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HIV and AIDS and poor sexual and reproductive health (SRH) are major causes of morbidity and mortality in the SADC region, impacting on the social, psychological and economic wellbeing of its people.
HIV and SRH responses are closely interlinked and have mutually beneficial impacts on each other’s outcomes. Examples of overlapping responses include, but are not limited to, family planning in the context of EMTCT programmes; ending gender-based violence and child marriage in the context of prevention of HIV among adolescent girls and women; providing HTC within antenatal care; and promoting condoms within family planning programmes, as well as for STI management and treatment, and HIV prevention.
The SADC SRH Strategy already reflects the linkages and overlapping responses between SRH and HIV through the prioritization of HIV and AIDS within its framework. However, the overwhelming impact of HIV and AIDS over the last two decades and the resulting increase in focus on this disease has led to HIV and AIDS becoming a separate, vertical issue which is mainly addressed in isolation from broader SRH policies and programmes. This approach has compromised the effectiveness of both SRH and HIV interventions.
SADC’s position is to address SRH and HIV using a ‘systems theory’ approach which recognizes the interrelatedness, interconnectedness and interdependence between phenomena such as HIV and SRH, where ‘the whole is greater than the sum of its component parts’. This entails delivering comprehensive services for SRH and HIV in an integrated manner which also takes into account related social and economic factors.
In order to ensure effective SRH and HIV integration, an enabling environment which includes supportive legal and policy frameworks and stronger health systems is an essential prerequisite.