Various factors should be considered when deciding whether integration of
HIV/AIDS services into Primary Health Care (PHC) would be beneficial or not. Many
studies have stated the necessity of integrating HIV/AIDS programs and Sexually
Transmitted Infections (STIs) in PHC and the positive impacts of this integration on a
number of PHC goals; however, lack of a monitoring and evaluation (M&E) system
makes it difficult to assess the efficiency of the integration into PHC. Considering the
scale-up of care and treatment for HIV/AIDS in developing countries, there is increased
debate that intensified attention to HIV programs may lead to declines in delivery of
other PHC services.
Overall most evidences establish that integrated services can exert a positive effect on
client satisfaction, leading to improved access to component services, and reduced HIV
stigma, and also these are cost-effective. Key aspects of integration programs include:
co-location of services, provision of effective substance use treatment, cross-training of
care providers, and provision of enhanced monitoring of drug-drug interactions. Key
components in implementing this agenda will be fostering the political tendency to fund infrastructure and service delivery, expanding street-level outreach services to
injection drug users, and training community health workers able to cost effectively
delivering these services.
Keywords: AIDS, Decentralization, HIV, Integration, Prevention, Primary Health
Care (PHC), Service delivery, Stigma, Substance use, Treatment and Care.
