PEPFAR funds are often used to incorporate and integrate other health services, including family planning. Linkages that directly serve PEPFAR priority populations by supporting the prevention, treatment, or care of HIV and AIDS, and are aligned with other PEPFAR guidance, should be prioritized.

When you are conducting FP/HIV integrated activities, you must consider the legal and policy requirements that apply to both family planning and HIV and AIDS activities. PEPFAR's FP/HIV programs are guided by the principles of voluntarism and informed choice. Under these principles:

• People living with HIV and AIDS should be provided with comprehensive information on and be able to exercise voluntary choices about their health, including their family planning choices.
• All individuals have a right to choose the number, timing, and spacing of their children, as well as decide on the use of family planning methods, regardless of their HIV status.
• Family planning use should always be a choice, made freely and voluntarily, independent of the person's HIV status.
• The decision to use or not to use family planning should be free of any discrimination, stigma, coercion, duress, or deceit and informed by accurate, comprehensible information, and access to a variety of contraceptive methods.
• Access to and provision of health services, including antiretroviral treatment, for people living with HIV and AIDS should never be conditioned on that person's choice to accept or reject any other service, such as family planning (other than what may be necessary to ensure the safe use of antiretroviral treatment, e.g., drug interactions).
• Women living with HIV and AIDS who wish to have children should have access to safe and respectful pregnancy counseling, antenatal, and childbirth services.

Additionally, there are legal and policy requirements that apply specifically to USAID family planning activities, including family planning activities conducted with PEPFAR funds. The legal requirements are implemented through USAID's standard provisions inserted in all grants, cooperative agreements, and contracts that include family planning activities. The current standard provisions for grants and cooperative agreements to NGOs are found in the USAID Automated Directives System (ADS) Chapter 303 mandatory references. The current standard provisions that apply to contracts are found in Acquisition & Assistance Policy Directive 08-01 [PDF, 59KB].

USAID takes these family planning requirements very seriously and works with Missions and partners to help ensure compliance in their programs.

Resources for USAID Staff and Partners

There are many resources available to USAID staff and partners to help them become familiar and ensure compliance with these requirements.

FP/HIV Integration Compliance Resources

• US Abortion and FP Requirements – 2013 eLearning Course: The purpose of this course is to provide an overview of the U.S. abortion and family planning legislative and policy requirements that govern USAID's programs.
• HIV/AIDS Legal and Policy Requirements eLearning Course: The purpose of this course is to provide an overview of the legislative and policy requirements that govern HIV and AIDS activities. The primary audience for this course is people who manage and/or implement USAID-supported HIV and AIDS activities.
• Acquisition & Assistance Policy Directive (AAPD) 14-04 [PDF, 339KB]: AAPD 14-04 provides information on the standard provisions for all awards that include HIV and AIDS activities. The AAPD implements a 2013 U.S. Supreme Court decision and makes explicit that the prostitution and sex trafficking policy requirement does not apply to U.S. NGOs, but does apply to non-U.S. NGOs and certain PIOs. Some of the other HIV and AIDS standard provisions were also updated.
• PEPFAR FY2015 Technical Considerations [PDF, 8.5MB]: See "HIV and Family Planning Integration" for recommendations on program planning and implementation in PEPFAR-supported FP/HIV programs, including how to ensure compliance with the U.S. Government requirements and uphold the principles of voluntarism and informed choice.

For more information, please contact Aasha Jackson at ajackson@usaid.gov.