Integrating HIV, Hepatitis, and STIs into Primary Health Care: Key Insights

In recent years, many countries have adopted a primary health care (PHC) approach to effectively address the growing epidemics of HIV, viral hepatitis, and sexually transmitted infections (STIs). This strategic shift represents a broader commitment to holistic and people-centered health care systems. A new policy brief titled "Integrating HIV, Viral Hepatitis and Sexually Transmitted Infections with Primary Health Care: Learning from Countries," published by the World Health Organization (WHO) on July 15, 2025, highlights the progress and lessons learned from various low- and middle-income countries in integrating these services into their PHC frameworks.

The policy brief emphasizes that countries such as Angola, Botswana, Brazil, Ethiopia, Indonesia, Kenya, Pakistan, Rwanda, Vietnam, and Zambia have encountered varied challenges, approaches, and outcomes in this integration effort. According to Dr. Maria Gonzalez, a public health expert at the University of Cape Town, the successful integration of disease-specific services with PHC requires a comprehensive approach that leverages multiple strategic and operational levers. The WHO/UNICEF PHC Operational Framework outlines four strategic and ten operational levers essential for effective integration. Dr. Gonzalez explains, “Countries that focused on four or more of these levers simultaneously tended to achieve significantly more sustainable health outcomes compared to those that addressed only one or two.”

The challenges faced by nations in integrating HIV, hepatitis, and STI services include declining donor funding, limited health workforce capacity, and persistent stigma associated with these diseases. A report by the Global Fund for AIDS, Tuberculosis and Malaria published in 2023 asserts that sustaining funding for these health initiatives has become increasingly difficult as international aid declines. In response, many countries are prioritizing domestic funding and governance to enhance the sustainability of their health systems.

Dr. Ahmed Zahir, Head of the Health Systems Strengthening Unit at WHO, underscores the importance of political leadership and community engagement in this integration process. He states, “Strong political will is crucial for implementing health policies that prioritize the integration of HIV, hepatitis, and STIs into PHC. Community engagement fosters trust, which is essential for effective service delivery.” The policy brief advocates for coordinated efforts among stakeholders, including government entities, non-governmental organizations, and the private sector, to develop innovative solutions that expand access to health services.

Additionally, the brief highlights the role of digital technologies in enhancing service delivery. According to the 2024 WHO report on digital health innovations, integrating telehealth services and electronic health records can significantly improve access and efficiency in managing HIV, hepatitis, and STIs within PHC settings. Dr. Linda Tran, a digital health researcher at Stanford University, notes, “Leveraging technology not only increases service accessibility but also helps in tracking health outcomes and improving patient engagement.”

The potential implications of this integration are profound. By addressing the social determinants of health and reducing stigma, countries can achieve improved health outcomes for their populations. The integration of these services within PHC can lead to increased health service utilization, enhanced community health literacy, and ultimately, a reduction in the burden of preventable diseases.

In conclusion, the integration of HIV, viral hepatitis, and STI services into primary health care represents a significant step toward more equitable and effective health care systems. As countries navigate the complexities of health service delivery, the insights and recommendations from the WHO policy brief provide a roadmap for achieving success in this critical area of public health. Future efforts must continue to focus on strengthening governance, securing sustainable funding, and fostering community engagement to enhance health outcomes across the globe.