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Pathfinder has developed a two-way referral system for infections and serious complications. CHWs send clients to nearby health facilities with a referral note, which helps ensure that people living with HIV/AIDS are seen promptly and free-of-charge. In some cases, if the client is too weak to travel alone and has no family to accompany him, or is afraid of the stigma associated with being HIV-positive, the CHW escorts the client to the health facility. The service provider returns the referral note with information about diagnosis, treatment, and follow-up appointments, which CHWs use to help clients manage their care at home. CHWs estimate that they receive the. | ELSEVIER www.rhm-elsevier.com 2003 Reproductive Health Matters. All rights reserved. Reproductive Health Matters 2003 11 22 51-73 0968-8080 03 - see front matter PII S09 68 - 8080 03 2 2101 - 1 REPRODUCTIVE matters www.rhmjournal.org.uk FEATURES The Contribution of Sexual and Reproductive Health Services to the Fight against HIV AIDS A Review Ian Askew a Marge Bererb a Senior Associate Population Council Nairobi Kenya. E-mail iaskew@pcnairobi.org b Editor Reproductive Health Matters London UK Abstract Approximately 80 of HIV cases are transmitted sexually and a further 10 perinatally or during breastfeeding. Hence the health sector has looked to sexual and reproductive health programmes for leadership and guidance in providing information and counselling to prevent these forms of transmission and more recently to undertake some aspects of treatment. This paper reviews and assesses the contributions made to date by sexual and reproductive health services to HIV AIDS prevention and treatment mainly by services for family planning sexually transmitted infections and antenatal and delivery care. It also describes other sexual and reproductive health problems experienced by HIV-positive women such as the need for abortion services infertility services and cervical cancer screening and treatment. This paper shows that sexual and reproductive health programmes can make an important contribution to HIV prevention and treatment and that STI control is important both for sexual and reproductive health and HIV AIDS control. It concludes that more integrated programmes of sexual and reproductive health care and STI HIV AIDS control should be developed which jointly offer certain services expand outreach to new population groups and create well-functioning referral links to optimize the outreach and impact of what are to date essentially vertical programmes. 2003 Reproductive Health Matters. All rights reserved. Keywords HIV AIDS sexual and reproductive health services sexually
