title: Integrating Human Immunodeficiency Virus and Reproductive, Maternal and Child, and Tuberculosis Health Services Within National Health Systems.
abstract: Joint United Nations Programme on HIV/AIDS (UNAIDS) established 90-90-90 HIV treatment targets for 2020 including the following: 90 % of HIV-infected people know their HIV status, 90 % of HIV-infected people who know their status are on treatment, and 90 % of people on HIV treatment have a suppressed viral load. Integration of HIV and other programs into the national health system provides an important pathway to reach those targets. We examine the case for integrating HIV and other health services to ensure sustainability and improve health outcomes within national health systems. In this non-systematic review, we examined recent studies on integrating HIV, tuberculosis (TB), maternal-child health (MCH), and sexually transmitted infection (STI) programs. Existing evidence is limited about the effectiveness of integration of HIV and other services. Most studies found that service integration increased uptake of services, but evidence is mixed about the effect on health outcomes or quality of health services. More rigorous studies of different strategies to promote integration over a wider range of services and settings are needed. Research on how best to maximize benefits, including sustainability, of integrated services is necessary to help inform international and national policy. We recommend additional interventions to test how best to integrate HIV and MCH services, HIV and TB services, HIV testing and treatment, and STI testing and treatment.
authors.affiliation: Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles, CA, USA. djosephdavey@mednet.ucla.edu.|Division of Infectious Disease, Geffen School of Medicine, University of California, Los Angeles, CA, USA. djosephdavey@mednet.ucla.edu.
authors.forename: Dvora
authors.initials: D
authors.lastname: Joseph Davey
authors.affiliation: Center for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa.
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.affiliation: Center for Microbiology Research, KEMRI, Nairobi, Kenya.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bukusi
authors.affiliation: Department of Obstetrics and Gynecology, Gaborone, Botswana.
authors.forename: Doreen
authors.initials: D
authors.lastname: Ramogola-Masire
authors.affiliation: Zambia Emory HIV Research Group, Lusaka, Zambia.
authors.forename: William
authors.initials: W
authors.lastname: Kilembe
authors.affiliation: Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles, CA, USA.|Division of Infectious Disease, Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D000068101:Maternal-Child Health Services / Q000458:organization & administration*; D009313:National Health Programs; D011247:Pregnancy; D011785:Quality Assurance, Health Care; D034121:Reproductive Health Services / Q000458:organization & administration*; D014376:Tuberculosis / Q000628:therapy*; D019562:Viral Load
keywords: HIV; Health services; Integration; Maternal-child health; Reproductive health; Review; Tuberculosis