SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
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daily lives <strong>and</strong> take priority over<strong>HIV</strong>.Their more immedi<strong>at</strong>e <strong>and</strong> urgentconcerns such as shelter, food, drugs,must be allevi<strong>at</strong>ed before they willbe concerned about the more distant<strong>and</strong> abstract fear of <strong>HIV</strong>. Thisbasic premise has to be taken intoconsider<strong>at</strong>ion if programmes are tosucceed.There is strong stigma <strong>and</strong>discrimin<strong>at</strong>ion towards PL<strong>HIV</strong>,perpetu<strong>at</strong>ing isol<strong>at</strong>ion <strong>and</strong> socialexclusion, thus worsening theepidemic <strong>and</strong> its consequences.i. Quality assurancePeople engaged in high-riskbehaviours often have limited accessto health care. The main constraintsare cultural values, norms <strong>and</strong>practices. Added to this, those whoare responsible for providing support<strong>and</strong> services are themselves notcomfortable talking about condoms,RTI/STI, problems of <strong>SRH</strong> <strong>and</strong><strong>HIV</strong> issues. The major challenge isto overcome the problem of socialstigma which is one of the barriersfor implementing programmes of<strong>HIV</strong> <strong>and</strong> <strong>SRH</strong> in rural areas.Lack of an effective monitoring<strong>and</strong> document<strong>at</strong>ion system to seechanges in knowledge, perception<strong>and</strong> practice levels.Lack of uniformity <strong>and</strong> inadequ<strong>at</strong>etesting facilities <strong>and</strong> campaignm<strong>at</strong>erials.j. Research <strong>and</strong>evalu<strong>at</strong>ionLack of qualit<strong>at</strong>ive evalu<strong>at</strong>ion of theprogramme <strong>and</strong> inadequ<strong>at</strong>e actionresearch.D<strong>at</strong>a g<strong>at</strong>hering through surveillance,surveys <strong>and</strong> research has beenunder-resourced.In order to havethis knowledge it is essential th<strong>at</strong>d<strong>at</strong>a is g<strong>at</strong>hered regularly, not onlythrough surveillance, but throughdifferent sources. Research studieshave received little priority inBangladesh.k. AdvocacyCulturally service providers feelrestrained to engage in open <strong>and</strong>frank discussions about the use ofcontraceptives. For example, teachersfind difficulty to teach the section on<strong>HIV</strong> th<strong>at</strong> has been included in textbooks.A rights based approach in <strong>SRH</strong><strong>and</strong> <strong>HIV</strong> programmes has not beenfully endorsed. This has resulted instigma <strong>and</strong> discrimin<strong>at</strong>ory <strong>at</strong>titudescontinuing to exist among serviceproviders.Lack of st<strong>and</strong>ard precautionsfor infection control <strong>and</strong> limitedprovision of essential supplies <strong>and</strong>commodities.<strong>HIV</strong> positive men <strong>and</strong> womenneed to be able to make informed<strong>SRH</strong> choices <strong>and</strong> have access to<strong>SRH</strong> services such as FP advice <strong>and</strong>contraceptive supplies.Generally people <strong>and</strong> MARPs need31
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