Sustaining sexual health programs: practical considerations and lessons from the President’s Emergency Plan for AIDS Relief

Joseph D. Tucker; Suzanne Day; Ucheoma C. Nwaozuru; Chisom Obiezu-Umeh; Oliver Ezechi; Kelechi Chima; Chibeka Mukuka; Juliet Iwelunmor; Rachel Sturke; Susan Vorkoper

doi:10.1071/SH24064

EDITORIAL (Open Access)

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Sustaining sexual health programs: practical considerations and lessons from the President’s Emergency Plan for AIDS Relief

Joseph D. Tucker

^A ^B ^* , Suzanne Day ^B , Ucheoma C. Nwaozuru ^C , Chisom Obiezu-Umeh ^D , Oliver Ezechi ^E , Kelechi Chima ^B , Chibeka Mukuka ^F , Juliet Iwelunmor ^G , Rachel Sturke ^H and Susan Vorkoper ^H

+ Author Affiliations

- Author Affiliations

^A Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

^B Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

^C Implementation Science, Wake Forest University School of Medicine, Winston Salem, NC, USA.

^D Center for Dissemination & Implementation Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

^E Centre for Reproduction and Population Health Studies, Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos, Nigeria.

^F Author Davison Childrens Hospital, Ndola, Zambia.

^G Division of Infectious Diseases, John T. Milliken Department of Internal Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.

^H Fogarty International Center, US National Institutes of Health, Bethesda, MD, USA.

^* Correspondence to: jdtucker@med.unc.edu

Handling Editor: Ian Simms

Sexual Health 21, SH24064 https://doi.org/10.1071/SH24064

Submitted: 27 March 2024 Accepted: 6 June 2024 Published: 25 June 2024

Abstract

Enhancing the sustainability of sexual health programs is important, but there are few practical tools to facilitate this process. Drawing on a sustainability conceptual framework, this Editorial proposes four ideas to increase the sustainability of sexual health programs – early planning, equitable community engagement, return on investment, and partnerships to address social determinants. Early planning during the design of a sexual health program is important for sustainability because it provides an opportunity for the team to build factors relevant to sustainability into the program itself. Equitable community engagement can expand multi-sectoral partnerships for institutionalisation, identify allies for implementation, and strengthen relationships between beneficiaries and researchers. From a financial perspective, considering the return on investment could increase the likelihood of sustainability. Finally, partnerships to address social determinants can help to identify organisations with a similar vision. Existing sustainability frameworks can be used to measure each of these key elements. Several approaches can be used to enhance the sustainability of sexual health programs. The President’s Emergency Plan for AIDS Relief provides potential lessons for increasing the sustainability of sexual health programs in diverse global settings.

Keywords: community engagement, financing, implementation science, measurement, partnerships, PEPFAR, sustainability, sustainment.

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