Table 1. Programmatic integration of the prevention and treatment of HIV, sexually transmitted infections, cervical cancer and female genital schistosomiasis in regions endemic for Schistosoma haematobium .

Life stage	Target programmes	HIV and sexually transmitted infection interventions	Schistosomiasis and female genital schistosomiasis interventions	HPV and cervical cancer interventions	Community mobilization, education and counselling
Infants and young children (< 5 years)	Ante-, peri- and postnatal care. Mother and child health clinics. Immunization, services and campaigns. Preventive care through the integrated management of childhood illnesses.	Voluntary HIV testing services for mothers and children.	Test-and-treat for urinary schistosomiasis for mothers and children (dipstick urinalysis for microhaematuria or other).a Treatment with praziquantel of mothers and children positive for Schistosoma haematobium.b Systematic praziquantel treatment in highly endemic areas.	NA	Counselling for mothers on HIV prevention. Promotion of behavioural change for prevention and treatment of schistosomiasis. Topics to include safe bathing practices for infants and children. Awareness-building and information on HIV, schistosomiasis, female genital schistosomiasis and HPV/cervical cancer. Dialogue with mothers and caregivers about signs and symptoms of female genital schistosomiasis, sexually transmitted infections and cervical cancer. Referral to appropriate services if indicated. Community-based outreach, including generation of demand for accessible treatment and for improved water and sanitation services. Examples include: through community health clubs and community water, sanitation and hygiene management groups
Primary school-age children	School health programmes. School meal programmes. Programmes targeting or including children not enrolled in school.	NA	Regular treatment with praziquantel as part of deworming programmes. Frequency according to level of endemicity and WHO recommendations. Possible extension of deworming to siblings and non-enrolled school-age children in same communities. Safe water and (girl-friendly and inclusive) toilets in school.	HPV vaccination. Possible extension of HPV vaccination to include siblings and non-enrolled school-age children in recommended age range in same communities.	Education about schistosomiasis, communicable diseases or other tropical diseases in the area. Age-appropriate, comprehensive health, sexual and reproductive health and rights and life-skills education. Topics to include: HIV, female genital schistosomiasis and cervical cancer. Hygiene education, including menstrual hygiene for girls.
Adolescent girls (12–19 years)	Secondary school health programmes. Innovative programmes targeting youth and adolescents, both in and out of school. Should include migrant and vulnerable populations.c	Voluntary HIV testing services as appropriate. Refer to health services for further care if indicated.	Discussion about girl’s risk of schistosomiasis. Test-and-treat for urinary schistosomiasis if indicated. Alternatively: regular, context-specific large-scale treatment in areas highly endemic for schistosomiasis.	Catch-up HPV vaccination as appropriate.	Provide youth-friendly, gender-aware and age-appropriate comprehensive sexual and reproductive health and rights education. Topics to include: HIV, sexually transmitted infections, female genital schistosomiasis and cervical cancer. Referral to appropriate services if indicated. Hygiene education, including menstrual hygiene for girls. Age-appropriate comprehensive sexuality education. Topics to include: counselling on condom use, negotiating skills relating to sexual interactions and safe-sex practices. Community-based outreach, including generation of demand for comprehensive sexual and reproductive health and rights services.
Women (≥ 20 years)	Prenatal care and mother and child health programmes. Family planning. HIV screening and prevention programmes. Sexual and reproductive health clinics. Other programmes targeting women of reproductive age.	Offer voluntary HIV testing services. Refer to health services for further care if indicated. Evaluate additional risks and whether pre-exposure prophylaxis against HIV is indicated.	Discussion about woman’s risk of schistosomiasis. Test-and-treat for urinary schistosomiasis if indicated. Evaluate additional risk of female genital schistosomiasis. Refer to health services or cervical cancer clinics for further screening and care if indicated. For women with infertility, refer for screening and treatment of female genital schistosomiasis if indicated.	Promote regular cervical cancer screening and colposcopy in appropriate age-groups. Provide and facilitate access to cervical cancer screening services. Include screening and treatment for female genital schistosomiasis in cervical cancer screening services.	Provide information on symptoms and risks of HIV infection, sexually transmitted infections and female genital schistosomiasis. Query women about signs and symptoms of female genital schistosomiasis, sexually transmitted infections and cervical cancer. Facilitate referral to appropriate services if indicated. Hygiene education, including menstrual hygiene for women. Train physicians to begin colposcopy for women at younger ages and to recognize, diagnose and treat female genital schistosomiasis. Community-based outreach, engagement and generation of demand for comprehensive sexual and reproductive health and rights services in existing community-based structures. Examples include: women’s groups, mother and child health clinics and village health clubs.

HIV: human immunodeficiency virus; HPV: human papilloma virus; NA: not applicable; WHO: World Health Organization.

^a Antigen-based urine dipstick is under development.

^b Paediatric formulation of praziquantel is under development.

^c Examples include the Adolescents and Youth Program⁴³ and the DREAMS partnership.⁴⁴

Note: Adapted from WHO and Joint United Nations Programme on HIV/AIDS, 2019.⁴¹