SRHR and ending HIV: Can one be achieved without the other?

This article was exclusively written for The European Sting by Ms. Agilandiswari Arumuga Jothi, currently a 3^rd year medical student at the University of Glasgow. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Current interventions to HIV prevention are customarily targeted to people who are singled out as, or self-identified being at risk. Not to mention, people living with HIV have the right to live healthy, satisfying sex lives and the requirement for that healthcare and legal systems must have support for these individuals (1). In the year 1990, some countries had taken up the initiatives as it did in the 1994 International Conference on Population and Development (ICPD) Programme of Action which had burgeoned to provide the awareness of connections amongst sex and reproduction and HIV (2). Strong evidence has depicted that SRHR services in a fair society can aid in the prevention of new HIV infections.

Myriads of development had been implemented from coughing up hundreds to millions of dollars on biomedical interventions to prevent HIV in women which had not been a success in limiting the number of HIV incidences (3). Consequently, in conjunction with the United Nations target, for reaching out to all women and teenage girls with comprehensive HIV prevention services by this year around had the notion to reevaluate existing strategies. However, both sex in this context are highlighted to provide underused linkages with holistic strategies to draw upon  in improving SRHR.

Promising interventions which would include in the reduction of HIVs in women and girls together come from those that stay in school, impede early marriages, steer clear off unwanted pregnancy, and effectively engage males along with nurturing economic independence through sexual education (4). Choice and control are two things that should be instilled into the minds of young women over their SRHR, and hence such plans of action would be manifested in breaking the cycle of deprived gendered relationships and prevent gender based violence among both partners.

Another key element would be empowering the evidence base practices. Peer education, youth centres that focus on abstinence-only education, have been lagging in terms of positive impact made on sexual and reproductive health. In hindsight, promising advancement in innovative multisectoral approaches that incorporate health, education and social intervention can have a positive outcome in changing gender norms and male behavior because getting to convene in providing boys and men with the awareness on issues about sexuality can help shape their role of being a respectful and responsible individual (5,6).

Possibly the greatest challenge is that of the complexity that revolves around HIV which is increasing yearly. Despite the advancements in medicine in Europe and North America however, the HIV-stigma is getting worse, and if we continue to go a blind eye on these issues, we are far from pushing back the epidemic. Evidence based interventions have the capability to halt the rising HIV, and by scaling this up, it would align with the United Nations sustainable development goals. The focal point of SRHR among both genders is to remedy the inequities in research, health care services and education that have positioned them in danger of contracting HIV.

Reference

1. Khosla R, Van Belle N, Temmerman M. Advancing the sexual and reproductive health and human rights of women living with HIV: a review of UN, regional and national human rights norms and standards [Internet]. Journal of the International AIDS Society. International AIDS Society; 2015 [cited 2020Nov22]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672403/
2. Berer M. HIV/AIDS, Sexual and Reproductive Health: Intimately Related. Reproductive Health Matters. 2003;11(22):6–11.
3. Narasimhan M, Askew I, Vermund SH. Advancing sexual and reproductive health and rights of young women at risk of HIV. The Lancet Global Health. 2016;4(10).
4. Gibbs A, Willan S, Misselhorn A, Mangoma J. Combined structural interventions for gender equality and livelihood security: a critical review of the evidence from southern and eastern Africa and the implications for young people. Journal of the International AIDS Society. 2012;15(3(Suppl 1).
5. Petrova D, Garcia-Retamero R. Effective Evidence-Based Programs For Preventing Sexually-Transmitted Infections: A Meta-Analysis. Current HIV Research. 2015;13(5):432–8.
6. Chandra-Mouli V, Lane C, Wong S. What Does Not Work in Adolescent Sexual and Reproductive Health: A Review of Evidence on Interventions Commonly Accepted as Best Practices. Global Health: Science and Practice. 2015;3(3):333–40.

About the author

Agilandiswari Arumuga Jothi is currently a 3^rd year medical student at the University of Glasgow. She completed her Bachelor in Medical Sciences (BMedSc) with a first class Hons in neuropharmacology at the International Medical University (IMU), Malaysia. She is a member of the Asian Medical Student’s Association (AMSA) Scotland. She has a keen interest in Global Surgery and Global health. Currently, she is actively taking part in medical and surgical conferences and working on research articles.