1. Making the Case: Ending Silos Once and For All with Evidence

2. Disclosure Relations that could be relevant for the meeting
Company names
Sponsorship or refund funds
N/A
Payment or other financial remuneration
Shareholder rights
Other relations
Reference:

3. Evidence for Ending Silos

4. Ending Silos Once and For All
Poor SRH and HIV outcomes share common root causes
Gender inequality, including GBV
Stigma and discrimination
Punitive or restrictive legal environments
Economic marginalization

5. Ending Silos Once and For All
Integrating SRH and HIV services can help ensure that women living with HIV and woman at high risk of HIV – including AGYW, key population members, and pregnant women – can access information and services that empower them to fulfill their SRH needs, goals, and rights.

6. Ending Silos Once and For All
SRH Services
• Family planning and infertility services
• Safe abortion services
• STI and cervical cancer services
• ANC and maternal health services
• Gender-based violence services
• Sexual health counseling and support
HIV Services
• Prevention services, including PrEP
• Access to condoms and lubricant
• Access to needles/syringes
• HIV testing and counseling
• Treatment services
• Care and support services
Integrated SRH/HIV Services

7. Ending Silos Once and For All
Integrated SRH/HIV services:
Are desirable for clients
Increase service uptake
Decrease stigma
Improve quality of care
Make more efficient use of limited resources
Promote better understanding and protection of rights

8. Ending Silos Once and For All
The impact of providing integrated SRH/HIV services is maximized when:
Structural barriers to service uptake – e.g., stigma, violence, criminalization – are addressed
Health systems are strengthened to support integrated delivery of services
Services are women-centered with attention to human rights and gender equality

9. The Evidence for Contraceptive Options and HIV Outcomes (ECHO) Study

10. ECHO Study Design 7,800 women ages 16-35 wanting to prevent pregnancy
and willing to be randomized
Randomize (1:1:1 ratio)
DMPA
(2,600 women)
LNG implant
(2,600 women)
Copper IUD
(2,600 women)

11. ECHO Current Status Enrollment began in December 2015
Ongoing at 12 sites in Kenya, South Africa, Swaziland, and Zambia
Fully enrolled with 7,830 participants
Performance standards to ensure quality continue to be met
Data and Safety Monitoring Board (DSMB) recommended continuation of the study to conclusion
Follow-up will end Q4 2018
Results expected in 2019

12. Ending Silos Once and For All
Power Talks
Potential safety issue affecting women living with HIV using dolutegravir at the time of conception
PrEP uptake among pregnant and postpartum women