Raising the Scope of Sexual and Reproductive Health Services in Vulnerable Populations

(Michael Prewett, Unsplash)

This article was exclusively written for The European Sting by Ms. Esther Bueno, a sixth-year medical student and Dr. Nediza Zacarías, a recent medical graduate from O&M Medical School (O&MED) in Santo Domingo, Dominican Republic. They are 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 writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

“It’s not the years in your life that count. It’s the life in your years” 

-Abraham Lincoln

Progress towards the elimination of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) relies on the improvement of access and availability of sexual and reproductive health (SRH) services. The potential benefits of linking sexual and reproductive health (SRH) and HIV programs at all levels – ranging from local service delivery to national policy – have been widely recognized as a way to end the HIV/AIDS pandemic. These connections can enhance coverage and uptake of services, reduce HIV-related stigma and discrimination, improve client satisfaction, and increase knowledge and promotion of sexual health education.

Proper testing and counselling through SRH services is the entryway to HIV-related care and prevention. Evidence suggests that the integration of HIV programs within existing SRH services can improve intervention effectiveness and efficiency, and maximize the utilization of scarce resources for health. This plan of action may also improve access to family planning and other key SRH services for people living with HIV, thereby reducing perinatal transmission with a cost-effective strategy for prevention of mother-to-child transmission. These potential strategies and cost savings are particularly meaningful in the context of a global response to HIV that focuses on ensuring long-term sustainability and comprehensive response to the sexual health demands of the population.1

As such, a significant gap has been identified in the delivery of SHR to adolescents and young women, especially within immigrant groups. Research has shown that this highly vulnerable population is more susceptible to sexual violence and other high-risk sexual behaviors, due to the poor sexual education and access to barrier-types contraceptives to prevent HIV transmission and other sexual transmitted infections (STIs). This population relies on family relatives for health information related to sexual education, and these opinions are usually influenced by cultural or religious beliefs, taboos, and sexual coercion.2

Nowadays, after more than 60 years since HIV was first discovered, we can easily say that HIV is a well-controlled disease under the recommended treatment and follow-up. As future health practitioners is important to understand the relevance of SRH in the control of preventable diseases, proper sexual behaviors, and family planning. For this reason, we recommend a public health policy that allocates resources at the primary health care level in order to develop sexual education campaigns targeting vulnerable populations at schools, immigrant shelters, and community centers. Through this call to action, national health systems can target these vulnerable populations and contribute significantly to reducing HIV/AIDS incidence and prevalence in the general population.


1. Hopkins J, Collins L. How linked are national HIV and SRHR strategies? A review of SRHR and HIV strategies in 60 countries. Health Policy Plan. 2017 Nov;32(Suppl 4):iv 57–66.

2. Ivanova O, Rai M, Kemigisha E. A systematic review of sexual and reproductive health knowledge, experiences and access to services among refugee, migrant and displaced girls and young women in Africa. Int J Environ Res Public Health. 2018 Aug;15(8).

About the authors

Esther Bueno is a sixth-year medical student at O&M Medical School (O&MED) in Santo Domingo, Dominican Republic. She is currently an active member and Local Coordinator of the Standing Committee on Public Health (SCOPH) of ODEM-Dominican Republic.

Dr. Nediza Zacarías is a recent medical graduate from O&M Medical School (O&MED) in Santo Domingo, Dominican Republic. She is as an active member of the Standing Committee on Research Exchange (SCORE) and Local Coordinator of Standing Committee on Research Exchange (SCORE) of ODEM-Dominican Republic. She also currently serves as the Vice-president of Internal Affairs of ODEM (IFMSA-DR).

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