HIV in Canada: A primer for service providers

Integrated Approaches to HIV Programming

Key Points

  • The goal of an integrated approach is to develop comprehensive health programs that will reach people in an appropriate context and with the best combination of services to most effectively reduce HIV transmission (as well as transmission of other infectious diseases) and improve health outcomes.
  • Two types of integration are important for HIV programming: integration of HIV prevention and treatment, and integrated approaches to sexually transmitted and blood-borne infections and tuberculosis.
  • Program science can play an important role in the planning, implementation and management of integrated programs.

Successful strategies for HIV programming involve selecting and implementing an effective combination of interventions to meet the needs of specific communities. The development of programming therefore involves consideration of the integration of individual interventions: What is the mix of interventions? How are they combined or linked together? How are they embedded within the broader healthcare system? Typically, integrated approaches involve a client-centred approach to HIV program development through which multiple health issues are addressed in a coordinated way.

Integrated approaches require knowledge of multiple factors within the community, such as:

 

  • the epidemiology of HIV and related infections (for example hepatitis C or sexually transmitted infections)
  • the availability, accessibility and linkages of health services
  • the uptake of health services across the full spectrum of prevention, testing, treatment and support.

The goal of an integrated approach is to develop comprehensive health programs that will reach people in an appropriate context and with the best combination of services to most effectively reduce HIV transmissions (as well as transmission of other infectious diseases) and improve health outcomes.

Emerging research is showing that two types of integration are important for HIV programming. First, there is a need to work toward more integrated, client-centred HIV programming that addresses engagement and linkages across the full continuum of prevention, testing, treatment, and care and support, instead of working in traditional “silos” of HIV services. This is called integration of HIV prevention and treatment. Second, there is a need to consider the way in which multiple infectious diseases within a community or population may collectively contribute to enhanced disease transmission and poor health outcomes. Sexually transmitted infections (such as syphilis, human papillomavirus and gonorrhea), blood-borne infections (such as hepatitis C) and tuberculosis can all make such syndemic contributions to the HIV epidemic. Programs that seek to simultaneously address these co-related infections are called integrated approaches to sexually transmitted and blood-borne infections and tuberculosis.

Program science can play an important role in the planning, implementation and management of integrated programs. It can help answer questions related to key program-related functions, such as identification and prioritization of target populations, development and packaging of interventions, community mobilization and resource allocation.

Resource

Transformation to Integrated Care – Canadian Nurses Association

Sources

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