HIV/AIDS Treatment and Care : Clinical protocols for the European ...

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HIV/AIDS TREATMENT AND CARE CLINICAL PROTOCOLS FOR THE WHO EUROPEAN REGION
II. Background
Reproductive health (RH) is concerned with the reproductive system and its processes and functions
at every stage of life. The term implies that people should be able to have a satisfying, responsible
and safe sex life, and that they should be able to reproduce and freely decide whether, when
and how often to do so (1).
Reproductive health overlaps but is not synonymous sexual health (2). Sexual health encompasses
positive aspects of sexuality and sexual relationships, as well as problems with power dynamics in
these relationships, including coercion, violence and discrimination. It concerns “the enhancement
of life and personal relations, and not merely counselling and care related to reproduction and sexually
transmitted diseases” (1).
In order to attain and maintain SRH, people must be empowered to exercise control over their sexuality
and reproduction and have access to related health services (2). SRH services are offered by a
variety of providers – from primary care physicians in western Europe to obstetricians, gynaecologists,
urologists, dermatovenerologists and sexologists in eastern Europe – at venues that include
family planning centres, youth-friendly health centres and sexually transmitted infection centres.
Reproductive health care providers should use any opportunity to promote voluntary testing and
counselling for HIV infection and strive to improve access to care for PLHIV. HIV specialists
should be informed of the reproductive rights and choices of PLHIV and refer them to appropriate
RH services for quality assistance.
In Europe, reproductive health services for drug-using women are particularly important. Female
injecting drug users (IDUs) are difficult to reach through the usual RH services and may mistakenly
perceive themselves as infertile because of drug-related amenorrhea.