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AIDS Research and Treatment
Volume 2013 (2013), Article ID 504792, 10 pages
http://dx.doi.org/10.1155/2013/504792
Research Article

The Linked Response: Lessons Emerging from Integration of HIV and Reproductive Health Services in Cambodia

1Department of Public Health, Institute of Tropical Medicine, 155, Nationalestraat, 2000 Antwerp, Belgium
2Centre for Research in Anthropology (CRIA), Lisbon University Institute, (IUL), 1649-026 Lisbon, Portugal
3Surveillance Unit, National Center for HIV/AIDS, Dermatology and STD, 855 Phnom Penh, Cambodia
4Resarch Unit, National Center for HIV/AIDS, Dermatology and STD, 855 Phnom Penh, Cambodia
5Technical Bureau, National Center for HIV/AIDS, Dermatology and STD, 855 Phnom Penh, Cambodia

Received 10 August 2012; Accepted 16 November 2012

Academic Editor: D. A. Katzenstein

Copyright © 2013 Joanna White et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A qualitative assessment was made of service provider and user perceptions of the quality of integrated reproductive health services established through a pilot intervention in Cambodia. The intervention aimed to promote pregnant women's HIV testing and general utilization of reproductive health facilities as well as improve the follow-up of HIV-positive women and exposed infants through strengthened referral and operational linkages amongst health facilities/services and community-based support interventions for PLHIV. The study was conducted in one operational district where the intervention was piloted and for comparative purposes in a district where integrated services had yet to be implemented. Service providers in the pilot district reported improved collaboration and coordination of services, more effective referral, and the positive impact of improved proximity of HIV testing through integrated local level facilities. Community-based support teams for PLHIV embraced their expanded role, were valued by families receiving their assistance, and were understood to have had an important role in referral, PMTCT follow-up and countering PLHIV stigmatization; findings which underscore the potential role of community support in integrated service provision. Challenges identified included stigmatization of PLHIV by health staff at district hospital level and a lack of confidence amongst non-specialized health staff when managing deliveries by HIV-positive women, partly due to fear of HIV transmission.