10 and 11: A new era has dawned for helping wo
Page 12 and 13: Contribution of prongs 1 and 2 toel
Page 14 and 15: FrAMEWORK AT A GLANCEsections 10 an
Page 16 and 17: PurposeThe purpose of this framewor
Page 18 and 19: This framework should be used in co
Page 20 and 21: Table 1: (continued)These intervent
Page 22 and 23: Principles relevant for this framew
Page 24 and 25: RationalePrimary prevention of HIV
Page 26 and 27: Antiretroviral treatment contribute
Page 28 and 29: Table 2: Prong 1 Package of Essenti
Page 32 and 33: RationalePreventing unintended preg
Page 34 and 35: In addition to the family planning
Page 40 and 41: Priority health service entry point
Page 42 and 43: Entry points for prong 2There are f
Page 44 and 45: 8Checklists fornational programmeim
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Page 48 and 49: Table 7: Implementation areas for f
Page 50 and 51: Table 7: Implementation areas for f
Page 52 and 53: Checklist for services that support
Page 54 and 55: Table 9: Checklist for services tha
Page 56 and 57: Strategy 1:Link SRH and HIV at thep
Page 58 and 59: Table 10: Bi-directional srh and hi
Page 60 and 61: Strategy 2:Strengthen communityenga
Page 62 and 63: Male partner involvement is critica
Page 64 and 65: Strategy 4:Engage organizationsof p
Page 67 and 68: Key actions to implement the strate
Page 69 and 70: 11OperationalresearchThe need for f
Page 71 and 72: 14. If a mother living with HIV pro
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Page 76 and 77: 100. UNAIDS Expanded Business Case:
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Page 80 and 81: 24. Global Guidance Briefs: HIV Int
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Page 84 and 85: Annex 2 Annotated bibliography ofsu
Page 86 and 87: n Overview of HIV interventions for
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Guidance on testing and counselling
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and vulnerable and marginalized pop
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Involving men in promoting gender e
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Box A: Risk and vulnerabilityHIV in
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Annex 4 Package of essential servic
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People living with HIV have indicat
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15endnotesto annexes1. www.un.org/m
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50. Rapid Assessment Tool for Sexua
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