What Works for Women and Girls

AIDS, and STIs, if they receive adequate training (IPPF/WHR, 2000). To date, however, inmost settings HIV and family planning services have been offered separately (Delvaux andNöstlinger, 2007). Given the frequency of new information on HIV and SRH, it is importantthat providers receive ongoing training (Asiimwe et al., 2005; Farrell 2007).Where HIV and contraceptive services are combined, women report greater use of bothservices. An analysis of VCT clients in Ethiopia suggests that various levels of service integrationmay attract different types of clients, including services provided in the same facility, thesame room and by the same provider. More atypical family planning clients (younger womenand males) were likely to increase use of HIV and SRH services provided in the same room.Facilities where counselors jointly offered HIV and family planning services and served manyrepeat family planning clients were most likely to serve older, married women who still hadsignificant rates of HIV. Integrating VCT with family planning and vise versa is an effectivestrategy for expanding both services and reaching a wider range of clients (Bradley et al.,2008a).Women Living With HIV Need Screening and Treatmentfor Cervical CancerCervical cancer is another sexual and reproductive health issue of particular concern forHIV-positive women. Cervical cancer is preventable and treatable (WHO, 2009c; Hale, 2009).Women living with HIV are at a high risk for developing cervical cancer (Agaba et al., 2009;Chaturvedi et al., 2009; and Singh et al., 2009a). Despite the fact that HIV infection increasesthe risk of cervical cancer as well as a range of vaginal and cervical infections (Levine, 2002;Cejtin, 2003 cited in Myer et al., 2007a; Franceschi and Jaffe, 2007; Banura et al., 2008),“coverage of cervical cancer screening in developing countries is on average 19%, comparedto 63% in developed countries, and ranges from 1% in Bangladesh to 73% in Brazil (Gakidouet al., 2008: 0863). “We are getting HAART, but we still die of cervical cancer,” noted GraceSedio, ICW representative in Botswana (Sedio, 2009). The impact of antiretroviral therapy oncervical cancer is unclear (Massad et al., 2009; Massad et al., 2008; Asheber et al., 2007 citedin Stevens, 2008; de Vuyst et al., 2008; Bernal et al., 2008), but ARV therapy improves immunityand increases lifespan, which increases likelihood of persistent HPV infection developinginto cervical cancer. What works best to detect cervical cancer in HIV-positive women in placeswithout sophisticated lab equipment is unclear and no test is optimal. PATH is currently testingdifferent screening options for cervical cancer in HIV-positive women (Jeronimo, 2010).WHAT WORKS FOR WOMEN AND GIRLS187